MD Whistleblower

Physicians and plaintiff attorneys have philosophically divergent views on our tort system. I know the attorneys’ views on this issue well. There are lawyers in my family who have prosecuted physicians for alleged medical malpractice. Sometimes, there hasn’t been enough antacids in our house to douse my flaming heartburn after some of our discussions. Obviously, one reason that lawyers support the current system is because it enriches them. However, there are purists among them who truly believe that the tort system, despite some flaws, is the best means available to pursue justice and to compensate injured people. They point out that the medical profession has been lax to monitor itself and to sanction incompetent physicians. Too many medical mistakes, they claim, are ‘buried’. Without aggressive legal advocacy, what recourse would negligently injured individuals have against the powerful and well financed medical profession? In addition, they argue that the system is a powerful deter...

Would you be comfortable buying a house if you didn’t know the price or weren’t sure you could obtain financing? Of course not, but this is exactly the kind of purchase the government is asking us to support. This past week, the non-partisan Congressional Budget Office threw the Obamians off balance with health care reform cost estimates that were beyond the stratosphere. None of reform plans on the table credibly explain how they will be funded. The public is becoming wary of buying into their Grand Plan on credit. Credit card purchases are easy to make and can seduce us to buy more than we can afford. As many American are learning, these purchases can haunt us and ultimately bury us in debt. President Bush was rightly criticized for signing the Medicare Part D prescription drug program, which deepened our debt. Imagine how reforming the entire health care system could affect the nation’s balance sheet. First, show me the money. Then, show me the whole pie, not a different piece of it...

Later today, President Obama will address the American Medical Association (AMA) in Chicago. I suppose that if the administration can make soft overtures to Iran, that it can also present its health care plan to physicians. The organization has already expressed its opposition to the president’s public option proposal, at least in its current form, which is regarded either as a panacea or a poison pill, depending upon your health care ideology. Some have accused the AMA of pursuing its own partisan agenda to protect physicians’ incomes rather than sacrificing a few dollars for the greater good. To this charge, issued by Kool-Aide drinking Obamophiles, I say guilty! Of course, the AMA supports physicians’ interests. Although I am not a member of the organization, I have always regarded it as a physician protector rather than as an advocate for the public interest. It’s history doesn’t inspire confidence that the organization is a paragon of humanitarianism. Recall that over 10 years ago...

Obama’s health care reform is moving steadily forward, or backward depending upon your point of view. He has reframed the issue entirely, empowered by his political standing and Democratic majorities in both houses of Congress. It is no longer whether there will be a public option (read: government take over), but only over the extent that the government will control our health care system. The GOP are trying to cry doomsday, but their damage control efforts are drowned out by the din of the Democrats. What a difference an election makes. Senator Kennedy’s new legislative plan will provide health care to all Americans with employers and individuals making mandatory contributions. In this pay or play proposal, if someone does not purchase medical insurance, then the government would extract its pound of flesh through punitive fines. Private insurance companies, like casinos, would be required to pay out a specified percentage of their premiums as health care benefits. So much for the ‘f...

Politicians speak out of at least three sides of their mouths. This is not just standard double talk, but represents the polished art form of triple talk. First, they tell us what we want to hear. Afterwards, they offer ‘clarifications and adjustments’ (never a flip-flop!) to their original remarks. Thirdly, they spin their views either to the right or left in order to repackage the policy for successful legislative butchering. All the while, they claim that their views have never changed. President Obama, before the election, assured us that he did not advocate the federal government taking over our health care system, realizing that most Americans would not support this policy. He offered us the safer bromides of expanding health care access, reducing costs and increasing medical quality. Who could oppose these noble objectives? However, campaign slogans such as ‘we need to create the finest public schools in the world’ generate enthusiastic support, but mask the complexity of the is...

Actually, sign me up for Plan B or C instead. Many fear that Obama’s end game for health care reform is a single-payer (read: government) system, despite his denials that this is his objective. Single-payer zealots argue that if government takes over health care, that many of our intractable problems will be solved. We will save tons of money, they argue, from increased administrative efficiencies. Spiraling health care costs will be tamed under the government’s whip. Private insurance companies will no longer gouge the public with rising premiums and unfair exclusions for preexisting medical illnessess. The 46 million uninsured would be covered. Big Pharm can finally be caged by Big Government establishing price controls. And, with the government in charge, the president can submit a bill to congress simply outlawing cancer. I agree that single-payer would resolve many recalcitrant issues, but at what cost? What health care system would we be left with? A guillotine is an effective tr...

There is a serious and expanding effort to address corruption in medicine. Regulators and lawmakers are addressing cozy relationships between physicians and industry to protect patients from financial conflicts of interests that may skew doctors’ medical advice. This is murky territory since not every potential conflict is corrupt. For example, is it acceptable for an orthopedist to benefit financially by using a particular artificial hip if the physician believes that this is the best product available for his patients? Does this practice become ethical if the physician discloses this financial arrangement? Are his patients entitled to know the actual dollar amount that the doctor receives? Is it proper for a gastroenterologist to receive a generous honorarium by a heartburn drug company to speak to primary care doctors about reflux treatment? Could this physician be trusted to offer truly objective information to his primary care colleagues with the company’s pharmaceutical represent...