Is there a doctor in the house? Not for long.

Doctors like me have to go. That much is clear. Even though we have done nothing wrong.

The problem is simple: I was trained to provide the best care possible, to everyone, all the time—regardless of race, ethnicity, sex, sexual orientation, wealth, power, position, politics, cost, cleanliness, friendliness, consciousness, or anything else.


Hippocrates Frustrated - ICD-10-Patient-Care-Impact-Frustration


A Simple Recipe for Care

Mine was a simple recipe. And it worked every time.

I was taught to consider only that person sitting in front of me needing my care. I was not burdened with considering the needs of society or the world. I was not charged with correcting past societal injustices by others—whether based upon race, ethnicity, religion, social status, sex, sexual orientation, or any other characteristic.

Health care, I was told, is too important an arena for mean-spirited revenge. As an ER physician, I have kept gravely injured murderers alive so that they can stand trial for their crimes against others, many of whom I pronounced deceased myself. I have even been called to testify in some of those trials. It is not, I was told, my place to judge. And so I did not judge—anyone. I had my opinions, but they never left my mind. Nor did they influence the care that I provided. It made my job easier. And it was more fair, because who is to say that my personal judgments would always be correct? Most certainly they are not. Of that, I am acutely aware.

I was not asked to make my treatment decisions based upon cost or in such a way as to save anyone money or make anyone money. Though I was aware that a lot of money was being spent and made by someone based upon the decisions that I made, that someone was not me, and it could not be me. Those were the rules. I was glad for those rules. They, too, made my job easier.

I was not expected to fret over whether what I wanted to give the patient was affordable in a societal sense. To the contrary, I was intentionally blinded to the money involved lest the independence of my medical decision-making be compromised. I liked it that way. I still do.

I was taught that it was not up to me to choose the winners and losers in the raffle of life. I was assured that if I just did my job, and fought my hardest, for every single patient, the rest would take care of itself. And until Obamacare came along, for the most part, it did.

In other words, I was taught to practice medicine like it says in the Hippocratic Oath that we traditionalists still take seriously.

For that I am grateful. It does, however, make me like a fish out of water in this brave new post-Obamacare America.


No Country for Old Doctors

Because of my training and resulting philosophy, there is no place for me in the post-Obamacare healthcare delivery system. You see, we traditional physicians are unwilling to ration care. We are unwilling to ration care, because we know better than to do so. We recognize the inherent cruelty, immorality, and self-defeatism in our being transformed from caregiver to executioner, if only through the passive withdrawal of care. Or at least most of us do.

I still feel that it is not my place to judge. And yet Obamacare will force me to do just that—to judge my fellow man not even according to my own guiding principles, but rather according to the impersonal, cruel yardstick of a federal government hundreds of miles away from where both me and my patient sit, and lie, and struggle.

And so we traditionalists must go. It’s either that or change—in big, oath-shattering ways. We must become controllable. We must forgo exercising the very judgment for which we are trained in favor of the ill-intended edicts of self-serving, non-medically trained government bureaucrats, politicians, and insurance industry and Wall Street fat cats.

Some of us will simply leave and never look back. Medicine is a funny discipline. Once we leave it, though we retain the knowledge and skills, we rarely return. To return is far too painful. And so we continue to sit it out.

Doctor's Back in Green Scrubs - Handcuffed

Many will claim to be retiring early. If pressed, they will talk of spending more time with the grandkids, gardening, or traveling around the country in that RV that has been parked in the backyard for years. That is a much easier conversation.

While they may end up enjoying their retirement years, that is not why they left. I can promise you that. They left because they are unwilling to change. They left because they are unwilling to do their government’s bidding, hurting their own patients in the process. They left because they are unwilling to work as government robots. They left because they are unwilling to work for free, and under constant threat of financial ruin, imprisonment, or both—which is what the government now demands.

Those who cannot or will not leave the profession will change. Many will become unrecognizable, though they will look the same on the outside.

That is bad for us physicians. It is even worse for you, our patients.

The Brave New World of Obamacare

In case you doubt me, consider these facts:

The Affordable Care Act specifically gives certain nurses the right to introduce themselves to patients as “Doctor.” Why would that be, except to confuse the healthcare consumer about who—and what—their provider really is?

