Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, September 7, 1993 TAG: 9309040066
SECTION: EXTRA PAGE: 1 EDITION: METRO
SOURCE: By KEVIN KITTREDGE STAFF WRITER
DATELINE: BLACKSBURG LENGTH: Medium
Koop - whose tenure as U.S. surgeon general spanned the Reagan years - said doctors used to spend more time with patients they knew well. Now patients often are treated by specialists they have never met before, he said.
In addition, patients nowadays have only a small chance of being cared for by their family doctor on their deathbed. "The chances of your dying in the hands of your physician are down around 20 percent," said Koop.
He will speak at Virginia Tech on Wednesday on the ethics of health care.
The blunt-spoken doctor is not known for backing away from controversial statements. As surgeon general he became known for his support of sex education and AIDS education for children, and for his attacks on smoking.
Koop also has stood up for laboratory tests involving animals and argued that old-fashioned morality is the key to preventing many deadly diseases.
A reviewer once wrote of Koop's memoirs, "With Koop it wasn't a matter of loving or hating him - you loved and hated him."
Koop, who was a pediatric surgeon with an international reputation before becoming surgeon general in 1981, said he knew he wanted to be a doctor when he was still a small child. "I was all set by the time I was 6."
In other interviews he has recalled sneaking into operating room balconies as a teen-ager to watch surgeries.
Koop said last week his days haven't changed much since he resigned as surgeon general in 1989.
He still talks on radio and television, and gives lectures on health-care topics - including the need for people to take responsibility for their own health.
In a short and occasionally combative telephone interview - which was set up three days in advance and then lasted exactly 15 minutes - the ex-surgeon general said the nation's health-care system needs reforming "from top to bottom."
But Koop also said he is not a fan of health maintenance organizations.
With HMOs, doctors are discouraged from spending more than a minimal amount of time with their patients, Koop said. "I think in the long run, HMOs 10 years from now are not going to look nearly as rosy as they do now."
Koop, whose advice was sought on the administration's health-care reform plan, said he is not supposed to reveal anything about the plan's contents.
But asked if HMOs would be part of it, he said, "You don't have to ask me to know it. Managed care is the thing they think will save the most money."
Koop said his own ideas for renovating America's health-care system would involve reducing the paperwork required by insurance companies, so that more time could be devoted to patients.
He also would substitute binding arbitration for the tort system in handling medical malpractice.
Koop blamed the current distance between patient and doctor largely on technological advancements and the growth of specialists.
Medicine has become "high tech," he said. And while the growth in the number of specialists has helped make America's health-care system the best in the world, it also has kept doctors and patients from knowing each other as well as in the past.
He said more medical school students should stick with general medical care.
Not that there aren't plenty of old-fashioned doctors left, who would think nothing of getting up in the middle of the night to attend to a sick patient, Koop said.
"I think there are a lot of those people still around," he said. "I missed a lot of sleep in my life."
Former U.S. Surgeon General C. Everett Koop discusses "Will the crisis in health care deprive us of the opportunity?" Wednesday, 7:30 p.m., Burruss Hall Auditorium, Virginia Tech. 231-3787. TDD: 231-8717.
by CNB