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'Defensive Medicine' Must Stop, Bush Tells Doctors


BALTIMORE — Decrying the "staggering" cost of health care in America, President Bush urged the nation's doctors Thursday to stop practicing "defensive medicine" by prescribing unnecessary treatments.

In return, the President said, he already has directed the Domestic Policy Council to find ways "to restore common sense and fairness to America's medical malpractice system," a major contributor to higher health costs.

Bush, in his first major address on the state of the nation's health care system, encouraged Americans to be less inclined to sue medical practitioners and to adopt healthier life styles.

"We've got to remember a simple truth: Not every unfortunate medical outcome is the result of poor medicine. You cannot make life risk-free. No risk means no progress. And that's not the American way," the President said.

"Eat sensibly. Exercise. Wear seat belts. Don't smoke, and if you do smoke--stop. Don't abuse alcohol--and don't use illegal drugs," Bush said in his address at the Johns Hopkins University, where he received an honorary degree as a doctor of humane letters.

The President arrived in a light rain and apparently did not see some 200 demonstrators--mostly Johns Hopkins health professionals--gathered on campus to protest what they characterized as the Bush Administration's neglect of public health issues.

One protester carried a placard that said, "Health Not Stealth." Another sign observed, "Dr. Bush? Get Real."

Earlier in the week, the protesters, led by Drs. Neil Holtzman, a pediatrician, and Philip D. Zieve, a professor of medicine, had called Bush "an inappropriate choice" for the honorary degree.

The President did not allude to the protest in his speech, although he emphasized that his Administration is committed to providing more affordable and accessible health care and to reducing infant mortality.

Bush noted that health care costs now account for about 11% of the nation's economy, as measured by the gross national product.

"Yet we remain behind other industrialized countries in life expectancy," he said. "And in the developed world, we rank 22nd in infant mortality rates."

The President also spoke of the need to encourage development of new disease-preventing technologies that can "avoid the expense of long-term treatment."

One deterrent to such breakthroughs is the medical malpractice crisis, Bush said. As an example, he cited the work of a Hopkins founder, Dr. William Halsted, who pioneered the radical mastectomy for breast cancer patients.

"The procedure was unprecedented in its time," the President said. "Yet in today's atmosphere of fear of malpractice--(it) probably would never even have been attempted."

According to the American Medical Assn., costs associated with the malpractice crisis, including escalating insurance premium rates and litigation expenses, amount to about $14 billion annually.

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