By Mark J. Tyler

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As a physician, I have seen quantum leaps forward in the profession that has meant so much to me personally. I can attest that during my 40-plus years in practice, there have been great advances in our fund of knowledge — better training, better drugs, plus more accurate and timely diagnoses leading to better patient treatment and outcomes.

As physicians, we want what is best for our patients and will go to extraordinary lengths to achieve that goal. It remains to be seen whether the practice of medicine today measures up to the excellence of the past.

I remember watching on television in the spring of 2009 as the president and the leaders in Congress discussed the merits and features of a national health plan. I applauded the president for asking the members for their input and at times, dissenting, views and/or positions. All of the senators and representatives present supported a great number of the proposed changes.

I thought some of the contrarian views/positions proposed at that meeting by the loyal opposition would be included in the final version of what we now call Obamacare. I was disappointed. Not one suggestion, as I understand, put forth by the loyal opposition was included in the final document.

We all realize that changes had to be made but the depth and breadth of Obamacare is truly overpowering and in many instances burdensome. It now seems that documentation and recording supersedes good care and excellent outcomes. But we must comply or there is no compensation forthcoming.

We are asked to do more with less time to perform the tasks. Frustration is a common denominator what with the amount of documentation that has to be asked, answered and recorded. It is more expensive for the practitioner or the health system as more people are needed to help record, monitor and collate each encounter. Compensation now seems to be based on the process and not the outcome — a healthy and satisfied patient.

It was a travesty that Obamacare passed Congress with not one member, to my knowledge, having read the entire 2,000-plus page document. Shouldn’t we have demanded that our legislators be knowledgeable of what they voted for?

Again, we all know and understand that reform was in the best interests of all of us, patient, doctor and payer. But did we need another, larger and intrusive federal bureaucracy?

I submit that even with all its foibles and shortcomings that we already have a plan in place and we know it does work and it is called Medicaid. Though it may take some time, I would have suggested that we “enfranchise” the next 8 percent to 10 percent of our population above the parameters that are now the rules for inclusion of Medicaid. Give the system at least 12 months to assimilate this population and learn the cost and the demands of these numbers. Then, and only then, progress to include the next agreed-upon percentage and eventually everyone will be covered.

I believe this is the best way to assess the physical and monetary demands on the nation and its resources. I would also include a “safety net” that would cover emergencies and hospitalizations of those not fully insured.

I fervently hope that the profession I love has its best days ahead, but sadly I do not believe that will be the case — not only for me, but also for the population of this great nation.

l Mark J. Tyler has practiced medicine in Cedar Rapids since 1971, first in family practice and more recently in urgent care. He also is medical director of the Cedar Rapids Physician Hospital Organization. Comments: mtyler@crpho.com