The good, the bad and the future for Trump's HHS nominee

Rep Tom Price has faced escalating criticism in the days leading up to his confirmation hearings.  Price, an orthopedic surgeon, has been involved with the medical device industry (particularly in the orthopedics space) both as a physician, as a congressman, and as an investor.

On Wednesday, he faced the first of two hearings. Democrats aggressively pressed him on his financial dealings with health care related stocks during the time in which he was actively pushing legislation in Congress that may have directly benefited many of the companies in which he was invested.

In addition, Dr. Price faced stiff questions about the future of health care in the U.S. and his plans for ensuring that millions of Americans would not be left without health care following the almost certain repeal of ObamaCare.

Here’s The Good

Dr Price has been an outspoken critic of the Affordable Care Act (ACA) and has worked diligently on legislation to repeal and replace the health care law. As a physician, he has long-standing experience with the inner workings of the American health care system and is very well equipped to provide insight into the failings of the ACA.

After 20 years of practice as a surgeon, Rep. Price not only has a real appreciation for the doctor-patient relationship, but also has a unique perspective on how government intrusion into the exam room has negatively impacted care. As a fellow physician and colleague, I believe that it is essential that we have someone (like Price) who has been on the front lines of health care delivery intimately involved in its reform. Politicians know politics—doctors know patients and how best to deliver high quality care.

In the hearing, Dr. Price addressed several important health care related issues and responded with answers that indicate that significant changes would likely take place within the HHS during his tenure. As a practicing cardiologist, several of these issues would directly and positively impact my ability to care for patients and improve public health in general.

1. Drug Prices

Dr Price committed to ensuring that skyrocketing prescription drug prices are addressed and that pharmaceutical companies will be forced to make these prices more reasonable. He made it clear that price gouging would no longer be tolerated. We must address the abuses of drug makers such as Mylan and others and hold them accountable when they put their own financial interests ahead of patients.

2. Medical Liability

The high cost of medicine can be directly related to the litigious nature of our society when it comes to medical malpractice. Dr. Price clearly stated that he wants to address tort reform in order to eliminate the practice of “defensive medicine.” Many doctors order tests and other examinations that are not clinically indicated in order to avoid lawsuits—these unnecessary tests drive costs and create an enormous amount of waste. When questioned about medical malpractice, Dr. Price stated “doing everything is rarely necessary.”

I think that it will be important to address medical malpractice—we must make sure that doctors are able to practice medicine by putting patients first—in an evidence-based way—rather than practicing medicine to avoid a lawsuit.

3. Obamacare Reform

When directly asked about repealing ObamaCare and how it may impact access to care, Rep Price reacted by correctly stating that many of the “insured” in the ACA have coverage but no care. The ACA exchanges now have less choice, diminished access for patients and increased cost.

Dr. Price also assured the committee that he would ensure that all children have access to medical care and that “we will always care for patients who need our care.” In addition, Dr. Price made it clear that he would advocate for a replacement health care plan to be implemented in parallel with the repeal and that he would make sure that insurers would have the support and stability that they need in order to provide coverage for all Americans.

Now The Bad

While I do think that Dr. Price is uniquely qualified to hold the post of HHS and help shape health care in the Trump administration, I am concerned about the fact that an orthopedic surgeon like Dr. Price would own stock in an orthopedic company such as Biomet Zimmer.  Moreover, as a congressman who had significant influence in legislation that directly benefited Biomet Zimmer, I do not think it was appropriate for him to have purchased interests in the company while influencing policy. If confirmed as head of HHS, I would hope that he will divest himself of all medically-related investments.

Personally, as a physician I make it a point to have no financial interests in ANY medical device or pharmaceutical company in order to avoid the appearance of any outside influence on how I practice medicine—which device I choose and which medicine I prescribe should be based solely on what is best for my patient.  As a cardiologist, I am involved in the implantation of pacemakers and other cardiac devices involving multiple manufacturers. While I do have some consulting and research relationships with several of these device manufacturers, I do not own any stock or have any financial interest in their products.

What’s Next?

Wednesday's hearings were contentious at best. While I do believe that there are real issues that need to be addressed when it comes to Dr. Price and his past dealings with the medical device industry, I think that the positives he brings to the post far outweigh the negatives.

I would hope that during his next hearing, we move away from partisan sound bites such as those provided by Senator Al Franken—who attacked Dr. Price for owning tobacco stocks as part of his portfolio during the 1990s. Let’s accept the fact that the Democrats are slow to come to grips with their losses in the election of 2016 and that they are pulling out all the stops to save the failed ACA. However, we must begin to work together to fix a broken healthcare system and I think that Dr. Price—particularly with his years of experience on the front lines of medicine—is the right choice for the job. Dr Price understands that government has no role in the exam room. We must allow doctors, patients and families to determine the direction of their OWN healthcare—without government interference. I trust that as head of HHS, he will put patients first and that he will work to make sure that we are able to ultimately preserve what makes medicine great—the sanctity of the doctor-patient relationship.