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Dear Editor:

I am a past president of the Nassau County Medical Society and a past member of the House of Delegates of the Medical Society of the State of New York and, as such, fought many a battle in the malpractice wars. Unfortunately, we lost the war, and Dr. Galvin’s words ring oh, so true. I, along with many of my fellow physicians, left independent practice because the malpractice insurance premiums were so high, and the insurance companies' reimbursement for patient care was so low, that it became impossible to maintain a private practice. The result was a job in corporate medical practice and well, more on that at another time. As an example, my insurance premium for practicing general surgery exceeded $146,000 per year. This is more than the yearly income for most middle-class families. Add to that the reluctance of insurance companies to pay realistic fees and, in many case, their reluctance to pay anything at all, and you can see where independent medical practice is going.

The problem behind this is partisan politics at both the state and federal levels. In New York State, a former speaker of the Assembly stated that we would get tort reform: “Over [his] dead body.” Of course, he was associated with a plaintiff’s law firm. The State Senate Republican majority leader  was found guilty of forcing one of the state’s malpractice insurers to employ his son who, apparently, did little to no work for his salary. So, the New York State Legislature had every reason in the world to prevent tort reform from becoming a reality. And, in the end, the physicians of our state have been royally shafted.

As for the electronic medical record, I can tell you that, from my vantage point in practice, it is more of a detriment than a help. My patients respond to my care because I know what I’m doing, not because of any computer program template. In fact, I spend more time typing and clicking than I do examining and speaking to patients and families. My timing of notes in the electronic medical records (EMR) is considered more important than the care that I render. My eyesight is suffering as a result of hours spent in front of a computer screen, and I resent the fact that clicks take precedence over patient care in this day and age.

I could go on and on, but I applaud Dr. Galvin for bringing these problems to the public forum rather than writing about the disease of the week. I have never met the man, but he deserves kudos for his insights and for making readers aware of some of the undercurrents of medical practice in 2020. Great job!

Burton J. Glass, MD FACS

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