And lest you think this will be the exception rather than the rule, consider this:

According to a new study, the healthcare workers anticipating the greatest job growth over the next decade are not physicians or nurses. They are not therapists or any other trained medical professionals. Rather, the three healthcare job categories anticipating the greatest growth over the next decade (by quite a large margin) are:

(1) with 555,000 new jobs and 38.1% ten-year job growth: home health aides, who make an average of less than $22,000 per year and who have no formal education or training;

(2) with over 458,000 new jobs and 26% ten-year job growth: personal care aides, who make an average of $20,000 per year and who have no formal education or training; and

(3) with 599,000 new jobs and 17.6% ten-year job growth, nursing assistants, who make an average of less than $26,000 per year and who are required to obtain only a postsecondary nondegree.

Hmmm . . . All of the high-growth healthcare jobs are as untrained aides and assistants. Go figure.

Why is this concerning? Because once this anticipated job growth takes off, and once they all don white coats and introduce themselves to you as “Doctor,” you will not know the difference, that’s why.

And there is a difference. That is not being elitist. It is a fact.

As an emergency physician with literally decades of education and training behind me, I am trained to save your life in the event of an emergency. It is what I do. It is what I love doing. With all due respect to the wonderful job that they do under my supervision, a home health aide, personal care aide, or nursing assistant can do little more than call 911—even from iElder Care - Holding Hands - end-of-life-800 - RESIZEDnside the hospital. That is neither a criticism of them nor an exaggeration of my skills. It is a fact.

Even so, in a few years’ time (if not sooner), you will have no way of telling me from them. In fact, if things stay on their current course, I will not be around. And so you will be left with them. Unsupervised. Good luck with that.

Don’t get me wrong: They will smile sweetly, hold and stroke your hand gently, and hug you warmly. They will make you feel both valued and appreciated. They may even bring you your medications and take your vital signs. Will they save your life? No. Will they cure, or even provide you with a concrete way to manage, your disease? Not likely. Are they me? Absolutely not. And yet you will be left in their unsupervised, if kind, care. And that is a dangerous place to be.

A New Breed of Doctor

Of course, lots of folks will still be walking the halls of hospitals and clinics wearing long white coats and introducing themselves as “Doctor.” Some will be nurses and nurse’s aides, and some will be other ancillary staff.

Some will be actual physicians—with MDs and everything. The difference is that they will be educated in a way that is completely foreign to me. Those who are already practicing but unwilling to retire early will be “re-educated” along with them. That process has already begun.

Together they will be taught to consider medicine as not a personal, but rather a societal endeavor. They will be taught to practice “population-based medicine.” They will be charged with practicing “outcomes-based medicine” (which will function to exclude the sick and the elderly from receiving care, because their “outcomes” are less likely to be good despite exemplary care). They will be expected to address—and remedy—”health disparities” by making it easier for some (the historically disenfranchised) to access care, while preventing others (the historically favored) from doing so. In that way, they will be taught to deliver “medical justice” through the care that they deliver to real human beings, all of whom are innocent of any of the historic wrongdoing ostensibly being rectified.

They will be taught to practice medicine that is judgmental rather than accepting, that is punitive rather than comforting, and that is redistributive rather than fair.

In fact, this is already being done behind the closed doors of the nation’s predominantly liberal progressive institutions of medical higher education.

Don’t believe me? Consider this:

A New Breed of Medical School

The Affordable Care Act explicitly provides for the establishment and federal funding of government-run medical schools, ostensibly to meet anticipated “physician shortages” caused by the passage of the law itself. The statute furthermore explicitly provides that government-run medical schools will emphasize affirmative action in their admissions and advancement policies.

Loyola Stritch - Dreamers to Doctors - Promotional Ad 01 - D2D-Screening-Flyer-Web-2

To make matters worse, there is already a movement afoot throughout the existing medical school community advocating for unrestrained affirmative action that will ensure that the country’s euphemistically labeled “Dreamers”—meaning the children of illegal immigrants who are themselves in the United States illegally—are allowed to attend and graduate from the American medical school of their choice regardless of accomplishment and promise—and, apparently, citizenship. No doubt, they will also do so for free. Unlike your kids and mine.

