"Difficult Doctors" patients and health care

Discussion in 'Fibromyalgia Main Forum' started by tansy, Nov 30, 2005.

  1. tansy

    tansy New Member

    New York Times Examines 'Difficult' Doctors' Effect on
    Patients, Health System. From the Kaiser Network

    The New York Times on Wednesday examined the "bane of the
    medical profession" -- problem physicians who "drive away
    patients who need help" -- and efforts by some medical groups to
    improve physician-patient relationships.

    According to the Times,
    problem physicians "may be arrogant or rude, highhanded or
    dismissive," and some "have been magnets for malpractice
    claims." Some medical groups maintain that problem physicians
    have become more common because of "pressure to see more
    patients" and that "most problem doctors apparently have no idea
    of their patients' opinions of them," the Times reports.

    Howard
    Beckman, medical director of the Greater Rochester Independent
    Practice Association, said, "What often happens is that the
    patient has something they want to tell the doctor, but they're
    not allowed because of the doctor's style to say what they want
    to say." Beth Lown, assistant professor of medicine at Harvard
    Medical School and former president of the American Academy on
    Physician and Patient, added, "This goes to the heart of
    medicine -- the skillful enactment of communication and a truly
    heartfelt understanding of the patient's circumstances.

    And it
    seems to have gotten lost as doctors get involved in medical
    systems that prioritize speed and technology. Increasingly,
    people are relying on tests instead of talking to patients."

    In
    response, some medical groups, such as RIPA and Tufts Health
    Plan, have begun to survey patients on physician performance
    and, in some cases, withhold pay or bonuses from physicians
    based on the results. In addition, by 2011, all new medical
    residents will receive instruction on "the basics of being
    nice," according to the Times. (Kolata [1], New York Times,
    11/30).
  2. LittleBluestem

    LittleBluestem New Member

    Between my own and my parent's health issues, do I ever know about difficult doctors!
  3. unbalanced

    unbalanced New Member

    All I can say is "about time!!!!"
  4. tansy

    tansy New Member

    The One Click Protest have made the following text available on their web site. Thanx.
    ---------

    CONFESSIONS OF A MEDICAL HERETIC

    By Robert S. Mendelsohn, M.D.
    Chapter 7
    pp. 123-140

    "The Devil's Priests"

    I always laugh when someone from the American Medical Association or
    some other doctors' organization claims that doctors have no special
    powers over people. After I finish laughing, I always ask how many
    people can tell you to take off your clothes and you'll do it.

    Because doctors are really the priests of the Church of Modern
    Medicine, most people don't deny them their extra influence over our
    lives. After all, most doctors are honest, dedicated, intelligent,
    committed, healthy, educated, and capable, aren't they? The doctor is
    the rock upon which Modern Medicine's Church is built, isn't he?

    Not by a long shot. Doctors are only human — in the worst ways. You
    can't assume your doctor is any of the nice things listed above,
    because doctors turn out to be dishonest, corrupt, unethical, sick,
    poorly educated, and downright stupid more often than the rest of society.

    My favorite example of how doctors can be less intelligent than the
    situation calls for is a matter of public record. As part of the
    hearings before the Senate Health Subcommittee, Senator Edward Kennedy
    recalled a skiing injury to his shoulder, suffered when he was a young
    man. His father called in four specialists to examine the boy and
    recommend treatment. Three recommended surgery. The advice of the
    fourth doctor, who did not recommend surgery, was followed, however.
    He had just as many degrees as the others. The injury healed. Senator
    Kennedy's colleagues then proceeded to question Dr. Lawrence Weed,
    Professor of Medicine at the University of Vermont and originator of a
    highly popular patient record system for hospitals. Dr. Weed's reply
    was that the "senator's shoulder probably would have healed as
    satisfactorily if the operation hadn't been performed."

    When doctors are formally tested, the results are less than
    encouraging. In a recent test involving the prescribing of antibiotics
    half of the doctors who voluntarily took the test scored sixty-eight
    percent or lower. We've already seen in the previous chapters how
    dangerous it is to have a doctor work on you. All of that danger
    doesn't necessarily derive from the inherent risks of the treatment
    itself. Doctors simply botch some of those procedures. When I meet a
    doctor, I generally figure I'm meeting a person who is narrow minded,
    prejudiced, and fairly incapable of reasoning and deliberation. Few of
    the doctors I meet prove my prediction wrong.

