I would love to have been the proverbial mouse in the corner, listening to Dr. Hickner’s conversation with Steve, the rural physician whom he met with the night after Obama’s reelection (Postelection culture clash? [Editorial] J Fam Pract. 2012;61:717).
As a rural solo physician for 22 years, I very likely am a kindred spirit of Steve’s. I also have little doubt that Dr. Hickner and I would not see eye to eye on the political scene, and more specifically, on the health care mandates coming at us. How in the world can anyone think that a health care bill that has income taxes, Medicare benefit taxes, and medical equipment fees buried within it is honest, forthright, and justifiable legislation?
Yes, medicine/health insurance is in need of real reform. I simply do not see bigger, more controlling, and more intrusive government as the answer, nor do I think that the best outcomes will come from the federal government’s excessively complex and overreaching involvement. The fact that after decades of opportunity to perfect it, Medicare is still a highly complex, ineffective, and insolvent mess (and a political football) should be enough proof for anyone.
With all due respect, Steve should remain firm in his convictions—with the knowledge that, unlike Dr. Hickner’s huge medical establishment, his community needs him.
Jeff Taber, MD
Windom, Minn
I’m glad Dr. Hickner recognizes that political diversity need not compromise the commitment to patient care. But I’m sad that in recounting his discussion with Steve, he failed to comment on an even bigger culture clash—the one between rural and metropolitan health care.
Here it is, in a nutshell: Steve is out in the hinterlands, where physician shortages are a constant, yet Dr. Hickner wants to recruit him to be a pseudo-internist in a system where you can’t swing a stick without hitting 2 subspecialists. Wouldn’t it be better for patient care to let Steve maintain the rapport he has with his patients and have the Cleveland Clinic ship some of its specialists out to Steve’s “shop” a couple of days a month?
Scott Walker, MD
Bethel, Alaska