I ask you: Do you want your surgeon to be a product of affirmative action—much less an illegal immigrant who is also the product of affirmative action? Call me crazy; but I’m guessing not. And yet he or she will be. And you will never be told the truth.

And the defendant is . . . no one.

If, Heaven forbid, you were to die on the table, your family will simply be told that nothing could be done. Only it could have, in the right hands. But they won’t know that. No doubt, your family will be told the tragic news by a sincere, tearful nurse’s aide who will actually believe the script that she has dutifully memorized. After all, she has neither the education nor the training to know better. And so her conscience is clear as your family breaks down before her.

Your distraught family may not even be told that much if—as the federal government tends to do—it does away with the ability of patients to sue those who provide care once those who provide care are all government bureaucrats rather than private folks like me. Ever wonder why the VA Health System can get away with providing such notoriously substandard care? That’s why—because no one can sue them. Because they are the federal government. Get my drift? It will be no different with Obamacare. Mark my words.

And how can you sue an ilGavel on White Background 01 - judicial-reformslegal immigrant? Do they even fall under the jurisdiction of the United States courts? What’s to keep them from fleeing back to wherever they came from? Again, you get my drift. Again, mark my words: This is not the last you have heard of this.

In fact, there is already serious talk among state and federal politicians and the medical elite regarding the establishment of a taxpayer- and physician-funded “funds” from which patients injured in the course of medical treatment are automatically reimbursed according to government tables and charts and projections. Whoopee!, the American people are told. No more lengthy, expensive, and exhausting trials! No need to prove your case! Just get in line for the cash that Uncle Sam is ready to dispense! After all, if you say you’re hurt, we can assume that your doctor screwed up, can’t we?

Are we all together on this?

I certainly hope not.

Think of such funds as strict liability for doctors like me. If you treat patients, you will pay them for their bad outcomes, regardless of the quality of your care.

While such a model benefits those who suffer minor injuries (or are not actually injured at all), it discriminates against those gravely injured by provider misconduct, who necessarily lose their right to sue in exchange for a pittance payment too small to cover their future medical bills. In the process, it deprives both patients and physicians of that most sacrosanct right, the right to a trial before a jury of their peers.

Finally and most importantly, it directly incentivizes hospitals and physicians not to provide serious care to old and gravely ill Americans, whose outcomes are notoriously bad despite quality care—precisely because they are elderly and ill, with depleted reserves. In a system of strict liability for bad outcomes, those folks represent too much risk. In fact, resulting payouts are a given. And so they must be let go. And they will—be let go, that is.

The worst part? No one will be the wiser.

It is the perfect plan for the perfect scam. It is also the recipe for government-sanctioned murder.

Kaiser to the Rescue: The Medical School of the Future

As we learned this spring, there is yet another wrinkle in the re-education of America’s physicians. And it’s a doozy.

It seems that the medical schools of the future will also be run by the very insurance and health administration fat cats who dutifully climbed into bed with the Obama administration and helped shove Obamacare further down your throats.

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Indeed, the first such medical school will be run by none other than the health insurance and healthcare delivery giant Kaiser Permanente. The new school, which will be located in Pasadena, California, will enroll its first students in 2019. Look it up.

So . . . the medical schools of the future will be run by the federal government and administered by the same corporate giants that already control the health insurance, healthcare administration, and healthcare delivery markets—in other words, the fattest of the Wall Street fat cats. And now they will control medical education as well. Even though they are the very individuals who stand to gain the most—and it’s a lot—from the denial of your care.

It is the ultimate self-serving, inside-dealing, corrupt monopoly. And it will kill us all if we let it.

Pretty Words for Ugly Actions

Yesterday, I published a blog post entitled, “Bad Influence: The 100 Most Influential People in Healthcare.” In that post, I decry the fact that that annual list is full of politicians and Wall Street fat cats and contains not one—not one, in a list of 100—practicing physician.