    Doctors can't be counted on to be entirely ethical, either. The dean
    of Harvard Medical School, Dr. Robert H. Ebert, and the dean of the
    Yale Medical School, Dr. Lewis Thomas, acted as paid consultants to
    the Squibb Corporation at the same time they were trying to persuade
    the Food and Drug Administration to lift the ban on Mysteclin, one of
    Squibb's biggest moneymakers. Dr. Ebert that he "gave the best advice
    I could. These were honest opinions." But he also declined to specify
    the amount of the "modest retainer" Squibb Vice-President Norman R.
    Ritter admitted paying him and Dr. Thomas. Dr. Ebert later became a
    paid director of the drug company and admitted to owning stock valued
    at $15,000.

    In 1972, Dr. Samuel S. Epstein, then of Case-Western Reserve
    University, one of the world's authorities on chemical causes of
    cancer and birth defects, told the Senate Select Committee on
    Nutrition and Human Needs that "the National Academy of Sciences is
    riddled with conflict of interest." He reported that panels that
    decide on crucial issues such as safety of food additives frequently
    are dominated by friends or direct associates of the interests that
    are supposed to be regulated. "In this country you can buy the data
    you require to support your case," he said.

    Fraud in scientific research is commonplace enough to keep it off the
    front pages. The Food and Drug Administration has uncovered such
    niceties as overdosing and underdosing of patients, fabrication of
    records, and drug dumping when they investigate experimental drug
    trials. Of course, in these instances, doctors working for drug
    companies have as their goal producing results that will convince the
    FDA to approve the drug. Sometimes, with competition for grant money
    getting more and more fierce, doctors simply want to produce results
    that will keep the funding lines open. Since all the "good ol' boy"
    researchers are in the same boat, there seems to be a great tolerance
    for sloppy experiments, unconfirmable results, and carelessness in
    interpreting results.

    Dr. Ernest Borek, a University of Colorado microbiologist, said that
    "increasing amounts of faked data or, less flagrantly, data with body
    English put on them, make their way into scientific journals." Nobel
    Prize winner Salvadore E. Luria, a biologist at the Massachusetts
    Institute of Technology, said "I know of at least two cases in which
    highly respected scientists had to retract findings reported from
    their laboratories, because they discovered that these findings had
    been manufactured by one of their collaborators."

    Another now classic example of fraud occurred in the Sloane-Kettering
    Institute where investigator Dr. William Summerlin admitted painting
    mice to make them look as though successful skin grafts had been done.
    A predecessor to Dr. Summerlin in the field of painting animals was
    Paul Kammerer, the Austrian geneticist, who early in the twentieth
    century painted the foot of a toad in order to prove the Lamarckian
    theory of transmission of acquired traits. When he was later exposed
    in Arthur Koessler's book, The Case of the Midwife Toad, Kammerer shot
    himself.

    Dr. Richard W. Roberts, director of the National Bureau of Standards,
    said that "half or more of the numerical data published by scientists
    in their journal articles is unusable because there is no evidence
    that the researcher accurately measured what he thought he was
    measuring or no evidence that possible sources of error eliminated or
    accounted for." Since it is almost impossible for the average reader
    of scientific journals to determine which half of the article is
    usable and which is not, you have to wonder whether the medical
    journals serve as avenues of communication or confusion.

    One method of judging the validity of a scientific article is to
    examine the footnote for the source of funding. Drug companies'
    records regarding integrity of research are not sparkling enough to
    warrant much trust. Doctors have been shown not to be above fudging
    and even fabricating research results when the stakes were high
    enough. Dr. Leroy Wolins, a psychologist at Iowa State University, had
    a student write to thirty-seven authors of scientific reports asking
    for the raw data on which they based their conclusions. Of the
    thirty-two who replied, twenty-one said their data either been lost or
    accidentally destroyed. Dr. Wolins analyzed seven sets of data that
    did come in and found errors in three significant enough to invalidate
    what had been passed off as scientific fact.

    Of course, research fraud is nothing new. Cyril Burt, the late British
    psychologist who became famous for his claims most human intelligence
    is determined by heredity, was exposed as a fraud by Leon Kamin, a
    Princeton psychologist. It seems that the "coworkers" responsible for
    Burt's research findings could not be found to have actually existed!
    There is even evidence that Gregor Mendel, father of the gene theory
    of heredity, may have doctored the results of his pea-breeding
    experiments to make them conform more perfectly to his theory.
    Mendel's conclusions were correct, but a statistical analysis of his
    published data shows that the odds were 10,000 to one against their
    having been obtained through experiments such as Mendel performed.

