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Winning the Power Struggle


The conflict over how to resolve the medical liability crisis is as much a fight over access to healthcare as it is a power struggle between the legal and medical professions.

Physicians want to practice free of spurious lawsuits and excessive malpractice premiums. Lawyers -- both those who sue physicians and those who defend them -- want the lucrative medical malpractice market maintained.

Earlier this year, physicians won limited victories in a few state legislatures, and scored big PR points with physician strikes. But lawyers represent a commanding majority in the Congress and state legislatures. Victory by physicians over lawyers will not come easily.
Fortunately, the medical profession has a secret weapon: the one-to-one relationship between physician and patient.

The level of trust between patients and physicians provides the opportunity for physicians to serve as an "important conduit of anecdotes and horror stories," according to Harris Interactive, a worldwide market research firm. Harris' studies conclude that physicians are a major force shaping public opinion and, ultimately, healthcare policy.

In the 1990s physicians across the country badmouthed managed care so much that it alarmed the public and prompted changes in laws covering mandated health insurance benefits. It did not happen overnight. But as Harris research shows, where there exists a high degree of trust, physicians share their opinions on healthcare with their patients, who spread the word. Ultimately legislators react.

Earlier this spring the AMA launched a grassroots initiative in support of medical liability reform, organizing rallies and physician meetings with legislators. That certainly could be an important tactic in persuading lawmakers to support reform, but they generally reject change unless they see it having broad public support. If you are too busy to march or reluctant to contact your legislator there is something else you can do. Briefly explain to your patients how rising insurance premiums affect your ability to provide them with quality care.

Relying on the power of a quiet conversation between physicians and patients to change public opinion and healthcare policies may be neither fast nor efficient. But the power of those relationships could eventually change the law. The voice of constituents, repeated in phone calls, letters to editors, and other interactions, will resonate and grow with time.

Have a quiet conversation with your patients today.

Politics & Your Practice is written by Ken Karpay, JD, CMC, associate publisher of Physicians Practice and a management consultant. He can be reached at kkarpay@physicianspractice.com.

This article originally appeared in the May 2003 issue of Physicians Practice.

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