Small-town doctor offers remedy for health care Okla. physician joins lobby effort

March 26, 1993|By Ann LoLordo | Ann LoLordo,Staff Writer

WASHINGTON -- In the debate on health care reform, the American Medical Association wanted Congress to hear from physicians who care for patients every day: Not academics or theoreticians, but doctors like Ward Hardin, a general practitioner from Stillwater, Okla.

Dr. Hardin answered the call, like hundreds of others, who came from places ranging from Paragould, Ariz., to Casper, Wyo. But this doctor's remedy for what ails America's health care system -- a typed, six-point, three-page statement -- may not have been precisely what the nation's premier professional group for doctors would have ordered.

A single-payer system. Health insurance for all. Reliance on primary-care physicians, not specialists. Reimbursement for wellness, not procedures.

But from where Dr. Hardin sits -- an internist who charges $39 for an office visit, practices in a town of about 35,000 and treats patients from university professors to the homeless -- health care reform must be substantive, across the board and, where necessary, radical. And everyone -- doctors, insurers, pharmaceutical companies, lawyers, hospitals, even patients -- will have to do their part if health care reform is to succeed.

"My personal feeling is the Clinton administration is going to do too little, which is a contradiction to a lot of my cohorts," said Dr. Hardin, a 36-year-old father of two whose wife is a physician.

"The only real solution to America's medical problems is to change the way physicians are reimbursed. They are paid for procedures instead of keeping people well. If they are paid for how they care for patients, there is incentive to do things in a cost-effective way. It makes the physician the patient's advocate again."

Is there an ultra-liberal loose amid America's well-heeled, historically gray-haired and traditionally conservative physician's group?

"Not only would they consider me a Democrat but a yellow-dog Democrat," said a smiling Dr. Hardin, as he waited yesterday morning for a meeting with his congressman.

Bespectacled and bow-tied, Dr. Hardin came to Washington because, as far as he's concerned, health care reform is the issue -- for himself and his patients.

"As corny as this may sound, I see my patients suffer because of the lack of access to care, lack of medication," says the doctor who describes himself as a "moderate" Democrat. "I have five people [in my practice] I can think of whose prescription costs exceed their monthly income."

An Iowa native who finished college and medical school in six years, Dr. Hardin practices alone and earns less than $100,000 a year.

"I did not get into medicine for megabucks. It's a very good income, but I work for it," says the doctor, the last of 10 children born to a farmer and his wife.

Every day away from his Stillwater office costs Dr. Hardin about $1,000. But it would be money well spent if he could get across the problems facing a small-town doctor. He fully expected "the AMA to do what they have always done, stand in the background, wring their hands and say, 'This is terrible,' but not offer any constructive alternatives."

Dr. Hardin admits he's no politician -- unlike the AMA's legion of lobbyists who have proved their ability at political persuasion. He's not the mingling type either. But he does have something to say.

Less than a week after President Clinton appointed his wife to head the health care reform task force, Dr. Hardin sent Hillary Rodham Clinton a 10-page, single-spaced letter, full of specifics on problems and remedies. He delivered the highlights yesterday to his congressman, Democratic Rep. Bill K. Brewster.

"OK, he's ready for you," a secretary said, as Dr. Hardin grabbed his green folder and went in.

Mr. Brewster, a burly man with a warm, open smile, welcomed the doctor, whom he had met before in Oklahoma. Unbeknown to Dr. Hardin, a contingent from the Oklahoma State Medical Association had invited themselves to the meeting -- and some were late. So until the others arrived, the group chatted about the congressman's hunting trophy (a buck mounted on his wall), his meeting with "the smokeless tobacco people," his new, larger office.

Then they got to the business at hand. As a courtesy to his colleagues, Dr. Hardin explained, "My views are not of the Oklahoma State Medical Association or the AMA. My positions are considerably more radical. We need to completely rework the system . . ."

Concisely and cogently, he ran through his points. Among them: the need to shift the focus of care to primary-care physicians and reduce the number of specialists in training.

"If you see the cardiologist first thing off the bat for your chest pain, you're going to spend a lot more money finding out it's your heartburn," he said.

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