    Doctors' unethical behavior is not limited to the medical business. A
    doctor whose name is practically synonymous with development of a
    major surgical procedure was convicted of five counts of income tax
    evasion for omitting more than $250,000 from returns for 1964 through
    1968. A few years ago the chairman of the Board of the American
    Medical Association was indicted, convicted, and sentenced to eighteen
    months in jail after pleading guilty to participating in a conspiracy
    to misuse $1.8 million in bank funds. According to the FBI, he and his
    codefendants had conspired to "obtain unsound indirect loans for their
    own interest. . .paying bank funds on checks which had insufficient
    funds to back them. . .and defrauding the government. . ."

    Keep in mind that these shenanigans are going on at the highest levels
    of the medical profession. If this kind of dishonesty, fraud, and
    thievery is going on among the bishops and cardinals of Modern
    Medicine at Yale and Harvard and the National Academy of Sciences and
    the AMA, imagine what is going on among the parish priests at the
    other medical schools and medical societies!

    Perhaps the most telling characteristic of the profession that is
    supposed to deliver health care is that doctors, as a group, appear to
    be sicker than the rest of society. Conservative counts peg the number
    of psychiatrically disturbed physicians in the U.S. at 17,000 or one
    in twenty, the number of alcoholics at more than 30,000, and the
    number of narcotics addicts at 3,500 or one percent. A thirty-year
    study comparing doctors with professionals of similar socio-economic
    and intellectual status found that by the end of the study nearly half
    the doctors were divorced or unhappily married, more than a third used
    drugs such as amphetamines, barbiturates, or other narcotics, and a
    third had suffered emotional problems severe enough to require at
    least ten trips to a psychiatrist. The control group of non-doctors
    didn't fare nearly as badly.

    Doctors are from thirty to one hundred times more likely than lay
    people to abuse narcotics, depending on the particular drug. At a
    semiannual meeting of the American Medical Association in 1972,
    surveys cited showed that nearly two percent of the doctors practicing
    in Oregon and Arizona had been disciplined by state licensing
    authorities for drug abuse. An even larger percentage got into trouble
    for excessive drinking. Even the AMA admits that one and one-half
    percent of the doctors in the United States abuse drugs. Various
    reform and rehabilitation measures over the years have not changed
    these percentages. Keep in mind that these figures represent only the
    identified cases. In Illinois, for example, Dr. James West, chairman
    of the Illinois Medical Society's Panel for the Impaired Physician,
    reported that four percent rather than two percent of Illinois doctors
    are narcotics addicts. He further estimated that eleven-and-one-half
    percent were alcoholics - one in nine.

    Suicide accounts for more deaths among doctors than car and plane
    crashes, drownings, and homicides combined. Doctors' suicide rate is
    twice the average for all white Americans. Every year, about 100
    doctors commit suicide, a number equal to the graduating class of the
    average medical school. Furthermore, the suicide rate among female
    physicians is neatly four times higher than that for other women over
    age twenty-five.

    Apologists for the medical profession cite several reasons for
    doctors' high rate of sickness. The drugs are easily available to
    them; they must work long hours under severe stress; their background
    and psychological makeup predisposes them to stretch their powers to
    the limits; and their patients and the community make excessive
    demands on them. Of course, whether or not you accept these reasons,
    they don't explain away the fact that doctors are a very sick group of
    people.

    Nonetheless, I prefer to look for more reasons. Fraud and corruption
    in the research process comes as no surprise to anyone who witnesses
    the lengths to which drug and formula companies go to doctors to their
    way of thinking. Free dinners, cocktails, conventions, and subsidized
    research fellowships still are only superficial explanations. When you
    examine the psychological and moral climate of Modern Medicine, you
    begin to get closer to understanding why doctors are so unhealthy.

    Medical politics, for example, is a cutthroat power game of the most
    primitive sort. I much prefer political politics, because there you
    have the art of the possible, which means you have to compromise.
    Medical politics is the art of sheer power. There is no compromise:
    you go right for the jugular vein before your own is torn out. There's
    no room for compromise because churches never compromise on canon law.
    Instead of a relatively open process in which people with different
    interests get together to try to get the most out of the situation
    that they can, in medical politics there is a rigid authoritarian
    power structure which can be moved only through winner-take-all power
    plays. Historically, doctors who have dared to change things
    significantly have been ostracized and have had to sacrifice their
    careers in order to hold to their ideas. Few doctors are willing to do
    either.

