Promote Health, Not Lawsuits

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Commentary — October 2013 

Tex Med. 2013;109(10):7.

By Stephen L. Brotherton, MD, TMA president  

A little more than two decades ago, the tobacco industry was at the height of its mendacious power, and it developed a diabolically clever scheme. It would donate money to physicians and institutions for research for a number of projects, with the only criteria being unstated — the research could have nothing to do with either smoking or cancer. The amount of money was tiny compared with their profits, but enough to look good when announced to the public.

This rhetorical deception — linking a question and an answer that were in fact unrelated — allowed the industry to claim that it had funded large sums of money for research, but that no link between smoking and cancer was found. It perhaps assumed that the recipients would like the money and be less vocal in their opposition to Big Tobacco, but there is little evidence that such occurred.

At my first Texas Medical Association meeting, the House of Delegates attacked this tactic the only way it could — by making it TMA policy that physicians would not accept money from the tobacco industry. I was an alternate delegate, but I was seated for my absent delegate. Some who spoke against the resolution seemed to me to be leaders by the way others deferred to them, but new leaders were less reticent. Sue Bailey encouraged me to go to the microphone to dispute a point one of these leaders had made, and Speaker Bernie Palmer, in his never-to-be-duplicated style, helped me get to the point effectively. The resolution passed.

The world did not change. Physicians and institutions could ignore TMA policy and take the money. I did not care. My state organization had stood up for honesty and public health over money, and I was in love. I still am.

I was reminded of this by a recent missive by Public Citizen that used the same tactic. This group, which claims to be a "consumer watchdog," points out the resounding success of our 10-year-old tort reform bill and amendment, but tries to link it to overall health care cost. This is either cynically devious or grossly misinformed.

Because of our tort reform, dozens of Texas counties that did not have an obstetrician now have one. The increase in rural physicians has been three times the increase in the rural population. However, it did not and could not reduce the percentage of diabetics in the population, reduce obesity, or make the latest disease-modifying autoimmune drug cheaper.

In fact, one might argue that our reform package could increase costs slightly: The bicycler with the head injury who once was 200 miles from a neurosurgeon now has one in his hometown. "Dead" is always cheaper, but don't try telling that to the cyclist's family.

If Public Citizen wants to reduce health care costs, it should promote fresh fruits and vegetables, not the plaintiff's bar. It should decry sedentary lifestyles, not a reform package that has made Texans safer and closer to their physician.

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