Fearing for the future of American medicine

Last Friday, I delivered the commencement address at UT Southwestern Medical School to a class that truly represents America - the ideals, commitment and perseverance that make this country great. They came from around Texas, around the country and around the world. Some were continuing a family legacy in the medical profession; others were the first in their families to go to college, much less medical school.

These young men and women were graduating from a world-class medical school, had shown tenacity to get there and endurance to make it through, and are clearly talented, smart and dedicated... yet I was worried for their future. They are entering a field that is in danger of suffering irreparable damage that will affect doctors and patients alike. It is vital, for their sake and for ours, that healthcare in America is saved from the collision course it is on.

The medical profession is different today than it was when my grandfather, Allan Bailey, practiced. He knew his patients and his patients knew him. This is not just folksy reminiscing. Those relationships meant that my grandfather had a deeper understanding of his patients' needs and could take a more informed approach to their treatment. He knew their family histories, their habits, their personalities - who was likely to play through the pain, who was telling the truth about that extra slice of pie, who forgot that his father had high blood pressure. The doctor-patient relationship is a fundamental aspect of good medicine, and it is progressively disappearing in today's bureaucracy-driven health care.

Government is increasingly inserting itself between doctor and patient, making more and more of our medical decisions for us. Take the recent recommendation by the United States Preventive Services Task Force (USPSTF) against routine prostate-specific antigen (PSA) screening. The USPSTF is a panel that recommends which services insurance companies must offer at no extra charge - meaning that a task force essentially has the power to dictate individuals' medical care. They recently decided that the cost and potential for unnecessary treatment outweighed the benefits of routine PSA screening. While the PSA is not perfect, it is the best tool we have for early detection. Before it was available, 80 percent of men diagnosed with prostate cancer were already in advanced stages; today, that number has dropped to 20 percent and the death rate has declined significantly. When the mandates for Obama health care kick in, this panel will effectively deny life-saving cancer screening to countless men. This is a decision that should be made on an individual basis, by well-informed patients and doctors who know their patients' histories.

There are obviously great benefits to evolving medicine - research, technology and medical advancements have helped society immensely - but the one-size-fits-all, Washington DC approach has hindered the profession, making it harder and harder to be patient-centered. The strictures of the president's health plan are already taking their toll: a recent survey of 5,000 physicians found that 60 percent believe the healthcare legislation will have a negative impact on overall patient care. More than half believe that increased bureaucracy is reducing the personal interaction that is essential to building better understanding of patients' needs. And - the statistic that stuck with me as I spoke to those graduates - nine out of 10 would not recommend the healthcare profession to a family member.

This is not the world I wish for the UT Southwestern Medical School's graduating class of 2012. I hope we can stop the dangerous trajectory of government-dictated medicine and get back to patient-centered, doctor-supported healthcare.