It was recently discovered that Fareed Zakaria committed
plagiarism in an essay he wrote for Time Magazine on gun control. He confessed and apologized. I think he could have been fired for this as
plagiarism, aka theft, is a cardinal offense for a journalist and a news
magazine where trust is a central pillar.
This was not a matter of an indiscretion in his private life or an
offense that doesn’t threaten his profession’s central mission. This was
dishonesty in a job that should demand honesty in every syllable. Zakaria is a Harvard graduate and a Yale
trustee. How would these institutions
have ruled on a student who admitted committing plagiarism? CNN and Time ‘suspended’ him. Was Zakaria too big to fail?
I’ve devoted several posts in this blog to professional
integrity and personal ethics. Medical plagiarism is a serious ethical wound in the medical world and all of us must
hold our academic colleagues, medical students and practicing physicians accountable.
In September 2012, the Institute of Medicine (IOM) issued a
report that delivered a bold and unexpected message – our health care system is
wasting money! Who knew? I have to assume that this 18-member panel
has plagiarized the Whistleblower as so many posts here are devoted to this issue
long before their report was published. I’ll
leave it to readers to decide if I should seek judicial redress on this
unethical appropriation. This is an
opportunity for an ordinary reader to become a Whistleblower.
Whistleblower Readers are Watching!
This panel after a year and a half of study concluded that
we’re incinerating a ton of money. Lest you accuse me of hyperbole, $750
billion are being vaporized annually, nearly a third of every dollar spent. How would your personal or professional
balance sheet appear if you wasted 30 cents of every dollar? No business or home can remain solvent under
that scenario, and neither can the health care system.
Why are there no checks on this system? Here are a several reasons why unnecessary
care is practiced.
- Fee-for-service medicine where physicians like me are reimbursed in an a la carte manner.
- Defensive medicine where physicians like me order unnecessary tests to reduce legal risk.
- Pressure from patients who desire more testing and treatment believing that more medicine is better medicine.
- Patients who pursue expensive care of questionable value that they don’t have to pay for.
- Physicians who practice non-evidenced based medicine.
- Rising administrative costs.
- Fraud.
Feel free to add to the list. Climbing out the hole will be like scaling a glass
skyscraper. Every reform measure angers
and threatens a powerful player in the medical arena. I support initiatives like comparative
effectiveness research and the more recent Choose Wisely program, which represent
the first steps of what will be a very long odyssey.
If any blogger has their eye on this post with an aim of
posting it as his own, caution.
Whistleblower readers will be watching.
One man's waste is another person's livelihood. As long as we continue to use a payment system which separates those receiving the service from those who have to pay for it, this will continue. When services appear to have no cost, demand for them will be infinite, even if they are not "needed". They will always be wanted.
ReplyDelete@MC,your return to the comment section noted and appreciated. Agree. Ever notice how we order differently at a restaurant when it's someone else's tab?
ReplyDeleteThere is an easy way to avoid plagiarism. Copyscape.com offers an easy means to find out if your copy contains phrases or paragraphs in other articles if the document is on the web anywhere. I have found how easily I can plagiarize, sometimes without thought now that it has become easy to copy and paste.
ReplyDeleteThanks, Gary. There is whole industry now of plagiarism detecting software. Dishonesty has created jobs!
ReplyDeleteWaste in medicine? And in other news, "No WMD in Iraq." The travesty is not the presence of waste in the medical system, but the blatant lack of initiative to cut waste, not only at the federal/state level, but also the hospital/corporate level. When is the last time anyone from hospital admin approached you as a physician to inquire about cutting waste in the hospital? Even if they were interested, I assure you they would not get a physician involved. When is the last time you were asked, "Dr. Kirsch, we need your help cutting waste in the endo suite." The person making the decision would be a suit incapable of differentiating an endoscope from a screwdriver. I think everyone acknowledges that there is massive waste. What's amazing is the utter contempt for addressing it.
ReplyDeletePayam, spot on! This will change, of course, now that hospitals will be penalized financially for failing to meet various benchmarks.
ReplyDeleteAmen to Payam's comment. It seems to me that the IOM is just part of the racket, though. Professing concern, they provide the following summary of where they think money is being wasted:
ReplyDelete• Unnecessary Services – $210 billion
• Inefficiency – $130 billion
• Excess administrative costs – $190 billion
• Inappropriately high prices – $105 billion
• Missed prevention opportunities – $55 billion
• Fraud – $75 billion
All of these figures come from a health-care system in which expenses totaled $2.5 trillion in 2009. Only the most conservative definition of "unnecessary services" could arrive at a $210B tab for them (< 10% of the total).
Those who practice medicine thoughtfully understand that the indications for MOST of the care we provide are gray, not black and white. Many of the "problems" we treat aren't really problems at all (but MIGHT become problems in the future) – and many of our expensive "solutions" provide only a small marginal benefit over less costly, more conservative options.
Mark, you're on to something there.
ReplyDelete