...letter to the nations new medical students
this week we were asked by department of health and human services secretary kathleen sebelius and national coordinator for health information technology david blumenthal, md to distribute the letter that follows to first year medical students. This letter is adapted from dr. Blumenthals commencement address to the university of florida college of medicine 2010 graduating class. I felt the content of the letter merited sharing it with our entire community.
an open letter to new medical students
congratulations on entering the profession of medicine. Many of you and your families have sacrificed enormously to get to this moment. We understand the tide of emotions you and your families are experiencing: Pride, relief, gratitude, anticipation and perhaps a little anxiety. After all, most of you will now begin the rigors of medical school and residency, from which you will emerge as fully trained physicians, but only after another long and demanding next phase in your professional life.
You are entering one of the most admired and privileged professions known to man, and with that honor comes great responsibility. You will be the bearers of hope: The hope of every parent for the recovery of a sick child, of every spouse for the healing of a suffering partner, of every son and daughter for the longevity of an aging parent.
We are struck by the fact that you are the first class of medical students to start since congress passed and president obama signed into law the affordable care act of 2010, also known to some as the health reform law.
We believe deeply that the affordable care act will be good for you and for your patients, and for the health system overall. We hope each of you can and will play a vital role in ensuring the vision of reform becomes the reality of high-quality, high-value health care for your patients, your families, and your neighbors.
It starts with making sure each of you understands what is in the new law so you can communicate both what it means in terms of the health care coverage options your patients may be eligible for, and how it gives both patients and doctors more control over their health care decisions. The best place to start this education process is our new consumer web site
healthcare.gov. This new tool, which has been widely praised as being straightforward and easy to use, not only will help patients find health care coverage options, but will also give them detailed information about what will happen when, as well as some important tips for healthy living.
While the implementation of this major new law will unfold over years, many positive provisions are already taking effect. Many of you and your siblings are undoubtedly under the age of 26. Before the enactment of the affordable care act, health plans decided when dependent child coverage would end, and, in many cases, such coverage would end the moment you left college unless you went on to graduate school.
Without college coverage, your families or the families of your friends have had to find individual insurance plans in the private market plans whose premiums are unaffordable to many americans or pass up health insurance altogether, which many have unfortunately done. The result: 3 in 10 young adults are currently uninsured in the u.s. Under the affordable care act, you and your brothers or sisters will now be able to stay on your families insurance policies until you are 26. While this part of the law is scheduled to go into effect for plan years beginning on or after september 23, 2010, more than 65 insurance companies, including the nations largest, have already voluntarily extended coverage to age 26.
Of course, the problem of insurance companies denying coverage to patients who need it most goes beyond young people. Practitioners of adult medicine have routinely faced the same thing: Patients with heart disease, cancer, multiple sclerosis, diabetes, or lupus losing their coverage; or running up against annual and lifetime dollar limits; or getting frozen into a job because, if they changed where they work, they could no longer get insurance that covered their pre-existing conditions.
That led to tough choices for them and their doctors, too: How to space out or prune away appointments and tests and treatments to minimize costs how to decide which necessary medicines were
really most essential. Sometimes, these patients just disappeared from care without explanation, ashamed to admit they could no longer pay their bills.
As a result of the affordable care act, those of you treating adults will no longer face these tough, troubling choices during your careers. Starting in 2014, around the time when you begin your residencies, insurance companies will have to sell coverage to all americans, regardless of their health status.
That means absolutely no one can be turned away. Insurance companies wont be able to place annual or lifetime limits on coverage, or take it away when patients get sick. Your patients lives will be better off as a result, and you will have a new level of clinical autonomy that preceding generations of physicians never enjoyed: The ability to do what is right and best for your sickest, most vulnerable patients who are not eligible for government programs like medicare and medicaid.
These are just a few of the affordable care acts benefits that are already being realized. But we also want to tell you about some other critical reforms to our health care system that have taken effect recently, and where we especially need your help to get the message out. One really significant way that we can reform the way we practice medicine is through the adoption and meaningful use of electronic health records.
Every doctor knows that she is only as good as the information she has about her patients. Information is the lifeblood of medicine. Without clinical data progress notes, laboratory data, images, microbiology reports were reduced to guesswork.
Yet, the united states today lives with a health information system that relies on the same technology pen and paper that hippocrates used 2400 years ago. Every aspect of your lives is computerized, from laptops to cell phones to pagers. Youre connected 24/7. Yet, most doctors go to work and pick up a pen or pencil to record the most precious resource of their trade data about their patients health problems.
Can you imagine caring for patients 20 years from now without computers, without electronic health records, without the ability to send patient information electronically from your office to the hospital, from one hospital to another, from the hospital to your office? It would be like practicing medicine with one hand tied behind your back.
The president and congress have authorized a huge amount of resources literally billions of dollars toward implementation of electronic health records for the entire nation through the hitech act. This is a new federal initiative dedicated to creating a modern, 21st-century electronic health information system for the nations clinicians and their patients.
The department of health and human services has been granted important new authorities to help create a private and secure nationwide interoperable electronic health information system. Our ability to make change pales in comparison with the power of your generation to transform medicine by insisting, by
demanding, that wherever you end up practicing, you have a modern electronic health information system at your disposal to help you be the best physicians you can be. We in the federal government will do our best to support you.
When you finish medical school, send the hospitals and residencies that are recruiting you a clear message. It is past time for them to enter the electronic age. It is past time for them to give you the information tools you need to do your jobs. You will change the face of medicine forever and for the better.
Every generation should be better off than the last. Well, we think the stars are aligned for you now. As you start your careers, medicine retains its age-old ability to apply the balm of hope, while scientific progress continually increases your ability to turn that hope into the reality of disease avoided or cured, of life prolonged, of suffering relieved.
And you and your patients will benefit from a new era in which the compassionate impulses of the american public have been translated into a commitment that all your patients will have access to the best care this country has to offer. Now, as pioneers of a revolutionary transition in the delivery of care, you have the responsibility to ensure that your successors have the same advantages and more that you will have. Good luck with that challenge, and congratulations.
kathleen sebelius and david blumenthal, md
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