    Another reason why doctors are less prone to compromise is because
    doctors tend to restrict their friendships to other doctors. Close
    friendships between doctors and non-doctors are nowhere near as
    frequent as among other professions. Consequently, doctors rarely have
    to defend their opinions among people who don't share their background
    and who might offer a different point of view. Doctors can develop
    their philosophy in relative privacy, foray at intervals into the
    public scene to promote these ideas, and then rapidly retreat to the
    security of other doctors who support the views of the in-group. This
    luxury is not available to others in influential positions in public life.

    Of course, doctors do see their patients. But they don't see them as
    people. The doctor-patient relationship is more like that between the
    master and the slave, since the doctor depends on the complete
    submission of the patient. In this kind of climate, ideas can hardly
    be interchanged with any hope of the doctor's being affected.
    Professional detachment boils down to the doctor rendering the entire
    relationship devoid of human influences or values. Doctors rarely rub
    elbows with non-doctors in any other posture but the professional.

    Furthermore, since the doctor's ambitions project him into the upper
    classes, that's where his sympathies lie. Doctors identify with the
    upper class and beyond, even. They view themselves as the true elite
    class in society. The doctor's lifestyle and professional behavior
    encourage autocratic thinking, so his conservative politics and
    economics are predictable. Most doctors are white, male, and
    rich—hardly in a position to relate effectively with the poor, the
    non-white, and females. Even doctors who come from these groups rarely
    return to serve and "be with" them. They, too, become white, male, and
    rich for all practical purposes and treat their fellows with all the
    paternalistic contempt other doctors do.

    When asked where doctors learn these bad habits, I used to reply that
    doctors learned them in medical school. Now I realize they learn them
    much earlier than that. By the time they get to premedical training,
    they've picked up the cheating, the competition, the vying for
    position — all the tricks they know they need if they want to get into
    medical school. After all, our university system is modeled after the
    medical schools, and our high schools are modeled after our universities.

    The admissions tests and policies of medical schools virtually
    guarantee that the students who get in will make poor doctors. The
    quantitative tests, the Medical College Admission Test, and the
    reliance on grade point averages funnel through a certain type of
    personality who is unable and unwilling to communicate with people.
    Those who are chosen are the ones most subject to the authoritarian
    influences of the priests of Modern Medicine. They have the compulsion
    to succeed, but not the will or the integrity to rebel. The hierarchy
    in control wants students who will go through school passively and ask
    only those questions the professors can answer comfortably. That
    usually means they want only one question at a time. One of the things
    I advise my students to do in order to survive medical school is to
    ask one question but never ask two.

    Medical school does its best to turn smart students stupid, honest
    students corrupt, and healthy students sick. It isn't very hard to
    turn a smart student into a stupid one. First of all, the admissions
    people make sure the professors will get weak-willed,
    authority-abiding students to work on. Then they give them a
    curriculum that is absolutely meaningless as far as healing or health
    are concerned. The best medical educators themselves say that the
    half-life of medical education is four years. In four years half of
    what a medical student has learned is wrong. Within four years of
    that, half again is wrong, and so on. The only problem is that the
    students aren't told which half is wrong! They're forced to learn it
    all. Supervision can be very close. There is no school in the country
    where the student-teacher ratio is as low as it is in medical school.
    During the last couple of years of medical school, you frequently find
    classes of only two or three students to one doctor. That doctor has
    tremendous influence over those students, through both his proximity
    and his life-and-death power over their careers.

    Medical students are further softened up by being maliciously
    fatigued. The way to weaken a person's will in order to mold him to
    suit your purposes is to make him work hard, especially at night, and
    never give him a chance to recover. You teach the rat to race. The
    result is a person too weak to resist the most debilitating instrument
    medical school uses on its students: fear.

    If I had to characterize doctors, I would say their major
    psychological attribute is fear. They have a drive to achieve
    security-plus that's never satisfied because of all the fear that's
    drummed into them in medical school: fear of failure, fear of missing
    a diagnosis, fear of malpractice, fear of remarks by their peers, fear
    that they'll have to find honest work. There was a movie some time ago
    that opened with a marathon dance contest. After a certain length of
    time all the contestants were eliminated except one. Everybody had to
    fail except the winner. That's what medical school has become. Since
    everybody can't win, everybody suffers from a loss of self-esteem.
    Everybody comes out of medical school feeling bad.

