A cardiologist for 20 years, Dr. Fredric Tobis is a longtime Mercer Island resident who founded the Center for Physician Leadership Training. The Reporter sat down with Tobis to discuss his new, self-published book, “The Healthcare Crisis: The Urgent Need for Physician Leadership.”
Tobis is the current chairman of Washington state’s Eighth District Health Care Advisory Committee, a Certified Physician Development Coach and a member of the Association of Physician Speakers, Experts, and Consultants. He is married to a physician, Carla Greenbaum, and the couple has four grown children.
What prompted you to write this book?
What inspired me to write the book was, actually, my kids had friends over for dinner one night and we were sitting around the table and they were discussing health care — and these are very smart young people, yet it was amazing to me how little they knew about what really was going on in health care. One of them said, ‘If you know so much, why don’t you write a book?’
What is the main idea of your book — what is one thing that you hope readers will learn or understand?
First, the real crisis in health care is cost. Everything else is secondary … the cost is completely out of control. The second point is the cost of health care is very difficult to control, unless you’re actually inside the system. In other words, regulation from outside, either through government policy or insurance policy, fails — it has been failing for 25 years and it will continue to fail.
Physicians need to have good, effective physician leadership. Either we take control of the cost or someone else will.
I try to do this in a nonpartisan, objective manner. The point is when you ask politicians to solve your problems, you’re asking people who don’t have the expertise to do it because very few of our politicians are physicians.
What are some of your main concerns about the Affordable Care Act, or Obamacare?
The biggest concern is the independent advisory board that has 15 political appointees deciding what’s quality. The term “quality” is very hard. … It’s dynamic because there’s always new information coming out that affects what the right thing to do is ... most medical care is based on data plus judgment, and there’s a lot of judgment involved in analyzing the data. To think that 15 people are going to be deciding on data … is a horrible idea.
Second, the cost analysis is completely bogus. There are funds flowing out of Medicare to pay for the Affordable Care Act, and Medicare is already bankrupt.
How do you see physicians taking leadership in this crisis?
If physicians don’t recognize that the only [alternative] to them controlling costs is to have someone else do it, then someone else is going to do it. And someone else will do it poorly.
They need to recognize the importance of physician leadership; they need to realize what the mission is … to promote this kind of culture where you’re going to be able to maintain quality and cut costs at the same time.
What can patients do?
By understanding how the current system works, it can give people an insight into the kinds of questions they ought to ask … one has to ask, is this test you’re ordering [necessary] — what are the alternatives?
They ought to be more actively engaged with the right information about health care and not believe some of the bromides (sound bytes, distortions, comforting thoughts) that somehow Medicare doesn’t have to change, insurance doesn’t have to change … that’s not going to work.
Dr. Tobis’ book is available from Amazon and Barnes & Noble.