TUCSON, Ariz., March 14, 2016 -- American medicine has undergone a metamorphosis into “healthcare,” and to the patient that means that “the system will see you now,” writes Jeffrey Hall Dobken, M.D., M.P.H., in the spring issue of the Journal of American Physicians and Surgeons.
After practicing medicine for 40 years, Dr. Dobken was faced with the diagnosis of cancer. He has had to confront many profound questions—including what defines a doctor in the world of “healthcare reform.”
Dobken delves into the roots of medicine and the mythical tension between Aesculapius, the Greek god of healing, and his daughters Panacea and Hygeia, who focused on prevention and public health.
U.S. healthcare reform legislation, the Patient Protection and Affordable Care Act (PPACA or ACA), is not just an extension of this ancient dialogue, he writes. It is a “dysphonic concatenation,” with a mixture of political, social, and economic concerns. “Healthcare” actually refers to insurance plans and payment, and is decidedly different from medical care.
“’Healthcare reform,’” he writes, “has been crafted as a means to control physician fiscal comportment by defining physicians not as professionals governed by a strong ethical code, but as merchants who sell their goods and services to customers.”
Physicians have been portrayed as avaricious and self-serving, and blamed for “unsustainable” costs. The proposed solution, Dobken states, is to eliminate private medicine and replace the “fragmented” system with a centrally planned one, staffed by “physician extenders,” medical “navigators,” and a battalion of bureaucrats and functionaries to implement protocols.
For the patient, the process is “scary,” Dobken writes: “The care is mechanical, automated, cold, and indifferent, just like the disease.” There is no code for the services of a personal, caring, trusted physician, to “act as the bridge through adversity, anxiety, and pain.” So such services don’t exist. “The physician has not been pre-authorized.”
Dobken concludes that he defines himself as a doctor as an “Oath-taker and a believer.” The Oath is the traditional Oath of Hippocrates.
For his journey as a patient, “there really isn’t a GPS…. the future is not what it used to be, nor is the profession of medicine.”
The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.
Contact: Jane M. Orient, M.D., (520) 323-3110, [email protected]


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