    Doctors are given one reward for swallowing the fear pill so willingly
    and for sacrificing the healing instincts and human emotions that
    might help their practice: arrogance. To hide their fear, they're
    taught to adopt the authoritarian attitude and demeanor of their
    professors. With all this pushing at one end and pulling at the other,
    it's no wonder that doctors are the major sources of illness in our
    society. The process that begins with cheating on a biology exam by
    moving the microscope slide so that the next student views the wrong
    specimen, that continues with dropping sugar into a urine sample to
    change the results for those who follow, with hiring others to write
    papers and take exams, and with "dry labbing" experiments by
    fabricating results, ends with falsifying research reports in order to
    get a drug approved. What begins with fear and fatigue over exams and
    grades ends with a drug or alcohol problem. And what begins with
    arrogance towards others ends up as a doctor prescribing deadly
    procedures with little regard for the life and health of the patient.

    My advice to medical students is always to get out as soon as possible
    and as easily as possible. The first two years of medical school are
    survivable because the students are relatively anonymous. The student
    should try his or her best to remain so, since if the professors don't
    know him they can't get to him. The last two years are more personal,
    but the student has more time off to recover from the assaults. If a
    student simply does enough work to pass and doesn't get all wrapped up
    in the roller derby mentality, he or she can make it to the finish
    line relatively unscathed. Then, as soon as the student is eligible
    for a state license, I advise him to quit. Forget residency and
    specialty training because there the professionals have the student
    day and night, and he can really be brainwashed. That's when the real
    making of the Devil's priests occurs.

    Doctors are only human. But so are the rest of us, and sometimes we
    need the services of all-too-human doctors. Because the doctor-priest
    acts as a mediator or a conduit between the individual and the
    powerful forces the individual feels he cannot face alone, a faulty
    conduit can result in some very powerful energy flowing into the wrong
    places. For example, when doctors are compared with other people in
    evaluating retarded and other handicapped persons, those who always
    give the most dismal predictions and the lowest evaluations are the
    doctors. Nurses are next lowest, followed by psychologists. The group
    that always gives the most optimistic evaluation is the parents. When
    I'm faced with a doctor who tells me a child can't do certain things
    and parents who tell me that the child can do them, I always listen to
    the parents. I really don't care which group is right or wrong. It's
    the attitude that counts. Whatever attitude is reinforced and
    encouraged will prove true. I know doctors are prejudiced against
    cripples and retarded people because of their education — which
    teaches that anyone who is handicapped is a failure and is better off
    dead — so I can protect my patients myself against the doctors'
    self-fulfilling prophecies of doom.

    Yet doctors continue to get away with their attitude and their
    self-serving practices. Even though doctors derive a great deal of
    their economic status and power from insurance companies, the doctors
    are in control. So much in control, in fact, that insurance companies
    generally act against their own interests when the choice is that or
    weaken the power of doctors. Blue Cross and Blue Shield and other
    insurers logically should be searching for methods of decreasing
    unnecessary utilization of medical services. Occasionally, we see
    half-hearted attempts in this direction, such as the flurry of rules
    requiring second opinions before elective surgery, or the
    every-so-often policy of discontinuing reimbursement for procedures
    long fallen into oblivion. These efforts are more window dressing than
    anything else. They are introduced with considerable fanfare, rapidly
    generate a groundswell of controversy, and then quietly slip away.
    Regardless of how well-intentioned they are, they still address
    themselves only to the peripheral aspects of medical care and not to
    the areas where real money is to be saved. If insurance companies
    really wanted to cut costs, they would promote reimbursement for a
    wide range of simpler, more effective, cheaper procedures — such as
    home birth. And they would allow reimbursement for measures that
    restore and maintain health without drugs or surgery — such as diet
    therapy and exercise.

    One of the most fascinating statistics I've ever run across is one
    that was reported by the Medical Economics Company, the publishers of
    the Physician's Desk Reference. Among other questions, they asked a
    representative sampling of more than 1,700 people, "If you learned
    that your doctor had lost a malpractice suit, would it alter your
    opinion of him?" What amazes me is that seventy-seven percent of the
    people said NO!

    Now I don't really know if that means that people expect their doctors
    to commit malpractice or if they don't care whether he does or not!

