There’s no doctor in the House.
Or in the Senate, for that matter.
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And so Dr. Howard Schulman, a general internist in Rhode Island since 1995, is running for a state representative seat in the General Assembly. An East Side resident with a medical practice in Warwick, he will run as a Democrat in Providence’s District 3, which encompasses College Hill and the East Side.
The Princeton University and Rochester School of Medicine graduate is expected to face incumbent Democrat Edith H. Ajello in a primary on Tuesday, Sept. 14.
Dr. Schulman is quick to point out that this is not about a deep-seeded political ambition on his part. It’s more the fact that he has had a close-up view of a health care system that is painfully out of whack.
Dr. Schulman’s decision to run for office is another sign that physicians are getting off the sidelines and into the game.
“There hasn’t been a physician as a member of the General Assembly in 12 years,” he said. “There are a tremendous number of bills and issues up there. The people up there are making decisions based on secondhand information. No one has taken care of a patient.”
On his Web site, Dr. Schulman notes that health care “is at a crossroads.” And adds: “Everyone is unhappy. Very powerful corporate chiefs and corporations have emerged, yet at its core, providing health care is a most personal endeavor. In Rhode Island we are faced with working with the existing system, possibly increasing regulation and competition among health care insurance companies, or scrapping the system and its inefficiencies altogether in favor of a single payer system, which will have its own problems.”
Ed Quinlan, president of the Hospital Association of Rhode Island, is not surprised to see someone like Dr. Schulman toss his hat into the political ring.
Whether it is the rising cost of medical malpractice insurance here or inadequate insurance reimbursements, the pressures on physicians, he says, are mounting.
“Many of these pressures … they end up being addressed through the process of government,” says Quinlan.
And so aside from running for office, Quinlan says more physicians are reaching out to tell their side of the story – to their local senators and representatives, at State House hearings and to the media.
“The best way to make a difference is to be a participant,” says Quinlan.
Malpractice insurance causes shift in practice
Like Dr. Schulman, Dr. Kate Cassin, OB/GYN, too is becoming a participant. No, she is not running for office. But she has been to testify at the State House and has contacted her local legislators.
The story she tells is disturbing.
A graduate of Brown University’s School of Medicine, Dr. Cassin has practiced at South County Hospital for 16 years. A month ago, she reluctantly decided she could no longer afford to deliver babies, opting instead to limit her practice to gynecology.
Why?
Consider the following numbers.
In 2000, Dr. Cassin paid $28,000 in medical malpractice premiums for the year; in 2001, she paid $33,000; by 2003 her premium had risen to $66,000; and if she were to continue in obstetrics in 2004, her premium would have been $90,000. Those increases came despite the fact that Dr. Cassin did not have a single claim filed against her.
And that is just part of the ugly economic picture that physicians are facing. Declining reimbursements make matters worse.
“People just don’t realize what’s going on,” says Dr. Cassin.
And so she is reaching out to lawmakers – hoping they will listen.
“I am trying to inform them … they’re interested, but they just never knew,” she says. “If they really knew what was going on, we could make some changes.”
Maybe that means more regulations and the appointment of an Insurance Commissioner (a suggestion currently being debated at the state Legislature), to scrutinize premium increases. Maybe we do need more competition.
But one thing is certain. The status quo isn’t working. Too many doctors are leaving Rhode Island.
Dr. Cassin looked the other day at a list of this year’s Brown Medical School graduates to see where they are heading and in what field they plan to specialize.
She has a special interest in OB/GYN. She noticed that only two of 80 graduates are going into that field. And both are heading out of Rhode Island to begin their careers.
It’s a sign, says Dr. Cassin, that this health care crisis is only going to get worse.
“It’s going to hurt 10 years down the line,” she says.
Community hospitals like South County Hospital are especially vulnerable. But so too is all of Rhode Island.
We’re losing our doctors.
Now, something just has to get done about that!