In the number 2 position, right under Barack Obama, is Bernard Tyson, Chairman and CEO of Kaiser Permanente and longtime Obama—and Obamacare—supporter.

Kaiser Permanente Sign 02 - KaiserPermanente05102012 - RESIZED

Upon announcing its plans to build the first government- and corporate-controlled medical school, Kaiser issued a press release stating: “Demographic changes in the U.S. population have created increasingly diverse communities. Physicians in the 21st century require cultural competency and fluency in order to meet the needs of their patients and to best serve their communities.”

Sounds reasonable, right? After all, who isn’t for “cultural competency and fluency?” And who doesn’t want to “serve their communities?”

Edward M. Ellison, MD, Kaiser’s Executive Medical Director, was quoted as stating, “We have an opportunity, even an obligation, to redesign medical education and be a catalyst for change.” He further opined that new generations of Kaiser-trained physicians “will be well-prepared to meet the total health needs of communities across the nation, including the necessary work of addressing health disparities.”

So . . . the new generation of Kaiser physician will “be a catalyst for change” and focus upon meeting “the total health needs of communities across the nation.” He or she will also strive to address “health disparities.”

Warning: That is liberal government-speak for “Gullible young doctors will be taught to consider society’s needs over your needs, and they will be taught to use your health care to correct historic injustices for which you are not responsible.” That, in turn, is code for “They will be taught to practice medicine in such a way as to make us rich and you sick.”

Please keep in mind that a bleeding heart cannot keep you alive for long.

Indeed, by their own admission, Kaiser’s stated mission is the very definition of redistribution and social engineering through health care. It is the main—and by far the most important—argument against Obamacare and socialized medicine.

It gets worse:

The same day as the press release, the LA Times published an article about Kaiser’s plans. As one of Kaiser’s most important objectives, Ellison told the paper, “Kaiser plans to train students as emergency medical technicians when they arrive at the school,” after which it will send them out “into the community, visiting patients’ homes.”

Hmmm . . . That seems suspiciously like they plan to provide a lower level of training, get the students out into the field quickly (where many of them will remain, having gotten accustomed to making money and having decided not to return to the classroom to become a doctor), and at the same time keep patients at home and away from the ER and hospital. That can be very dangerous, particularly in the hands of a wet behind the ears recent college graduate with no real medical school training.

That, too, is the very definition of intentionally rationing care by blocking patients’ access to that care. Because with all due respect, a young college kid with a medical bag and a stethoscope standing in your living room is about as capable of saving your life as that nurse’s aide dialing 911.

The point is so obvious that even the young LA Times reporter felt compelled to address it.  By way of a passing reference, she noted that critics of Kaiser’s plans worry “that a Kaiser medical school would focus on cutting costs that could negatively affect patient care.”

I don’t think there is any question about that.

History Repeats

The problem is as old as the history of dictators and despots. It is also as filled with the tragedy of needless human suffering and death as are their tales of conquest and defeat through the control of human beings.

Hitler's Physicians - Karl-Brandt Sentenced to Dealth by Hanging - RESIZED

Physician and Nazi Officer Karl Brandt being sentenced to death by hanging by the Nuremberg War Crimes Tribunal, 1947.

Keep in mind that one of the very first steps that Adolf Hitler took was to require all physicians—in both Germany and its German-occupied neighboring territories—to swear an oath promising—innocently enough, it seemed—to treat their individual patients in accordance with their social utility and for the good of German society rather than the individual.

More specifically, the order of the Reich Commissar of 19 December 1941 read in part as follows:

“It is the duty of the doctor, through advice and effort, conscientiously and to his best ability, to assist as helper the person entrusted to his care in the maintenance, improvement and re-establishment of his vitality, physical efficiency and health. The accomplishment of this duty is a public task.”

To their credit, the physicians of the Netherlands immediately recognized the new oath for what it was—a directive to ration care. According to Leo Alexander, MD, Chief U.S. Medical Consultant at the Nuremberg War Crimes Trials, the physicians of Holland recognized Hitler’s oath as “the concentration of their efforts on mere rehabilitation of the sick for useful labor, and abolition of medical secrecy.”