    I do know that the insurance companies are bamboozled by the doctors
    into spending more money than they have to. I also know that only
    about seventy doctors lose their licenses every year — despite all the
    obvious corruption, sickness, and dangerous malpractice. Here we come
    to one of the truly wondrous mysteries of Modern Medicine. Despite (or
    because of?) all that fear and competition among medical students,
    doctors are extremely reluctant to report incompetent work or behavior
    on the part of their colleagues. If a hospital, for example, discovers
    malpractice by one of its doctors, the most that will happen is the
    doctor will be asked to resign. He won't be reported to state medical
    authorities. When he seeks employment elsewhere, the hospital will
    most likely give him a shining recommendation.

    When the famous Marcus twin-brother team of gynecologists were found
    dead of narcotics withdrawal during the summer of 1975, the news that
    the doctors were addicts came as a surprise to everyone but their
    colleagues. When the brothers' "problems" were noticed the year before
    by the hospital staff, the twins were asked to take a leave of absence
    to seek medical care. When they returned to New York Hospital-Cornell
    Medical Center, they were watched for signs that they had improved.
    They had not. Were they then whisked off the staff and kept out of
    touch with patients before anyone was seriously harmed? Were they
    reported to state licensing authorities? No. They were told in May
    that as of July 1, they would not be allowed to work in the hospital.
    They were found to have died within days after they lost the privilege
    to admit patients to the hospital.

    Another favorite example of doctors allowing their colleagues to
    commit mayhem on unsuspecting patients occurred in New Mexico. A
    surgeon tied off the wrong duct in a gall bladder operation and the
    patient died. Although the error was discovered at autopsy, the doctor
    was not disciplined. Apparently, he wasn't taught the right way to do
    the operation, because a few months later he performed it again, wrong
    — and another patient died. Again, no punishment and no surgery
    lesson. Only after the doctor performed the operation a third time and
    killed another person was there an investigation resulting in the loss
    of his license.

    If I had to answer the question of why doctors are so reluctant to
    report negligence in the practice of their colleagues yet so cutthroat
    when it comes to medical politics and medical school competition, I go
    back to the basic emotions engendered in medical school: fear and
    arrogance. The resentment doctors are taught to feel for each other as
    students is transferred to the patients when the doctor finally gets
    into his own practice. Other doctors are no longer the enemy as long
    as they don't threaten to rock the status quo through politics or
    research which doesn't follow the party line. Furthermore, the old
    fear of failure never goes away, and since the patient is the primary
    threat to security — by presenting a problem which must be solved,
    much like a medical school test — any mistake by a single doctor
    threatens the security of all doctors by chalking one up for the other
    side. Arrogance on the part of any professional group is always
    directed at the outsiders that the group fears most — never at the
    members of the same profession.

    Obviously, doctors get away with more arrogance than any other
    professional group. If Modern Medicine weren't a religion, and if
    doctors weren't the priests of that religion, they wouldn't get away
    with anywhere near so much. Doctors get away with substantially more
    than priests of other religions, because of the peculiarly corrupt
    nature of Modern Medicine.

    All religions promote and relieve guilt. To the extent that a religion
    is able to encourage useful behavior by promoting guilt and relieving
    it, that religion is "good." A religion which promotes too much guilt
    and relieves too little, or which encourages the wrong kind of
    behavior—behavior which will not result in the improvement of the
    welfare of the faithful — is a "bad" religion. An example of how a
    religion promotes and relieves guilt is the almost universal
    proscription against adultery. Obviously, if religions didn't try to
    make people feel that adultery was "wrong" and encourage them to feel
    guilty about it, more and more people would do it and necessary social
    structures would weaken. People wouldn't know who their parents were,
    property could not be orderly transferred from generation to
    generation, and venereal disease could threaten the existence of an
    especially energetic culture.

    Doctors are so powerful precisely because they have, as priests of the
    Church of Modern Medicine, removed all the old guilts. Modern Medicine
    invalidates the old guilts which, strangely enough, held people to
    their old religions. Nothing is a "sin" anymore, because there is a
    physical consequence, the doctor has the power to fix you up. If you
    get pregnant, the doctor can perform an abortion. If you get venereal
    disease, the doctor can give you penicillin. If you are gluttonous and
    damage your heart, the doctor can give you a coronary bypass. If you
    suffer from emotional problems, the doctor has Valium, Librium, and
    other narcotics to help you get by without caring, or feeling. If
    those don't work, there are plenty of psychiatrists.

    There is one "sin" that Modern Medicine will make you feel guilty
    about: not going to the doctor. That's OK, because the doctor is the
    priest who takes away every other guilt. How much harm can there be in
    guilt that drives you to the doctor every time you feel sick?

