On Friday, November 15^th Senator Rand Paul hosted a physician “roundtable” at Floyd’s Fork Park in Louisville. While he did invite us to attend the fundraiser to follow, he made it clear that our attendance was neither expected nor was our checkbook necessary. The media was not invited to the roundtable. I was never asked about my political affiliation or leanings.  Mine was the seat just to his right.

Not including Dr. Paul, there were seventeen physicians assembled. We expressed frustration with underfunding of procedures, rationing of healthcare, electronic medical records flooded with useless data solely for the sake of bureaucratic compliance, the burden of multi-layered government regulations, being “forced” to become hospital employees to survive, and physician depression with this whole mess.

Senator Paul was focused and engaged – and not short on opinion. He spent about one-half of the time talking and one-half listening.  Here is a summary of my take on Dr. Paul’s positions:

1. Due to the swell in population of older Americans, our current system (i.e. Medicare and Social Security) will not be able to deliver the promised benefits.  People with “means” will have to pay more, and the qualifying age will have to be increased.
2. The Affordable Care Act is 2000 pages of law that unfortunately became 20,000 pages of regulations.
3. The recent cancellations of health insurance plans are not directly due to the Affordable Care Act; rather they are due to bureaucratic interpretation of the law.
4. We cannot have a “one size fits all” health care system. There should be a tiered system allowing the option of paying less for less.
5. The consumer must have a role in controlling health care costs.
6. Health savings accounts encourage people to ask, “How much does this cost?”
7. All seniors should be allowed to enroll in the same health care plan that is offered to government employees.
8. Medicolegal tort reform on a national level will never happen. It has to happen at the state level.

Near the end of the hour-long discussion I had an opportunity to contribute to the discourse and spoke directly to the Senator:

First, I want to thank you for having this roundtable. We know you have tremendous demands on your time. Being here tonight to meet with your colleagues is both gracious and generous.  As a senator, we know you deal with a range of important issues. As a physician you offer a unique and expert perspective.

What is obvious from tonight’s discussion is that your colleagues share passion for providing care and a deep concern – if not outright fear – that medicine is rapidly becoming so automated, so regulated, and so litigated that caring for individuals will be soon be irreversibly sacrificed in favor of managing populations. As a result, talented, dedicated, and independent thinkers will shun medicine, leaving behind a failed health care delivery system, devoid of innovation, imagination, and heart.

I polled my colleagues, asking them what one thing they would tell you and what one question they would ask.  The top three messages for you are: 

1. Republicans should stop trying to defund the Affordable Care Act and instead come up with solutions.

2. Don’t give up on tort reform.

3. Get us out from under the crushing burden of government regulations.

The most common question for you is: What can WE do? 

The senator’s answer was one I have heard before: “Get involved.”

Regardless of your personal ideological leaning, no one can dispute that Dr. Paul is involved.

And on this night Dr. Paul involved us.

Depressed? Not me.

Motivated? You bet.

Sometimes a little from a lot means more than a lot from a few, so…

Contact your elected officials.

See how you can work with the American Medical Association.

Check in with the Kentucky Medical Association.

Hoosiers should explore the Indiana State Medical Association activity.

The Greater Louisville Medical Society is a great place to get involved.

Still need motivation? Watch this video.

To paraphrase my comments at the Kentucky Medical Association this past September…

The strength that comes as a product of our shared core values is the greatest safeguard for the health and well being of our neighbors and loved ones.

No one can change that or take that from us.

We care.

We put patients first.

We cherish and deserve their trust.

And trust is the foundation of our strength.

Yours in earnest,

Sir Pat

Addendum:  Dr. Paul left the roundtable with more than just our thoughts…

He accepted the Excalibur of writing utensils… mightier than the sword.