OPINION: Talk of the Town

Sharing health info will lead to better care

I am a primary care physician in Santa Fe. I regularly see patients whose care is compromised and slowed because necessary medical records are not shared with other members of a patient’s care team. Health care in New Mexico is delivered by multiple independent organizations. These organizations do not reliably share records with doctors in a different organization. This is frustrating for patients and physicians and leads to inadequate health care. New Mexico has a HIPAA-compliant solution to this problem, the state health information exchange called Syncronys. However, health care organizations are not required to participate, and must pay to participate with Syncronys. Therefore, many organizations (both corporate and private practices) do not do so. Part of the solution to improving care for patients is to make their health care records available to the physicians who are caring for them. This also reduces the cost of health care by reducing duplicate testing and making doctor’s visits more efficient. I encourage New Mexico lawmakers to require all organizations who keep certain kinds of medical records to share those with the state health information exchange, and to cover the cost for small private practices to do so.

One way to put patients first is to improve our non-private-equity health care infrastructure. This is one way to do so.

Thank you,

Joanna Toews, MD

Santa Fe

Time to speak out about health care

I have been pleased to see articles discussing New Mexico’s health care crisis in the Albuquerque Journal and other publications from around the state. I believe it is a subject that should be discussed over and over again until we no longer have a crisis.

However, I am wondering why more doctors aren’t speaking out; why more people who have experienced difficulties aren’t speaking out; why more elected officials aren’t speaking out, why all residents of voting age aren’t demanding their local, county and state governments work together to improve/solve the crisis as quickly as possible.

I am thankful I am healthy. I am thankful for the doctors I use. But I deplore the fact that anyone in New Mexico struggles to find medical care when it is needed. Do you? I deplore the loss of a doctor to another state due to our high liability insurance rates. Do you? I deplore the fact that our legislators failed in the last legislative session to prioritize approving more interstate compacts, which would allow a variety of medical professionals to practice in New Mexico. Do you?

I am calling and writing my elected officials. I ask you to do the same. If need be, ask a family member, a friend, your pastor or priest to help you. My voice, your voice, all our voices are needed. We must speak for ourselves and for each other. All New Mexicans deserve accessible, quality, affordable health care.

Janet Nordmann

Las Cruces

Egolf’s column left out some crucial details

Former House Speaker Brian Egolf’s op-ed, “Putting patients, providers first: A plan for NM health care” (Aug. 24 Sunday Journal) is well-thought out, but nonetheless, woefully deficient and incomplete. He is silent about the elephant in the room — the needed adjustment of New Mexico’s malpractice environment — that would bring it in line with the laws and practice in other states.

It is recognized by many in New Mexico that a large part of the problem of retaining medical professionals is the high cost of their insurance. The insurance costs are seen by many as driven by huge malpractice awards. The billboards all over the state advertising attorneys able to right wrongs suggest that these large awards are worth seeking.

But Egolf’s column is jarringly silent on this issue. His plan is deficient and incomplete. Writing as a trial attorney can make his plan, by ignoring our medical malpractice problem, appear as self-serving.

We need to have all the pieces on the table and in the discussion.

Peter Collins

Albuquerque

Economy should serve the community

Allan Oliver and Alex Horowitz suggest this: The redevelopment of vacant commercial buildings into “dorm-styled” residences (Aug. 24 Sunday Journal). They make a strong economic statement, allowing a higher density of occupants and reducing the per-occupant cost of development. I don’t believe the writers meant to suggest, but their concept incorporates an element of stratifying the value of members of our society.

Their concept of affordable living and addressing the very real problem of insufficient housing in our communities also has an underlying tone of an acceptance that the economy is to be served by humanity, and that the economy does not serve humanity. For “… entry-level workers, hotel and restaurant employees, health care workers ... micro-apartments offer an affordable, community-oriented option. Workers could live near transit and job centers and could walk, bike or take a bus to work.”