    The doctor-priest gets away with a lot because he can claim to be up
    against the very Forces of Evil. When a priest is in a touchy
    situation and the probability for success is dismal, he escapes blame
    by saying that he's up against the Devil. The doctor-priest does the
    same thing. When the prognosis is not good, he retreats into his
    mortality and admits that he's only a man up against the Devil Then,
    if he wins, he's a hero. If he loses, he's a defeated hero — but still
    a hero. Never is he seen in his true light—as the agent of the Devil.

    The doctor never loses, though he plays both sides against the middle
    and takes bigger risks than necessary. That's because he has succeeded
    in identifying his rituals as sacred and potent regardless of their
    real efficacy. He uses his holiest implements to raise the ante and
    make the game more ominous than it really needs to be. If a mother
    comes into the hospital with her baby in the breech position and the
    fetal monitor says the baby is in distress, the doctor loses time in
    declaring it a life-and-death situation — which, indeed, becomes once
    he starts to perform a Caesarean-section delivery. Biologically, the
    doctor knows the C-section is dangerous. But game is no longer being
    played by biological rules. It's a religious game, a ceremony, and the
    priest calls the shots. If mother and child survive, the priest is a
    hero. If they die, well . . . it was a life-and-death situation anyway.

    The doctor never loses: only the patients lose. The adage that a
    doctor buries his mistakes still applies. We used to refer mistakenly
    to doctors as airplane pilots. If the plane goes down, the pilot goes
    down with it. But the doctor never goes down with the patient.

    Doctors also escape blame by claiming that their failures are caused
    by their successes. If you point out, for example, that a
    disproportionate number of premature babies seem to be turning up
    blind in premie nurseries, the doctor will say that it's the price you
    have to pay. "Gee, we managed to save these little I- and 2-pound
    babies. Of course they all end up blind and deformed. They'd be dead
    if we didn't save them." Doctors use the same excuse with the problem
    of diabetic blindness. The reason we have so much diabetic blindness,
    they say, is because we have succeeded in keeping so many diabetics
    alive longer. Doctors will use this "we managed to keep them alive
    longer" excuse for every disease they have trouble treating
    successfully — which includes all the major causes of non-accidental
    death. They absolutely ignore the biological facts that creep in and
    point the finger at Modern Medicine's mismanagement of both health and
    disease. Doctors even manage to get away with blaming their own
    disease on their successes. When you point to the large numbers of
    dishonest, unhappy, and just plain sick doctors, the excuse usually
    runs something like this: "The reason for the psychological disability
    is our tendency to be compulsive, perfectionistic, easily given to a
    sense of guilt if our clinical efforts fail." A president of the
    American Medical Association offered that one.

    Doctors protect themselves further through the sacred language of the
    priest. A religion must have a sacred language to separate the
    discourse of the priesthood from the lowly banter of the masses. After
    all, the priests are on speaking terms with the powers that seep the
    universe on course. We can't have just anyone listening in. Sacred
    language of doctors is no different from jargon developed by any
    elitist group. Its main function is to keep outsiders ignorant. If you
    could understand everything your doctor was saying to you and to other
    doctors, his power over you would be diminished. So when you get sick
    because of the generally filthy conditions in the hospital, he'll call
    your infection nosocomial. That way, you'll not only not get angry at
    the hospital, but you'll feel privileged to have such a distinguished
    sounding disease. And too scared to get mad.

    Doctors use their semantic privileges to make you feel stupid and
    convince you that they are genuinely privy to powers that you'd better
    not mess with. As long as their rituals are mysterious, as long as
    they don't have to justify them biologically, they can get away with
    anything. They're not even subject to the laws of logic. Doctors will,
    for example, justify coronary bypasses by saying that everyone who has
    one feels better. But if you ask to be treated for cancer with
    laetrile because everyone you know who has been treated with it feels
    better, your doctor will tell you that it hasn't been scientifically
    proved effective.

    Semantic isolation also serves to disenfranchise the individual from
    the healing process. Since the patient has no hope of knowing what's
    going on, let alone assisting, why allow him or her any part in the
    process at all? The patient gets in the way of the ritual, so get the
    patient out of the way. That's one reason why doctors aren't
    interested in helping patients maintain their health. To do that,
    they'd have to inform them rather than work on them. Doctors aren't
    going to share information, because that means sharing power.

