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LIVE FROM THE HEADLINES

Interview With Nancy Snyderman

Aired June 26, 2003 - 20:33   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

PAULA ZAHN, CNN ANCHOR: There is an alarming new study on health care in America out today. It says that on average American doctors provide appropriate care, get this, only about half the time. The researchers outlined in the "New England Journal of Medicine," some examples in the study are just plain disturbing. It indicates that in a quarter of the cases, just about a quarter of diabetics had their blood sugar tested regularly, and fewer than half of all heart attack patients received medications that could actually help reduce their risk of death by more than 20 percent. To put this study into prospective, we're joined now by medical reporter Nancy Snyderman, who joins us from San Francisco tonight.
Welcome, Nancy.

NANCY SNYDERMAN, MEDICAL REPORTER: Hi, Paula.

ZAHN: You're a practicing surgeon.

SNYDERMAN: Yes.

ZAHN: Or practicing doctor. Do you buy these numbers?

SNYDERMAN: I not only buy them, I think they're probably rather optimistic. And the reason I say that, is this is a retrospective study looking at patient's records, which means that it's already looking at people who accessed the health care system. And I worry that because we're looking at people who know how to use the health care system, it really isn't addressing those people who already slipped through the cracks.

ZAHN: Well, who is off the hook here, anyone?

SNYDERMAN: Well, I don't think anybody is off the hook. And it's a really complicated story, because what you said is absolutely true, only 50 percent of the time are people getting the right medical care. But it raises the question, is it because the doctors aren't doing their jobs, is it because patients aren't listening to their doctors, is it because people don't want to pay anything more than the $20 copay anymore, or is it because health care companies and managed care companies say, forget it, we're not going to cover that, it's not worth it.

The bottom line is, we tout ourselves as being the best medical care in the world, and we're far from it.

ZAHN: How much of a role does money play in all of this? SNYDERMAN: You know, interestingly, if you go back to the 1950s, you can say the doctors are just in it for the money, they go to the operating room, they take patients to the cleaners. And what I think has happened now is we have just the opposite. If I take you to the operating room, you may do very well. On the other hand, you may have a lousy outcome; you may sue me. You could die, something could be disastrous, and I may not get very much money considering the time and effort it takes for me to do some surgery. Because every time I'm in the operating room, I still have to keep an office going, I have to worry about all the patients who can't see me for routine medical care. And for the average surgeon, although I know no one is going to cry a pile of tears for a doctor these days, the average surgeon is not making the income that people would like to think.

So my concern now is that the economic incentive is on the other side. Surgeons are saying, why go to all of that trouble. I can make more money being in the office, and I'm concerned patients are not getting the surgical procedures they should be getting.

ZAHN: I think you've done a very good job of trying to cut through the complexity of this. But what is the bottom line for the medical consumer out there tonight?

SNYDERMAN: Well, I think you have to look at it in a multitude of levels. I think there's inherent racism in the medical community. We know that people of color do not get access the same way. Women access the medical community and the medical establishments more often than men, but they are denied care more often than men.

So white men probably get a better shake in this whole situation than anyone else.

That doesn't, however, mean that, you know, they're getting the best of all possible worlds. The bottom line is, you cannot afford to be a dumb patient. You have to find a doctor who will have a relationship with you. You have to demand time in a doctor's office, which isn't so easy these days. Take someone with you who will listen to the conversation. Take notes, don't be afraid to ask questions, and then fight for your rights. If you think something should be covered by an insurance company, fight for it. I will tell you the doctors and health care companies do not like squeaky wheels, and if you are a squeaky wheel, you will get better care.

ZAHN: I smile when you say that, because a number of us have been squeaky wheels in doctors' offices over the years.

SNYDERMAN: And you know you're better taken care of.

ZAHN: Absolutely. Do you think these numbers can be turned around? Yes or no.

SNYDERMAN: Sure they can be turned around, but it's no time to be timed, and especially for the women out there, when you look at cardiac disease being the number one killer. Only a third of women get an angiograms, only a third of women get stents. Less than 50 percent know to take aspirin. So for all of women who parked their good manners at the doorstep, pick them up, brush them off and go demand better care.

ZAHN: Time to be bold, isn't it, Nancy?

SNYDERMAN: That's right. You bet, Paula.

ZAHN: Thank you, Dr. Snyderman. Glad to have you for a house call tonight.

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