Alexander continued: “Although on the surface the new order appeared not too grossly unacceptable, the Dutch physicians decided that it is the first, although slight, step away from principle that is the most important one.”

They refused to obey Hitler’s order to take the oath. All were stripped of their medical licenses and put out of business. Many were imprisoned. Many were eventually murdered in cold blood for their refusal to take the oath and practice medicine according to Hitler’s directives.

Of those physicians who took the oath, Hitler gradually transformed them from caring healers into cold-blooded killers. They let him, because they had no choice. Soon, they became the monsters Hitler had envisioned—his personal army of killing machines. They became professional torturers, and maimers, and executioners without kindness, or mercy, or compassion, or pity. They became utterly soulless.

A Dark Path to a Dead End

Dark Path 01 - dark_path_2_by_stephariara - RESIZED

We are on that same dark path. It is an overgrown path at first discovered, then cleared (with the help of an optimistic community of believers), by all dictators, despots, and social engineers. It is the same path that, once unburdened of its wild overgrowth, is walked—first enthusiastically, then willingly, then reluctantly, then fearfully—by all civilized societies that embark upon the practice of socialized medicine. All believe that they will be different. None are. Ever.

Kaiser is Obama’s Josef Goebbels. While Kaiser paints happy pictures for young reporters of optimistic young doctors caring for the world, that is propaganda. It is pretty wrapping obscuring a most ugly package. Once that package is unwrapped and the beast springs forth into plain sight, it will be too late. By that time, the beast will be grown, unleashed, and uncontrollable. Just like Hitler’s army of physicians. Even the most casual student of history—and of medicine—knows that.

Heaven help us all. For this sad story will end no better for us than it did for Nazi Germany. Because it never does end well.

That, too, is a fact.

Welcome to Obamacare. I’m sure you’re going to hate it. You’re also going to fear it, for good reason.

Those are my thoughts. Please let me know yours.







Bad Influence: The 100 Most Influential People in Healthcare

Leave it to the healthcare establishment to snub its own heroes—physicians, nurses, and other providers of care—real heroes who go above and beyond and save countless lives, all in a day’s work. Leave it to the healthcare establishment to overlook its own in favor of the government and Wall Street fat cats who are trying to put them out of business.

It’s called propaganda. And whether you realize it or not, it surrounds you.

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Modern Healthcare is a leading publication and research institution serving America’s healthcare providers and healthcare systems. Every year, they publish a list of the “100 Most Influential People in Healthcare.” They just published their 2016 list. And it’s a doozy.

Some of the entries, while dismaying, are not surprising.

The Politicians

For the third straight year, Barack Obama has been named the number one most influential person in healthcare. Go figure. If by “influential” you mean the most destructive, I suppose Obama’s placement at the top of the list makes sense. More on that in a moment.

Obama is in good political company on the list, which is slightly more surprising.

Joining Obama at the top of the list are the anticipated individuals who gave you Obamacare. These include at number 5 Silvia Mathews Burwell, Secretary of the United States Department of Health and Human Services (HHS) and, at number 9, Marilyn Tavenner, disgraced former administrator of the United States Centers for Medicare and Medicaid Services (CMS). Tavenner currently serves as President and CEO of America’s Health Insurance Plans. Go figure. It seems no one in Washington actually loses their job these days.

Burwell and Tavenner are joined by Andy Slavitt, the current acting administrator for CMS (#10), Patrick Conway, Deputy Administrator and Chief Medical Officer for CMS (#26), Thomas Frieden, Director of the Centers for Disease Control and Prevention (CDC) (#28), and Karen DeSalvo, acting Assistant Secretary of Health for HHS (#31). Next up is Francis Collins, Director of the National Institutes of Health (NIH) (#53), Robert Califf, Commisioner of the U.S. Food and Drug Adminstration (FDA) (#61), and Mark Chassin, President and CEO of the Joint Commission, the body that accredits and certifies American hospitals and clinics (#65).

