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John Livingston

Organized Medicine — Organized Corruption and Tuskegee Revisited

Organized medicine in all the modern Western Countries over the past 100 years has been at best progressive and in selected instances fascist in its application of moral and ethical standards. For conservatives, the predicate for any policy position or legal edict can be found in Biblical and Natural Law Principles. We look backwards to go forward. By placing God at the center of our moral arguments we remove ourselves from any agency position we might have individually. We look outward when making moral judgements. Progressive liberals look inward in making emotional decisions. The respect and esteem that the previous generations of physicians and surgeons have earned for those now currently practicing the art and science of medicine has been seriously eroded over the past 30 years by organizations like The American Medical Association, The American College of Surgeons, and The American College of Physicians—and in our State The Idaho Medical Association.

These organizations have evolved from being “guilds”, organizations that oversee the practice of the craft and trade of Medicine, into sophisticated organizations more analogous to trade unions like the AFL-CIO and The National Education Association (NEA) The wellbeing of patients has taken a backseat to the financial and political positions of the professional class they represent. And let’s not get medical ethics and morality mixed up with THE LAW. Under the cover of law and with the support of the medical professional organizations in Nazi Germany, 8 million Jews and other marginalized ethnic and religious groups had their lives terminated. All legal. In our own country and in my own professional lifetime and under the cover of “science” let us not forget the Tuskegee Experiment—all legal. Where was the outrage in the world of organized medicine or in the legal community? It was all “legal”. Certainly not moral. And one of the lessons to be learned from “Tuskegee” was that the perspective that the (CDC) and the (PHS) had and have today is toward the “common good” or the “herd”, not the wellbeing of individual patients.

We saw this in the top-down Command and Control approach to Covid public health policy. This was enforced Federally by the threat of withholding not only Covid funding to providers—hospitals and practitioners, if they didn’t adhere to clinical guidelines—Best Practices”, but also by Governors and Health Districts who wanted to maintain an access to the gravy train of “Covid Dollars”. A doctor advising a patient and making an individual clinical decision that was best for the patient and not for society, was subordinated to Public Health Policy—just like the Tuskegee Experiment. And what did Stalin say—”An individual death is a tragedy; a million deaths are a statistic”

The Tuskegee Study of Untreated Syphilis in the Negro Male[1][2][3] (informally referred to as the Tuskegee Experiment or Tuskegee Syphilis Study) was a study conducted between 1932 and 1972 by the United States Public Health Service (PHS) and the Centers for Disease Control and Prevention (CDC) on a group of nearly 400 African Americans with syphilis.[4] [5] The purpose of the study was to observe the effects of the disease when untreated, though by the end of the study medical advancements meant it was entirely treatable. The men were not informed of the nature of the experiment, and more than 100 died as a result.

Today I received an e-mail from my professional organization—The American College of Surgeons. The opening paragraph follows:

The American College of Surgeons (ACS) has long opposed governmental interference in the clinical practice of medicine and in the privileged physician-patient relationship. The Supreme Court’s decision in Dobbs v. Jackson Women’s Healthwill allow states to eliminate access to reproductive services for women and will jeopardize the autonomy of this relationship. We are concerned that this decision will impact the availability of comprehensive and safe reproductive healthcare services.

Talk about “cherry picking” an argument. In my most humble opinion nobody has done more to erode the “doctor patient relationship” than the American College of Surgeons. Their support for The Affordable Care Act (ACA) and Covid top-down policies and economic incentives that did not benefit patients but benefited large vertically integrated health care networks (big hospital systems) who now employ most physicians in our country making professional codes of ethics defining the doctor patient relationship subordinate to employment contracts with no compete clauses. Requirements to adhere to institutional “accepted clinical guidelines” promulgated from Federal Agencies, and edicts from hospital administrators have replaced clinical judgement and the doctor patient relationship.

Most physicians that hold leadership positions in these “professional” organizations are not self-employed. They work for large hospital systems or a university. The former group may even receive most of their compensation from the organizations they are employed by and not from direct patient care. Kind of like professional athletes receiving appearance fee income. Many academic physicians receive most of their wages from government grants or from pharmaceutical companies. In either case the patient is not at the center of the professional or financial transaction. Sounds like “the common good” is becoming more important than the doctor patient relationship. Sounds like Tuskegee revisited.

These organizations are self-serving and don’t speak for me or my patients. They are more aligned with the interests of large pharmaceutical companies, health insurance companies, and large hospital systems. Certainly, a formidable force when an individual patient is looking for health care answers for themselves and their families. Remember the cry of the Obama Care sycophants? Access—Quality— Cost. How is that working out in 2022? Waiting times are longer. Quality has taken a backseat as the productivity of employed physicians has gone down by 15%, and Costs have skyrocketed—I mean there is a price for paying CEOs of hospitals $18 million/2 years.

Corruption and cronyism are rampant in health care the National and State level. Organized medicine is at the center of it.

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