Stop treating physicians as the enemy
I was planning on not writing this letter and simply going about the work of being a physician in Bermuda. I was going to go to work every day, and attempt to help those in the community who had decided to put their healthcare in my hands. However, I was taken back by an interview I heard on VSB, in which I and other physicians who attended a town hall meeting on Monday, August 22, were described as disgruntled.
The meeting was put on by the Bermuda Health Council, and labelled as an attempt to gauge the community’s concerns with healthcare in Bermuda. Although the room was not as crowded as I had hoped, there were a lot of physicians in attendance and the focus of most who spoke, was our concern about recent legislation being proposed to give the BHeC more control and oversight over healthcare providers in Bermuda.
It was stated by the CEO of the BHeC that they would not compromise quality of care in developing their regulations. Although improving quality is a noble goal, the physician community has been very concerned that in the desire to improve healthcare, the proposed BHeC amendment Act being tabled in the next session will do little to decrease the cost of health in Bermuda, and will not assist those most vulnerable to access the care that is already available.
Many years ago, when we stressed our concern with the removal of patients’ private doctors from the hospital, the BHeC fell silent, and care of our hospitalised patients has been compromised ever since. When the cost of malpractice increased exponentially, the doctors who delivered the babies born here asked for help to fix these cost. The BHeC did nothing, and the government shunted the responsibility to the hospital, which was already challenged in paying its bills. When we stated that our elderly patients were being forced out of private insurance by virtue of the accelerated cost of their premiums, we were told the insurance companies were private businesses, and the council did not have authority over the cost of their premiums, yet they did use their power to deny the private businesses of doctors’ offices the right to collect the full fee for their visit at the time of the service.
We hear loud accolades proclaimed when they recoup health insurance fees not paid by employers, but we hear the chirping of whistling frogs when we ask for our future care patients to receive larger amounts for the cost of their medications.
The rising cost of healthcare is constantly labelled as a function of physicians mismanaging healthcare dollars, yet although certain members of government state that they have never met a poor doctor, I would challenge that minister to find a physician who is able to retire off of the backs of their patients.
Doctors spend nine to 14 years after high school learning the skills required to take care of patients. We spend horribly long hours in our training with little sleep, dealing with suffering that most in politics would not even contemplate. We see everyone when they are their most vulnerable, and are often expected to be available at all times. This is not an excuse, but a reality of the calling that we rise to.
What the policymakers must stop doing is treating the physician community as enemies of the state, who must be controlled for the good of Bermuda. The issue for us is not preventing regulation of healthcare, but the ranking of priorities of what should be regulated first.
There are people in Bermuda who do not access healthcare because they do not have the money to pay for their healthcare. They are not asking for a handout in the form of government financial aid. They need the system to be balanced for all.
They speak to us everyday about their desires for their healthcare, but as long as those who control the purse for paying for health continue to support expensive treatment options, over the cost of doctor’s visits, the cost of healthcare will rise, and the outcomes will not improve.
So I encourage those in the community to reach out to the BHeC and tell them your desires for your healthcare. In the end, we do not work for the government, nor do we ask for a handout from the insurance companies. My colleagues and I work with our patients towards empowering them to take control of their health, now and in the future.
If we are supported in this, the future can look bright. But if over-regulation, and insurance hurdles continue to loom over our practices, then like many of those physicians in the US who have already lost to these “reforms”, our future in medicine in Bermuda might be sidelined for government clinics for the poor, and a mega-hospital that is bloated with overpriced outpatient services, all with the blessing of the policymakers. These changes have the potential to further fracture the access to healthcare, with choice of health services being reserved for those with insurance policies whose cost will be out of reach of the average Bermudian.
DR HENRY DOWLING
President of the Bermuda Medical Doctors Association