Finally, there is Vivek Murthy, Obama’s controversial (and largely publicly absent) Surgeon General. Murthy, an Indian American physician born in Great Britain, is married to a Chinese American physician. Together they run a national physicians’ organization dedicated to liberal progressive healthcare reform. Murthy publicly declared gun violence a threat to public health, leading many to conclude that he would like to see gun control shoved in through the Obamacare back door. That almost cost him his appointment to the Surgeon General’s post. Even so, Murthy came in a surprisingly low 73rd. I guess he was a little too absent from the Obamacare debate, when he could have done so much for the liberal progressive cause. Oh, well.

Whew! But wait! We’re not done with the politicians yet!

I know what you’re thinking: But the list is only 100 entries long! Why so many politicians?

Which is exactly my point. But I digress . . .


US Capitol - Large Banner - Capitolhill


Then there is the group of politicians—and politicians posing as non-politicians—who are slightly more surprising given that they have done absolutely nothing of record for the sake of health care—unless, of course, you consider opposing those seeking to inject a modicum of sanity into an increasingly insane system to be “influencing healthcare.” Those include U.S. Attorney General Loretta Lynch (at a surprisingly high #11), Speaker of the House Paul Ryan (an equally surprisingly high #13), and Senate Majority Leader Mitch McConnell (#32). Rounding out the group from the other side of the aisle (or wherever it is that he hails from these days) is U.S. Senator, longtime Independent, and former Democratic presidential candidate Bernie Sanders (#15). Then there are the political outliers, including John Edwards, Governor of Louisiana (#35), joined by Kentucky Governor Matt Bevin (#89).

Finally, there are the non-political politicians whose inclusion should make every decent and informed American scratch his or her head: At number 19 is the Honorable John Roberts, Chief Justice of the U.S. Supreme Court, who virtually single-handedly secured the survival of the inaptly named Affordable Care Act (ACA). Roberts is joined at number 54 by his colleague on the High Bench, the Honorable Anthony Kennedy, the High Court’s notorious “swing vote” who dutifully swung in Roberts’—and Obama’s—direction when it came to the ACA. No coincidence there, I’m sure.

Nor is it any coincidence that not a single justiUS Supreme Court - supremecourt - CROPPEDce who opposed the constitutionality of the ACA—even for reasons espousing a firm understanding of the American healthcare delivery system—is included in the list. To the contrary, the most vocal among them, the Honorable Antonin Scalia, the ACA’s most outspoken critic, died alone in a remote part of Texas, was pronounced deceased of natural causes by an individual who did not know him, never met him, did not travel to the location, and in fact never examined, much less investigated, anything. After refusing to conduct any inquiry whatsoever (or even, apparently, send any federal officers to the scene), arrangements were quickly made to cremate Scalia. As if that weren’t enough, the ever-self-absorbed Barack Obama again treated us to a disgraceful show of disrespect by refusing, oh-so-publicly, to attend Scalia’s Funeral Mass on a lovely Saturday a few days later during which Obama had nothing better to do. Again, I’m sure there is no connection. None at all. Nothing to see here.

Altogether, 20 of the 100 individuals honored are politicians, the heads of federal government healthcare bureaucracies, or idologues masquerading as objective jurists. So 20% of the list is made up of the D.C. powers that be. Got it.

What about the other 80%? That is even more dismaying.

Health Insurance and Wall Street Fat Cats 

Man Holding Money 01 - 47536562To make a painfully long story short, 65 out of 100 spots went to the healthcare insurance and Wall Street fat cats. That’s right: The guys who have already made themselves rich at the expense of your health, including those who just grabbed the money and ran—away from the Obamacare exchanges that they convinced you to adopt. This group includes the CEOs of most of the country’s largest and most profitable insurance companies, healthcare systems, healthcare federations, associations of healthcare professionals, and healthcare managers. Also included in the list are the well-heeled heads of ancillary providers such as Big Pharma. Also included are some of nation’s largest healthcare technology giants—who, like their corporate colleagues on the list, publicly supported Obamacare, with its onerous technological mandates, in exchange for promised—and now delivered—wealth and control beyond what we regular Americans can even fathom.

Okay. So between the politicians and the industry fat cats, we’re up to 85.

Yikes! We’re running out of spots!