They suggest entry-level, hotel and restaurant, and health care workers should accept that serving an economy marked by inequity necessitates limitations on their participation in society. If you are a waitstaff or health aide, you should not expect to be able to raise a family and fully participate in your community.

Our society needs to have a grand discussion about the causes of our economic inequity. We need to revisit the accomplishments of the “Greatest Generation” not just in landing on the beaches of Normandy and Iwo Jima, but also for embracing a post-war economy that would serve humanity, fund the greatest expansion of educational opportunity, reduce poverty and lay the groundwork for a society of inclusion.

They were not perfect, but like the writers of our Constitution, they sought to provide a strong foundation to build upon. Especially the boomers need to re-examine how we turned off the interstate of prosperity for all, and urge our children and grandchildren to steer us back.

Jim Gannon

Rio Rancho

Lawsuits not a problem — malpractice is

I’ve seen a lot of opinion online recently about medical malpractice in New Mexico. I don’t have a horse in this race. I’m neither an attorney nor a physician, and I don’t live in New Mexico, but I do have some expertise with malpractice. I retired as associate director of the National Practitioner Data Bank for Research and Disputes Resolution. The Data Bank receives reports of all malpractice payments for practitioners throughout the United States.

The malpractice problem isn’t malpractice lawsuits or payments. The problem is malpractice itself. To solve the problem, you have to reduce malpractice. A study of 20 years of malpractice payment data in New Mexico showed that only 2.4% of physicians were responsible for half of all the dollars paid for malpractice. Almost 90% of this small group were responsible for multiple payments. Yet only 6.9% of them had ever had any action taken against their license, not even a reprimand. Only 8.2% of them had ever had any action taken by their peers at a hospital against their clinical privileges.

So little is being done to require retraining for or to restrict or revoke the licenses of the worst malpractice offenders — those responsible for half of all the money paid out in malpractice cases. That suggests to me that the best way to reduce the malpractice problem is for the licensing board to be more proactive to ensure that only safe physicians treat patients and for physicians themselves to stop circling the wagons to protect physicians with bad records and instead insist they get retrained or limit their practice to what they can do safely. Doing those two things should not only greatly reduce malpractice payments but also prevent harm to patients and save lives.

Robert Oshel

Silver Spring, Maryland

Oversight in council bill should be addressed

I am writing to express my concern about the recently introduced open space management ordinance amendment (O-25-92), which is scheduled for a final vote by the City Council on Sept. 5. While the intent of District 7 Councilor Tammy Fiebelkorn’s proposal is laudable, it raises serious public health, equity and procedural issues that the council must address.

Any elementary school student can tell you that insects are invertebrates. Thus, this amendment, which would fine anyone who intentionally harms, hunts, pursues, molest, harasses, traps, collects, or removes any ... invertebrate from ... open space lands,” could prevent us from engaging in our essential integrated pest control programs. These programs are vital for combating diseases like West Nile virus, malaria and Zika, which are spread by mosquitoes. This ordinance also overlooks other public health threats, such as fleas and ticks, both invertebrates, which are vectors for serious diseases like the plague and Lyme disease.

The fact that this amendment made it through committee and was introduced without a comprehensive analysis of its potential conflicts with existing public health protocols is alarming. This suggests a procedural failure (and a lack of basic scientific knowledge), where a potentially well-intentioned idea was not vetted for its real-world consequences. This raises concerns about the level of expertise and due diligence applied to drafting legislation.

Finally, expanding this ordinance to include invertebrates raises significant questions of equity and fairness. The stated penalties for violating city ordinances have an inequitable impact on low-income and unhoused residents. For people struggling to make ends meet, a citation for something as trivial as swatting a bug in an open space area could lead to fines they cannot pay, which in turn could lead to warrants and further criminalization.

I urge the City Council to reconsider this ordinance change before the final vote.

Lissa Knudsen

Albuquerque