D

ear Mr. Trump,

We are a group of doctors who saw in your presidential campaign a threat to the health and well-being of the country. We wrote an open letter sharing our concerns, which more than 600 doctors signed.

You were not our candidate. But now you will be our president and, more important, our patients’ president. And so we write again.

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First, we ask that you do no harm.

Second, we respect that your campaign ran on changing a system that you and your supporters said was corrupt and that neglected millions. In many ways we agree. To improve the health of all Americans, we urge you to do the following:

Improve primary care. You spoke about forgotten Americans. We see them all the time — young, old, and in-between — fighting complex conditions that require constant help from physicians and others but struggling with a system that can be hard to get into. In many ways it is deeply unfair, missing whole segments of the population because they don’t fall into convenient revenue streams. This help should take place close to their homes through stronger primary care. Not only does such care focus on the often forgotten, it is a smarter way to use the country’s resources.

Invest in public health. Public health measures make the biggest impact on improving the quality and length of life. We are seeing the absence of sound public health policies in the rise of opioid deaths. This is a crisis that demands bold action and leadership. In addition, please focus on improving nutrition, disease surveillance, consumer safety, and fighting stress, obesity, and inactivity.

Provide affordable health insurance. We agree with you that the Affordable Care Act has its flaws. But ending it abruptly would be a harmful setback, and millions are now insured through the ACA. You compassionately stated that we won’t have people dying in the streets. We recommend focusing on the ACA’s biggest weakness and addressing the premium increases. Whatever you choose, please do not go forward without a plan to support the millions for whom the ACA is a lifeline. You have previously expressed support for a public insurance option, which we agree is a worthy alternative.

Negotiate drug prices. Both the Medicare Prescription Drug, Improvement, and Modernization Act and the ACA allowed the pharmaceutical lobby to set the terms for drug pricing, essentially allowing the industry to siphon money from Medicare without allowing the government any power to negotiate. Please use your negotiating skills to stop this burden on our seniors.

Protect our veterans. The US Department of Veterans Affairs is an ideal proving ground for improving health care in America. Like all Americans, our veterans deserve better support for mental health, addiction, and chronic disease. Combating these challenges requires well-functioning organizations of health care professionals, but also systems that support stronger social ties. The VA knows that investments in housing, food, employment, education will all be essential.

Aim for quality care. You ran for president as someone who understands business. The business of health care in America is growing larger each year, but being sick, needing care, and suffering with illness is not a simple matter of dollars and cents. Many have called ours a sick-care system — the more sickness there is, the more money can be made. In fact, by giving patients tests and treatments that don’t help and only harm, spending more on health care can actually make people more sick rather than less. We ask you to use your business savvy to help patients get the quality care that they pay for, nothing more and nothing less.

Health care in this country is in desperate need of improvement. We applaud you for shining a light on the millions for whom it has failed. In working for them, and for all Americans, we urge you to be thoughtful. The field of health care workers, researchers, and policymakers is filled with hardworking, dedicated, and decent people who care for all Americans, including marginalized groups like women, minorities, and the poor. We all need compassionate and informed leadership that listens to patient needs and to those who have committed their lives to this calling.

Aaron Stupple, MD, is an internal medicine physician practicing hospital medicine in Boston. Andrew Goldstein, MD, is a primary care physician and postdoctoral public health researcher in New York City. Stephen Martin, MD, is a primary care physician in Massachusetts.

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  • If you change the Affordable Care Act it should include a single payer option. I realize that under a Trump administration this is highly unlikely. Any dismantling of the system will disenfranchise millions of Americans who rely on the current system. Sign me up as a physician who will actively oppose Trump as much as possible.

