THE SUMTER ITEM N.G. Osteen 1843-1936 The Watchman and Southron
FRIDAY, JUNE 5, 2015 H.G. Osteen 1870-1955 Founder, The Item
H.D. Osteen 1904-1987 The Item
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Margaret W. Osteen 1908-1996 The Item Hubert D. Osteen Jr. Chairman & Editor-in-Chief Graham Osteen Co-President Kyle Osteen Co-President Jack Osteen Editor and Publisher Larry Miller CEO Rick Carpenter Managing Editor
20 N. Magnolia St., Sumter, South Carolina 29150 • Founded October 15, 1894
COMMENTARY
Why doctors quit, Ch. 2 W
ASHINGTON — I rarely do follow-up columns. I’m averaging one every 10 years. And while my last such exercise resulted in a written apology from the White House (for accusing me of making up facts over its removal of Churchill’s bust), today’s is not a complaint. It’s merely a recognition that the huge response elicited by last week’s column, “Why Doctors Quit,” warrants both rebuttal and clarification. Physicians who responded tended to agree with my claim that doctors are being driven out of the profession by the intrusions, interferences, regulations, mandates, constraints and sundry other degradations of their vocation that are the result of the bureaucratization of medicine. Chief among them is the imposition of electronic health records. I’ve also heard from people who notice how much attention their doctor must devote to filling out EHR boxes on a computer screen rather than to engaging with them during an office visit. To the point CHARLES Krauthammer where a heretofore unheard of profession has been invented — the “scribe” who just enters the data so the doctor can actually do doctoring. On the other hand, my critics, vocal and many, had two major complaints. First, that I’m just a Luddite unwilling to adapt to the new digital world and looking for excuses not to. Second, that while I might have a point about the bureaucratization of medicine, could I not have made it without satisfying my anti-Obama tic and blaming it all on him, and my other itch and blaming it on liberalism? First, I don’t oppose going digital. Properly used, it brings many benefits. The gains, however, are not coming from massive databases attempting to cover and extend to all of medicine but from far more narrow and tailored adaptations. In radiology, for example, one is dealing with artifacts — X-rays, CT scans, MRIs — that can be easily categorized, digitized, filed, transmitted and shared in a way impossible in the age of the shadowed X-ray film held up to backlight. The problem with the EHR, however, is that the pretense of universality leads to information collection that is largely irrelevant to the patient. And, more fundamentally, that the EHR technology, being in its infancy, is hopelessly inefficient. Hospital physicians will tell you endless tales about the wastefulness of the data collection and how the lack of interoperability defeats the very purpose of data sharing. As for my complaint about President Obama and his fellow liberals: Again, I don’t oppose going electronic. What I oppose is the liberal instinct to impose doing so, giving substance to that old saw that a liberal is someone who doesn’t care what you do, as long as it’s mandatory. Why could they not leave the decision of when and how to go electronic to those who use the technology and can best judge its ripeness and usefulness? Instead, the Obama administration decided arbitrarily six years ago that EHR should be universally in use by 2015. Time being up, doctors who did not conform are now penalized through partial loss of Medicare reimbursement. In time, we will surely develop more tailored, specific and efficient data-collection systems that doctors and hospitals will adopt if only to keep up with the increasing efficiency of their digitized competitors. Why, then, the punitive mandate? I was in no way arguing that the bureaucratization of medicine began with Obama. It is the inevitable and inexorable result of the industrialization of everything from cloth making to food service, now extended to health care. My point is that, given the consequent loss of autonomy and authority of doctors, why are we compounding their demoralization by forcing an EHR mandate that robs them of both time and the satisfaction of proper patient care? Yes, in principle, vast record collection will create mass databases that in theory could be mined to help administrators and perhaps even to yield medical insights. But it is somewhat ironic that with incessant complaints about NSA collection of telephone metadata — as of last Sunday, now banned in these United States — as an assault on privacy and civil liberties, we seem not at all disturbed by the current amassing of mountains of medical data about you and your insides, a literal and far more intrusive invasion of the self. My argument is simple. If electronic records are such a great boon — as I think they eventually will be — they will be adopted over time as the benefits begin to exceed costs. Let the market work. Let doctors breathe. And while you’re at it, drop the Medicare penalty. Charles Krauthammer’s email address is letters@ charleskrauthammer.com. © 2015, The Washington Post Writers Group
SOUTHERN WITH A GULF COAST ACCENT
Back in black for a funeral
