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As we just heard from Scott Horsley, one of the biggest applause lines today was the president's vow to let doctors be doctors, not bean counters. Doctors may not agree with each other or with the president on the details of a new health care system, but as NPR's Joanne Silberner reports, they are fed up with the current system.

JOANNE SILBERNER: Nancy Nielsen, head of the American Medical Association, says that one of the most frustrating things for doctors is dealing with people who lack health insurance.

Dr. NANCY NIELSEN (American Medical Association): That is a problem, because every study that's been done has shown that people who lack health insurance don't go to the doctor for preventive care. They delay their care. They wait until it's late.

SILBERNER: And they come in sicker and harder to cure. Family physician Richard Roberts misses the old days, when doctors were paid more for spending time with patients. He's been practicing in tiny Belleville, Wisconsin, for 23 years. He says health care is about relationships, about a patient going to a doctor for help or advice or assistance.

Dr. RICHARD ROBERTS (Family Physician): We don't structure our health system to support that. In fact, we do everything possible, it seems to me, in the way that we have patients jumping health plans one year to the next, and consequently maybe having to change doctors one year to the next, the way that we pay physicians - we reward them for doing procedures and not necessarily getting to know people. Those are the things that doctors are grieving.

SILBERNER: And in his speech today, President Obama grieved them, too, though some specialists fear for their autonomy and their pocketbooks if the system changes to favor more talk and fewer tests. One change all doctors would welcome is less paperwork. Roberts estimates he spends 15 to 20 hours a week on what he calls administrivia - filling out disability forms, medical leave forms, insurance forms.

Oncologist Robert Fein of Somerset, New Jersey, has paperwork problems, too. Some of it comes from his efforts to help patients get free or discounted chemotherapy from drug companies. He's been sending in forms for them, forms that require that patients attest to their income.

Dr. ROBERT FEIN (Oncologist): I am now having to ask many of these patients for their tax returns so I can fill out paperwork so they can get alternative coverage for their drugs. I mean, I'm a physician. I'm not their accountant.

SILBERNER: He says this is not why he went to medical school. And the recession is making the situation worse for those uninsured patients the AMA's Nancy Nielsen worries about. Emergency physician Arthur Kellerman works at Grady Hospital in Atlanta.

Dr. ARTHUR KELLERMAN (Emergency Physician, Grady Hospital): We're seeing newly uninsured patients. We're seeing patients who, as they get into greater financial distress, are cutting corners and delaying the care that they need, sometimes until it just becomes so bad that they can't put it off any longer. And by the time they come to us, they are in legitimate emergency condition with problems that are far more costly and, in some cases, impossible to treat. And that's heartbreaking.

SILBERNER: There's a patient he can't get out of his mind: a woman who went to five public clinics trying to renew a prescription for blood pressure medication.

Dr. KELLERMAN: Now, her blood pressure was dangerously elevated. It had took her five days, in a system that spends more money per person on health care than any other nation on Earth. That's just outrageous. It's stupid, and surely we can do better than that.

SILBERNER: Stupid is a word you hear a lot from doctors, family physician Richard Roberts, too. He says the health care system has to change soon.

Dr. ROBERTS: It's beginning to collapse of its own stupidity.

SILBERNER: But Roberts, for one, won't say how he wants it to change.

Dr. ROBERTS: You know, the debates about whether it needs to be single-payer or multi-payer - I'm going to leave that to the politicians and the economists to hammer out. From my vantage point, I just want to get it done and have everybody covered.

SILBERNER: And he says what a lot of physicians and surgeons say: He just wants to go back to being a doctor full time.

Joanne Silberner, NPR News.

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