Tuesday, January 8, 2008

Healthcare Wars

By far the most famous feud in medicine, the DeBakey-Cooley schism was almost certainly a primarily personal affair at its core. But this NYT article places the argument in a healthcare policy context, and does quite a job of making that context just as interesting as the ego clash itself. Good read.

On one side is Michael E. DeBakey, 85 years old and still practicing. Many operations that are now routine first took place under his knife, including the bypass procedure that has kept millions of failing hearts throbbing.

But now he is on the defensive, intent on preserving the traditions of American medical research, training and treatment. He says the pressure to contain medical costs endangers not only patients on the operating-room table today but also those who would someday benefit from the expensive research, like his, that has made American medicine arguably the best in the world.

He mocks the growing number of physicians who are accepting prices and practice standards dictated by Government bureaucrats or insurers. When someone from an insurance company -- "some clerk," he says -- called recently to urge him to discharge a 90-year-old stroke victim, he snapped: "You come here and tell the patient's relatives you want her transferred to your care. Otherwise, butt out."
Needless to say, I'm with Debakey. In fairness, I did not find the article particularly friendly to Cooley. Whether it was his fault or the reporter's, his case looks weak and he looks like an asshole. There are much better advocates of his position (which is not nearly as true of DeBakey), but not ones that have legendary status in medicine, and of course a great backstory in a legendary feud.

[Note: This article is quite old. Debakey is STILL practicing at a hair away from 100 years old. I don't know what Cooley is up to, but about a year ago they formally reconciled and, for sake of appearances at least, let much of the bad blood dissipate.]