Quasi-governmental Agency Leaders

Just wait: With only 15 spots remaining, guess who garnered 13 of them? Why, the illustrious heads of quasi-governmental agencies and foundations that also lent their public support to Obamacare while cashing in behind closed doors. These include the presidents of such quasi-political, quasi-professional membership associations as the American Medical Association (AMA), the American Nurses Association (ANA), the National League for Nursing, the American College of Healthcare Executives, and the American Association of Nurse Practitioners. Joining them are the executive directors of the union National Nurses United and the American Public Health Association. Also joining them are countless  heads of other ideologically motivated so-called “professional organizations” that serve everyone except their real, working members.

With only two spots left, the editorial board of Modern Healthcare had to be discriminating.

The Final Two

Coming in at number 41, the 98th spot went to Atul Gawande. Gawande, a professor, author, and speaker from the Harvard Medical School, has spent most of his career criticizing his own profession and devising overly simplistic “checklists” that, according to Gawande, will prevent medical errors. Only they don’t. But that’s another blog post for another day.

Drumroll, please . . .

The last and final place of honor on the Modern Healthcare list of the 100 Most Influential People in Healthcare for 2016 goes to . . .

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Cecile Richards, President of the Planned Parenthood Federation. You know—the national organization started by a confirmed racist and eugenicist that today trades in free abortions for poor minority women and the auctioning off of the partially formed body parts of their aborted fetuses. You know—the same organization that is now using the Zika crisis to advocate, yet again, for unrestricted access to free late-term abortions.

You know—the organization that engages in the abject practice of genocide, all the while claiming to champion “women’s rights.” (Except, of course, the rights of women not to have their children murdered and their tiny bodies sold off like so much meat. Or the rights of baby girls who will never even be given a chance at life, much less an opportunity to exercise their feminist rights. Or the rights of the scared young women whom they dupe into believing that they are exercising a personal freedom, all the while knowing that it is only later in life that those same women, upon becoming mothers, will likely be traumatized by the magnitude of what they did out of desperation, fear, manipulation, and ignorance of their options—which are many, happy, and life-saving.)

That Cecile Richards. Right. Let’s honor her. What a feminist and healthcare hero.

The Final Tally

So there you have it:

In a list of 1Hippocrates - With Hippocratic Oath 01 - hippocrates200 supposed “movers and shakers” in healthcare, we have: (1) one U.S. President taking the number 1 honor for the third year running, who ran roughshod over his own Congress and the American public that elected him in enacting and defending the very law that will increase our suffering and hasten our death; (2) 19 other politicians who have done . . . what, exactly, for healthcare in America? Anyone? Anyone?; (3) 65 of the heads of the country’s wealthiest insurance, pharmaceutical, health care administration, technology, and other corporate conglomerates who sold out the American people by publicly supporting Obamacare even as they arranged—and collected—their own bailouts behind closed doors; (4) 13 equally well-heeled heads of quasi-governmental bodies that likewise supported Obamacare publicly while polishing their golden parachutes in private; (5) a Harvard academic who has spent the better part of his career criticizing and oversimplifying what his colleagues—unlike him—still actually do for a living in an increasingly hostile healthcare environment; and (6) the President of Planned Parenthood, which trades in free, on-demand abortions and the selling of fetal body parts.

These are the “most influential people in healthcare?” Seriously?

What in the world do you suppose Hippocrates would have to say about this list?

A Matter of Definition

I guess it depends upon how you define “influential.” If by “influential” you mean the 100 people who did the most to destroy the American healthcare system, then the list is pretty darned accurate. On the other hand, if by “influential” you mean the heroes of healthcare, not so much.


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Where did all the doctors go?

There is one very large and diverse group that was left completely off of the list. Not one entry. Not one out of 100.

That is practicing physicians, nurses, and other healthcare providers. You know—the ones who get up most days weary from the day before, put on scrubs and a white coat, and take care of folks in need. The ones who have not traded in their stethoscope for a Rolex and their dingy call room for an oceanfront vacation home. The ones who you hope are working when illness or injury strikes you.Young Doctor Studying at Table 01 - 8617738979_98826c79fe_o - RESIZED

Healthcare’s Real Heroes

Since Modern Healthcare won’t do it, I will tell you who the heroes of healthcare are:

They are the young medical resident working his 18th, or 24th, or 30th hour in a row without sleep, food, or a moment to himself so that your needs are met no matter the hour.

