Seeking an Otis Brawley in Florida

Once in a while, someone comes along who has the courage to look at the emperor and observe the simple truth that he is, as my kinfolks in South Georgia used to say, buck-naked.

Dr. Otis Brawley is such a man. Last week, at the Association of Health Care Journalists, he wowed about 500  hard-bitten reporters with his keynote speech. He earned a standing ovation.

"The health-care system isn't failing," he said. "Failure is the health-care system."

Brawley's credentials are impeccable: medical director of the American Cancer Society, Emory University professor of hematology-oncology, and a bigwig on many advisory groups to disease agencies. See his bio.

He said that much of what Americans assume to be true about the U.S. health-care system is just baloney. The system, to the extent that it is a system at all, he said, is a mess, driven by money rather than science.

"Health-care today is a subtle form of corruption," he said. "Who's at fault? Doctors, hospitals, ...drug companies, lawyers, even the patients..."

The U.S. spends about $8,000 per person on health care; Switzerland gets better results at half that cost, he said. It's time we demanded value for our spending, he said.

It was an enormous relief to hear someone from the medical profession finally rip off the false smiley face that it wears. He said we're very good at doing things to people, selling unproven products and services and  otherwise wasting money, but not very good at keeping people healthy.

As for politicians who shamelessly warn about death panels, he said, "We need to be talking not about rationing, but the rational use of medicine."

Brawley is all about data. He doesn't spare his colleagues' feelings. "A lot of doctors are out to make a buck and a lot of doctors make it up as they go along," he said.

Patients still think more is better, and they demand tests and treatments and drugs that they'd be better off without, he said.

I would love to find an Otis Brawley -- a smart, uncorruptable doctor with the courage to speak the plain truth -- in Florida.  I would give him or her column space and prominent play.

It would also be good to find a nurse, a hospital or insurance executive or other insider who tells it like it is. No particular ideology. Just the truth. No marketers, please. No PR. 

Here is a linkto Brawley's entire speech, including the Q/A. Better yet, buy his book, How We Do Harm: A Doctor Breaks Ranks About Being Sick in America.