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few months after a cheerful parade celebrating her 100th birthday, complete with a ride in a convertible Corvette, my great aunt passed away, and I was thrown into a tizzy trying to find a dress to wear to the funeral. Or should I say, a “proper” dress to wear to the funeral. I searched my closet for my go-to summer black dress but remembered it had become a bit too ... let’s go with “worn” as opposed to “snug.” My longLeslie Anne sleeved wool Harrison dress was the only suitable black dress I had, and a July funeral in Jay, Florida, is no place for such an oppressive garment. I own other black frocks, but they are more “night on the town” than “hole in the ground” types of outfits. Nothing is worse than someone being a little too “hoochie–coochie” looking at a funeral. I know these days, people accept all sorts of colors when we gather to marry them or bury them, but, for a funeral, I just feel a strong pull to the tradition of sad, sorrowful black. I also like it when it rains at a funeral be-
cause it’s like the whole world is shooting out tears. People who say they want everyone to wear colorful clothing to their “Celebration of Life” are getting birthdays and funerals confused. It’s the same as if they had a piñata at the service so people would have fun, but then filled it with bees so there wasn’t too much fun. “Be happy! Wear red! Then cry your head off ’cause I’m not here anymore!” The only other set-in-stone color rule in society is for weddings, where the only one wearing white should be the person holding the largest bouquet of flowers and being presented the gift of jewelry. White is for the bride alone, although a few grooms in the 1970s thought they’d give the all-white tuxedo a try. (Not such a good idea after all, was it, Mr. Polka-Dot Underwear?). Much to my horror, an old girlfriend of my husband showed up at our wedding wearing white and managed to jump into several photos. I swear on a stack of Bibles I had nothing to do with it, but the poor girl was never seen or heard from again, bless her heart. Back to my great aunt’s summertime funeral; I finally settled on a lightweight tan dress with coordinating tan heels, minimal jewelry and no perfume — because you never want to clash with all the
flowers. I was suitably subdued, respectfully bland, but still not in proper black. My husband’s college roommate, John, was raised in the South by a mother from Boston who was extremely proper. After John’s date with a promising young lady, we asked him how it went. He gloomily shook his head and said, “I knew she wasn’t for me when she answered the door wearing all black before sundown.” At 20 years old, I had never heard that rule but was deeply impressed there were still social and fashion rules I didn’t know. From that point on, John’s mother was my hero, and years later, she attended my wedding and endeared herself to me even more for casting an evil eye at the chick wearing white. If any of you aren’t feeling well, I’d appreciate it if you could just hang on a little longer while I find a decent black dress. I promise it will be worth the wait. And if heaven forbid, it’s my turn to be planted in the ground, by all means, wear whatever you’d like. But those in black get preferred seating. And pearls will earn you a souvenir funeral fan.
gants know about each other. Why is the birth rate, outside of wedlock, such a prevalent matter in one race more than another? If the illegitimacy problem were not a factor, would the child support system be so overloaded? Why can I say all this? I worked in child support enforcement in Sumter, as a constable and deputy sheriff for 19 years. I have witnessed the judges, court clerks and DSS support enforcement people do everything in their power to work with the men and women involved with paying and receiving support. It is further amazing how when facing a jail sentence the defendant can come up with some money to pay toward the support. Guess what happens then? They do not make another payment until again facing jail time. Each time, as it should be, the
money or length of time to be served becomes greater for violating the court’s order. Many of the men and women I locked up would tell you, I told them to at least make an attempt to pay something through the window for their child, if they make $20 doing something, put $10 in to the support case. When they make no effort at all that pretty much shows they really don’t care about a court order and worse, their child. If the value of a “family unit” is taught, maybe the illegitimacy which is even being glorified today in the Hollywood way of life would bring our morals back in check. That would keep our inmate rate lower because fewer would be in jail for “Failing to Pay Child Support as Previously Ordered.” JIM AUSTIN Sumter
Leslie Anne Harrison is a contributing writer for Gulf Coast Media — www.gulfcoastnewstoday.com. She can be reached at la@fairhopesupply.com.
LETTER TO THE EDITOR Rose-colored glasses need to be checked Wow, Dr. Williams, again it is somebody else’s fault that a failure to do right ends up putting the poor black man in jail. You say, “Most men and women reckon with their mistakes and shortcomings with intentions, prayers, hopes and desires to make amends, repent, reform and reconcile.” Check your rosecolored glasses; I do believe a cleaning is necessary. The percentages you quote of those locked up, by race, are probably pretty close. Check with DSS Child Support in Florence; get the percentage of race in child support cases in the Sumter courts. I wish they had rates on the recidivism of those cases, or how many of the litigants are multiple cases. It is also amazing how little the liti-
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