Dr. Herbert Riemenschneider, Urologist and Surgery Center Owner, Shares His Thoughts on the Healthcare Reform Process

Editor's note: The following is a letter written by Herbert Riemenschneider, MD, urologist and founder of Knightsbridge Surgery Center in Columbus, Ohio, to David Brooks, Op-Ed columnist for The New York Times, regarding an article titled "The Town Hall Mob" written by Op-Ed columnist Paul Krugman.

Dear Mr. Brooks,

I am sharing my thoughts related to an article written by Mr. Krugman in you absence. I present the following:

I am a urologist in Columbus, Ohio. If you choose you may look me up on the Web at www.riverside-urology.com. I have been in practice for well over a quarter of a century, been on teaching faculties and in private practice during that time. I am a member of the American Urological Association and active on the Health Policy Council.

My patients are from a wide spectrum of society, in that I have a good private practice and I also take care of the less fortunate in public clinics and teaching clinics.

I have discussed this reform process with many patients as I care for their needs. We, in my profession, agree that there are areas that need reform. However it is clear by focusing on the cost factor with other factors coming in with significantly less priority, much which is constructive is being missed. For example, the issue of legal liability insurance in the practice of medicine/surgery is being ignored as a major driver of the cost. This clearly affects the style of practice and the resources that allow uniform distribution of these services.

The fact is that some of the proposed reforms may have value, but the fact that they have not been tried and proven effective on a smaller scale is frightening. States like Massachusetts, Oregon and Ohio are ideal laboratories for healthcare reform. In Ohio we are responsible as the laboratory that made possible the early diagnosis of Prostate Cancer for the Medicare population (Medicare eligibility for PSA testing). This early diagnosis has resulted in cure for the majority of cases. Early in my career it was not at all unusual to see patients that had no option but palliative care.

Without reviewing each experience, medicine/healthcare are not nearly in the terrible condition that is so frequently portrayed in the media. I do have significant concern about how the Administration and the majority party in Congress are responding to the public's reaction as the public expresses its concerns and opposition to the dramatic proposed changes. These changes (without meaningful input from healthcare professionals who deal in the everyday healthcare market place) are perceived as damaging a system that these people (patients) believe is good.

I listen to patients who are recognized as stalwarts in their communities and in many instances leaders, as they articulate opposition to the reform process in a very vehement, and at times in more aggressive statements. In short these are good people, the people that make America great, they have served in the military and run small businesses like those that employ the majority of Americans. These folks are really upset about what is going on in the Administration and the non-partisan activity, in the halls of Congress.

Mr. Brooks, I appreciate that you have taken the time to read this and listen. I know there will be others who express their views in a much more forceful manner, they are not eccentric, they are the American people, patients, and they are mad that this current government has every appearance of not being representative of their wishes and needs.

Sincerely,

Herbert Riemenschneider, MD
riemenschneider.2@osu.edu
www.riverside-urology.com