    To back them up, doctors have an enormous tonnage of technological
    gadgets which proliferates alarmingly. First of all, the patient must
    stand in awe of the array of machinery the doctor assembles to attack
    his problem. How could any single person — other than the doctor, who
    has the power — hope to control such forces? Also, the electronic
    wizardry adds weight to the doctor's claim that he "did everything he
    could." If it's just a doctor standing there with a black bag, "all
    that he could" doesn't mean very much. But if the doctor throws the
    switches on $4 million worth of machinery that fills three rooms, that
    means he did "all that he could" and then some!

    Typical of any developed religion, the ceremonial objects in which the
    most power is concentrated reside in the Temple. The higher the status
    of the temple, the more machinery within the walls. When you get to
    the cathedrals and the little "Vaticans" of Modern Medicine, you are
    up against priests who have the weight of infallibility behind them.
    They can do no wrong, so they are the most dangerous.

    The reforms that have been introduced in an effort to solve some of
    the problems I've talked about in this chapter don't impress me as
    doing very much good. Rehabilitation programs, for example, don't
    really attack the roots of the sicknesses doctors seem to fall prey
    to. That may be a result of their shying away from exposing the
    problem as a disease of the core of Modern Medicine. Of course,
    doctors are not trained to attack the core of any problem, merely to
    suppress the symptoms.

    Attempts to keep doctors' knowledge up-to-date also do little good,
    since what doctors don't need is more of the same kind of information
    they received in medical school. That's precisely what they get in
    most continuing medical education programs. They're taught by the same
    people who taught them in medical school. Who's responsible for
    keeping them properly informed?

    As I've already said, you have to protect yourself. To do that, you
    need to remember the two major attributes of doctors: fear and
    arrogance. What you have to do is learn how to work on his fears
    without challenging his arrogance until you have the winning hand.
    Since doctors are scared of you and what you can do to them, you
    shouldn't hesitate to use that fear. Doctors are scared of lawyers,
    not because lawyers are so powerful but because lawyers can ally
    themselves with you, whom the doctor really fears. If a doctor does
    you dirty, sue him. It is in courts and juries that you're most likely
    to find common sense. Find a good lawyer who knows a lot about
    medicine and who is not afraid to put a doctor through the ringer. If
    there's one thing a doctor doesn't like it's to be in court on the
    wrong end of a lawyer — because that's one place where the patient has
    allies that can effectively challenge the doctor's priestly immunity.
    The increase in malpractice suits is encouraging, since it means more
    and more people are being radicalized to the point where they
    challenge the doctor's power to determine the rules.

    If your doctor gives you trouble but not enough to take him to court,
    you need to be careful about how much you challenge him —not because
    of what he can or cannot do to you, but because how far you go will
    determine your effectiveness. If a doctor threatens you and becomes
    angry, you should stand up to him. Don't back down. Threaten him back.
    When a person really threatens a doctor, the doctor almost always
    backs down if the person shows that he means it. Doctors back down all
    the time because they figure, "What do I need this one kook for?"

    It's important, though, not to threaten a doctor unless you are
    prepared to carry through. In other words, don't reveal your rebellion
    until you have to, until you have the emotional commitment and the
    physical capability to carry on a successful campaign. Don't get into
    an argument with a doctor with the hope of changing his mind on
    anything. Never say to the doctor who's treating you for cancer with
    traditional chemotherapy, "Doc, what do you think about laetrile?" You
    won't get anywhere, and you won't get any laetrile, either. Don't say
    to the doctor who recommends a security bottle for your baby, "But I'm
    breastfeeding and I don't want to do that." Don't bring your doctor
    columns from the newspaper expecting him to change his mind or try
    something new. Don't challenge him until you're ready with an
    alternative action. Do your own homework.

    What does a Catholic do when he decides that his priests are no good?
    Sometimes he directly challenges them, but very seldom. He just leaves
    the Church. And that's my answer. Leave the Church of Modern Medicine.
    I see a lot of people doing that today. I see a lot of people going to
    chiropractors, for example, who wouldn't have been caught dead in a
    chiropractor's office a few years ago.

    I see more and more people patronizing the heretics of Modern Medicine.

    -------
    "CONFESSIONS OF A MEDICAL HERETIC" is published by Contemporary Books: ISBN Number 0-8092-4131-5
  5. dobrydy

    dobrydy New Member

    Bravo, Tansy! Thsi stuff is gold and I plan to use for my students.