    Gary R. Fujimoto, M.D.
    Los Altos, CA 94024
    Retired Palo Alto Medical Foundation and Stanford University School of Medicine (26 years)

  • First, I do appreciate the “Doctors” addressing key issues that negatively impact society.
    Second, “First Do No Harm” is and we all know to well is a oxymoron statement. Too numerous good intentions and Doctors working long hours can not make sound decisions for patient care. The fact that science itself doesn’t allow a pilot, truck driver, or any other operator to work past 12 hours as being awake for 16 -24 hours is equivalent to drunk driving. Why make medical students or staff physicians to work these unrealistic long hours with an increase Hospital deaths that no one speaks or writes about? (Ethics)
    Thirdly, This “opiod” crisis really had nothing to do with Physician based care other than a few episodes of physicians that have went overboard with going from “function to dysfunction” management. As one professional mentioned, it’s the 80/20 negative impact. 20 percent are abusing on the black market or professional market and the rest of 80 are taking opioids to function educated enough to know the limits and natural consequences.
    4th, Where are the dietitians????? Statins are not the way for some as everyone is not created equal. CoQ10 is a very important enzyme and the serious side effects from Statins strip the body of CoQ10 and some physicians to date don’t know this.
    Healthcare in the USA is ranked 30 something on most statistical graphs and patients pay more than any other country in the world in premiums, deductibles, copays. It appears the profiting healthcare machine in USA is not keeping up with other countries that are truly using science based healthcare and out performing the USA.
    When are the teaching physicians, FDA, Pharmaceutical companies going to overhaul an archaic system to be effective and effiecient with internally and extrernally science based results to improve the overall outlook for USA healthcare?
    Lastly, countries like Sweden and many others have paid healthcare systems and they work. We are still seeing even after the ACA was implemented people losing homes, capital, to the number 1 cause of Bankruptcy is HEALTHCARE in the USA? We,USA, can build a 2 billion dollar water plant near Baghdad, Iraq and it’s not being used and we can’t take care of the SSI card holder who pays Fedral, State, County, and USE taxes?
    First DO no Harm is doing harm for the 80 percent that are trying with stagnant wages and many jobs that left our country in the thousands! There is no science justification for a healthcare professional of any kind to pay 600 dollars in monthly premiums to have healthcare insurance when the person or patient lying in the hospital bed is paying way less!
    The profiteering healthcare machine is doing further harm!

  • What are you doing, doctors, about those in your own ranks who have harmed and continue to harm patients through sheer ignorance? Medical educators aren’t teaching ongoing research is necessary for maladies and conditions that aren’t as easy as a ‘pill’ thrown down our throats and ignoring our deteriorating conditions.

    Doctors are the most suspicious people, not trusting any patient nor believing most – we are not partners, you treat us like THE enemy.

    Patients nationwide are being harmed BY doctors and I don’t see one of you standing up for PATIENTS, only for your incomes and wealth.

    Patients’ records are being abused, changed and used as weapons, so don’t tell a person who DID vote for Trump that you don’t want any ‘harm’ but won’t police your own ranks!

    PATIENTS ARE BEING HARMED.

    TELL US WHEN YOU ARE GOING TO DO SOMETHING ABOUT THE IGNORANCE IN YOUR OWN RANKS!

  • What are you doing, doctors, about those in your own ranks who have harmed and continue to harm patients through sheer ignorance?

    Patients nationwide are being harmed BY doctors and I don’t see one of you standing up for PATIENTS, only for your incomes and wealth.

    Patients’ records are being abused, changed and used as weapons, so don’t tell a person who DID vote for Trump that you don’t want any ‘harm’ but won’t police your own ranks!

    PATIENTS ARE BEING HARMED.

    TELL US WHEN YOU ARE GOING TO DO SOMETHING ABOUT THE IGNORANCE IN YOUR OWN RANKS!

  • Not mentioning reproductive rights is a gross oversight given that the president-elect has repeatedly said he would appoint judges that will overturn Roe v Wade. If that happens, and many states outlaw abortions, thousands of women will probably die.

    • Baloney!

      Abortion laws are not going to be changed unless you believe, like Obama, Trump will overwrite laws OF states.

      Abortion is only ‘right’ when it is to save the mother’s life – otherwise one is causing the death of a HUMAN BEING.

      Grow up, no one is going to stop abortions.

      You *really* need to read the Constitution and learn about States’ Rights.

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