The Deer in the Middle of the Road
Written by: Dr. Michael Weiss

You have a choice. You can, one, apply the brakes, honk the horn and calmly steer your SUV around Bambi or, two, commission a study to determine if the large animal that’s now 10 feet from your moving bumper is really a problem.

Most people would choose Option A, also known as Recognizing and Reacting to the Obvious.

Then, there’s the state politician for whom obvious isn’t obvious enough.

I’ve never seen him drive. Can’t even remember his name. But he’s clearly not an Option A sort of guy.

When faced with an immediate circumstance (i.e., the exodus of physicians from Pennsylvania) that requires decisive action (i.e., permanent relief from runaway malpractice insurance premiums), this particular lawmaker advocates a position that amounts to no meaningful change pending further analysis.

To summarize his position, he’s not convinced that the thing standing in the middle of the road is even a deer.

It’s not like the image is unclear. Physicians throughout Pennsylvania are retiring early, limiting their clinical activities to low-risk services, leaving the state altogether or choosing not to practice here in the first place.

The impact on patients goes beyond the inconvenience of having to travel farther to an office visit or wait longer for an appointment.

Across the state, certain types of providers are in critically short supply, affecting the operation of many hospital emergency departments and having either direct or eventual impacts on almost every other facet of care delivery. Rural areas have been hit especially hard, but the squeeze can be felt in our cities and suburbs, too.

The impetus behind the trend is the high cost of malpractice insurance —- which, when combined with infamously low reimbursement rates, can make the practice of medicine here economically untenable.

The temporary relief that some specialists, including orthopods, received last year was akin to hitting the horn but neglecting to swerve.

It made some noise but didn’t get us past the problem.

In order to do that, we need the help of legislators who share our sense of urgency and can offer an effective legislative response. The politician above appears not to qualify.
Studies are fine when you want to pinpoint a cause, understand an effect or get at some other unknown piece of information. When you already have a handle on all of the above, further analysis only serves to stall. You may think you’re being productive. But, really, you’re just confusing movement with action.

Last year’s Code Blue initiative was intended to dispense with the former and stimulate the latter.

Did we make the point as forcefully as we hoped? I’m not sure. Forceful is a tough act for us to pull off. Physicians aren’t like Teamsters. We can’t compel change through a true work stoppage. If we did, it’s the patients who would suffer.

Then again, without change, doctors will continue to leave or avoid the state, and our problems with access will continue to grow.

I’m not advocating a strike by physicians, just encouraging our research-happy politician and others like him to acknowledge and act on the obvious. A deer is a deer, and it’s blocking the road.

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