Writing letters to the editor is not what Richard Ennis, MD, spends a lot of time doing. In fact, until he wrote the letter that appears below, he’d never written a single one.
But not unlike the fictional news anchor Howard Beale in the 1976 movie “Network” who shouts “I’m as mad as hell and I’m not going to take this anymore!,” Dr. Ennis is disenchanted with a healthcare system that he believes is going in the wrong direction. He has had enough, and he also has vented in letters to Sen. Alexander and President Trump.
“I just wanted somebody to hear that there’s an opinion on the other side of the changes, and I think it would be a widespread opinion if you took a survey,” he said.
“Nobody is advocating for the patient now,” he added. “Maybe it’s because I grew up with a dad who worked at Sears. I understand what average families have and what they go through, and the rug to some extent is being pulled out from under them in the area of healthcare.”
Ennis is an orthopedic surgeon who specializes in arthritis treatment and joint replacement. He founded Specialty Orthopedics about 15 years ago after he’d been with Memphis Orthopedic Associates for 25 years.
He grew up in Memphis, went to public schools and the old Treadwell High School, then Southwestern College and medical school at the University of Tennessee in Memphis. As long as he can remember, any time someone asked him what he wanted to be, he said “a doctor.”
When he broke a foot playing football in high school, “I went to the orthopedic surgeons, and it got into my mind that that’s a good kind of doctor to be,” he said. “They seemed to be smiling and happy, so I just chose that and I started to college to be an orthopedic surgeon.”
It wasn’t a professor or doctor who inspired him so much as it was his father, who was as solid as Sears.
“Just by being the person he was,” he said. “He was always straight up, honest and hard-working. I hope they’ll say that about me.”
Aside from a year at the Mayo Clinic and a six-month fellowship at the University of Southern California, Ennis has stayed in Memphis.
“It’s home,” he said. “There are some nicer places to live, but that didn’t attract me. Three of our four children have moved away to nice places, but I’m a Memphian and I stuck with it.”
When he did his general surgery training at the Mayo Clinic, it was just a year after the first hip replacement in the United States had been done there.
“The specialty of joint replacement was exploding at that time,” he said.
But now he thinks the practice of medicine is exploding in a bad way. At an American Academy of Orthopaedic Surgeons meeting last month, he said the big push in joint replacement was bundled payments, which he said ultimately means less care for the patient and more money for the doctor.
“The doctor gets paid more if he reduces the care of the patient,” he said. “And to me that’s just absolutely wrong. But now that is becoming the standard. And I can’t tell you how that upsets me.”
Another issue is whether certain procedures on certain groups will be worth the cost.
Ennis said his father’s final five years of life were much better after he had a total knee replacement at age 91.
“He was able to live independently,” he said. “To me, that’s a worthwhile procedure.
“Overweight people now aren’t supposed to have the surgery because the results aren’t quite as good. But I can tell you some of the happiest patients I have are very overweight patients who could not walk until they had their hip or knee replaced.
“But it won’t be long until those groups can’t get the operation. To me, this is America, and people should be able to get care if it helps them.”
Ennis lamented the ICD-10 coding, a system that, he said, “is so complicated nobody can figure it out. You go to conferences to understand it, and then you go to an additional conference to learn how to cheat that system.”
And then there is the rising cost of medicine.
“Half the money spent in Medicare goes to medications,” he said. “The price of generic medications has doubles, tripled, quadrupled and quintupled in the last couple of years, for no good reason. … The price of insurance if you buy your own insurance has gone up astronomically.
“If you look at profits in the insurance industry … For several years recently the president of United Health Care has been the highest-paid executive in the United States – hundreds of millions of dollars. To me the system is wrong, and I don’t know what Trump’s gonna do, but somebody has to come in and change things.
“I like money as well as the next guy, but I don’t like it to the point of punishing my patients so that I have more of it.”
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