More advice from Dr. Emanuel that needs to be ignored, and other letters

I loved the recent blog post about Dr. Zeke Emanuel's advice that people should skip their annual physicals “Here's one Emanuel reader who won't skip his annual physical,” Vital Signs. This latest recommendation from Emanuel really could cost people their lives.

His Atlantic piece about why we should all die at 75 was bad enough. No one makes much of a contribution after the age of 40 or so? Tell that to Pablo Picasso, Mother Teresa, Ella Jenkins, Georgia O'Keeffe, Grace Hopper (who was still consulting on information technology when she died at 85) and dozens of others who were and are actively contributing well into their 80s and beyond. But to tell people to skip an annual checkup is dangerous. Many symptoms of serious disease are subtle and can be missed by patients. Good for you for contesting it.

Emily Friedman

The Jan. 19 editorial “National action needed to advance telemedicine” distorts the facts about the proposed interstate compact. It is disappointing that the author, who supports expanding telemedicine, opposes an effort like the compact, which would do just that.

The state medical board community has, with the compact, created a dynamic licensing system that will modernize and streamline the licensure process, facilitate multistate practice, enhance telemedicine practice and expand access to healthcare to underserved areas—while maintaining critical oversight, accountability and patient protections.

Just a few short months since the compact's introduction, eight states—Iowa, Minnesota, Nebraska, South Dakota, Texas, Utah, Vermont and Wyoming—have already formally introduced the compact in their state legislatures and more than 25 medical and osteopathic boards have publicly expressed support for it. And the numbers keep growing.

The Federation of State Medical Boards hardly thinks that is an indication that states won't sign on. That's because the states know the compact is a sound idea and will facilitate telemedicine, not impede it. The compact will help ensure that those who use telemedicine to deliver healthcare do so in a safe and accountable manner and that the strongest consumer protections are maintained.

Dr. Humayun Chaudhry

Regarding the recent guest commentary “Hospital CEOs need different model for managing physicians”, Uwe Reinhardt is right: Aligning physicians with your organization's aims and strategy is a new ballgame. In addition to the advice he offers (share financial data, welcome physicians into management), clear and reciprocal expectations—an explicit compact—can accelerate successful physician integration.

Many hospitals and systems are working collaboratively with physicians because they have spent the time to agree on the expectations management will have of physicians and that physicians will have of their organization (which, by proxy, comes down to its leaders and managers). Many compacts are designed to support shared responsibility for the enterprise's success.

Having written about the successful use of new compacts at large and small organizations, I can report that the key ingredients in successfully managing employed (or independent) physicians are respect, mutual trust and reciprocal accountability. Compact work fosters all three.

Mary Jane Kornacki