Former Surgeon General Dr. C. Everett Koop '37 shared his thoughts on healthcare in the United States and the future of the medical profession Tuesday evening at a fireside chat in the Hyphen to roughly 40 students and community members.
Koop expressed his disdain for managed care insurance companies. He said he believes they are restricting the quality of care doctors can provide for their patients and greatly decreasing the role of doctors as "patient advocates."
Koop said the advocate role of doctors is vital to patients' ability to get the best medical care possible.
Koop gave several examples of why he believes managed care is detrimental. One such case, he noted, is the fact that most managed care companies do not cover the cost of experimental procedures that may prove helpful for patients such as bone marrow transplants for people with cancer.
Koop also reflected on his past as a general surgeon and then as a pediatric surgeon. He recounted stories from his time working with and educating patients -- something he said he remembers as one of his favorite facets of the medical profession.
"If I could relive my life again, I would live it the same way," Koop said.
To students who are considering entering the medical field, he said the greatest joy for him was to be able to go sleep every night "knowing that everyone you encountered that day you had the opportunity to help."
Something that troubles him, Koop said, is the number of students he meets whose parents currently are doctors and discouraging them from studying medicine. Koop attributes this to the negative effect managed care has had on doctors.
Fortunately, Koop said, the future may bode better for healthcare. He said there are two paths healthcare could take.
The first and, according to Koop, more fateful path is that in the near future the President of the United States will declare the need for a government-run system because the current system has degraded so much. A single-payer system will result, similar to much of Europe's healthcare regulation that Koop said is not working.
The second path would involve the improvement of current managed care resulting in lower costs.
One thing in particular that gives Koop pause is some HMOs' requirement that doctors see up to five patients an hour.
"Would you want to be told you had breast cancer in 11 minutes?" Koop asked.
Koop currently chairs the board of drkoop.com, an Internet site designed to provide medical information that is accessible to and hopefully educates the "average layman."
Though the site has generated its share of controversy, with some saying the doctor is merely cashing in on his famous and respected name by peddling information influenced by money, Koop said websites such as his own will play an important role in the future of medicine as doctors will be able to direct their patients to the internet to educate them and possibly save time and anguish for both parties.
As an example, Koop created a hypothetical situation in which a middle-aged man, late in the evening, feels chest pains so he calls his family doctor, fearing heart disease. The doctor directs the man to come to his office in the morning but to read up on the symptoms of certain heartburn condition such as chest pains that may mirror those of heart disease.
Likewise, Koop quoted Supreme Court Justice Sandra Day O'Connor as saying, "The minute the doctor said I had breast cancer, I didn't hear another word he said," of being diagnosed with the disease.
Koop said, in cases such as this, the patient could later search the Internet for information on his or her illness. At one point in the discussion, Koop said with a laugh, "Hopefully they'll go to drkoop.com."
Despite the decreasing need for doctors to educate their patients with the expansion of the Internet, Koop said, when he practiced, he enjoyed teaching his patients and their families.
However, Koop said to the future doctors in the room, "You will practice medicine far differently than I did."
Acknowledging the discord among doctors today, he told current pre-medical and medical students not to worry. On the medical profession, Koop said, "You will think it is right, and you'll refer to these days as the 'good ol' days."
Besides chairing drkoop.com and the Koop Institute, Koop has recently been editing a 24-chapter book on public health crises along with two professors from the Dartmouth Medical School. The book will be officially released in July at an international health conference in Salzburg, Austria.
Also, in August, he will be co-chairing the 11th International Triennial Conference on Tobacco and Health in Chicago.
Koop also noted that drkoop.com has recently enlisted the research help of DMS, with 10 percent of current evidence-based material on the site coming from DMS research.
Koop said the amount of DMS research will increase greatly in the future -- possibly 20 percent next year and 30 percent the year after.