They are the local ER physician who misses sleep, food, and major events in his own and his family’s lives so that when illness or tragedy strike, he will be there for you.

They are the beaming obstetrician who Medical Resident with Newborn Baby 01 - 20150618_0371 - CROPPED AND RESIZEDbreathes a sign of relief, smiles broadly, and discreetly wipes away a tear as she completes her 1,000th delivery of a healthy baby, who was prepared to pull out all the stops and cry tears of frustration and pain had things not gone so well—which happens more often than she would like, but thankfully far less often than the joyous deliveries.

They are the dedicated cancer doctor who specializes in not only eradicating that most dreaded of diseases, but also in holding the hands of the suffering as they bravely battle their way toward certain death.

They are the dedicated family physician who, in the middle of the night, trades his warm bed and comfortable pajamas for a snow-covered car and a pair of mismatched scrubs as he heads, for the third time in 24 hours, back to the hospital across town because a patient needs his help or simply wants to hold his hand.

They are the idealistic young doctors and nurses who fly to faraway lands to care for those without the benefit of hospitals, doctors, and medications in an efforSalvation Army Clinic 01 - c8811cbb-3a9f-47e4-a54d-a02c0a81faa5_Picture31t to make not only our great nation, but also the entire world a better, happier, healthier, safer place to live.

They are the nurses, midlevel providers, therapists, and other clinicians who work alongside the nation’s physicians to care for those in need. They are the ones who specialize in heartbreakingly human maladies that know nothing of the rising and setting of the sun, family vacations, and other personal luxuries.

They are the doctor who will one day be there for you to pull you back from the brink—of pain and despair, if not death. They are the doctor, like me, who will be there for you just because you ask.

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Because in that moment, there will be no discussion of politics, or money, or your “right” to care. There will be no consideration of what is right for society if that is not also what is right for you.

In that moment, there will be only you and me. Neither of us will be rich. Both of us are likely to be tired, and overwhelmed, and afraid. That, however, will not matter, for we will have something far more important than money, or rest, or nerves of steel.

In that most private of moments, despite the bustling activity around us, we will have a quiet connection. A real, human connection. We will care. We will be there for each other. We will trust each other. And we will get the job done, the government and Wall Street be damned.

We will have no choice—for unlike them, we have no boardroom to which to retreat. Nor do we have a golden parachute to transport us to safety.

When the going gets tough, unlike them, we will get going. Together we will stare down the beast, come what may. Together we will see you to safety, whether in this life or the next.

Because that is what we do. We do it not for fame, or weath, or recognition. We do it for each other.

Modern Healthcare can have its list. I’ll take holding your hand any day of the week.

Those are my thoughts. Please let me know yours.



The New Wage Wars: Physicians and the “Maximum Wage”

There is a new wage war brewing in the United States. The federal government says that doctors are paid too much. Is a “maximum wage” for physicians next?


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The New Wage Wars

Thanks to Bernie Sanders, this election year has seen a reinvigoration of the liberal Democrats’ ever-advancing war on free markets and at-will employment. Referring to this latest political skirmish as the “Fight for 15,” they seek to mandate a so-called “living wage” that, as we all know, will actually result in the intended beneficiaries losing their jobs. It is a typical liberal Democratic initiative that will punish the very individuals it claims to help.

Ironically, those same liberal Democrats—and the federal government bureaucrats who work for them—have no problem arguing the opposite case when it comes to the country’s physicians. Doctors, it seems, make too much, and therefore should be limited to a federally imposed, one size fits all “maximum wage.”

Unfortunately, in today’s post-Obamacare America, this outlandish and blatantly unconstitutional position has teeth. It is also being enforced at hospitals around the country.

Welcome to Obamacare. The outlook for your future care is very bad, indeed.

Don’t believe me? Sounds outlandish? Well, read on . . .

Making Examples of the Nation’s Hospitals

It was recently announced that Lexington Medical Center located in Columbia, South Carolina will pay the federal government $17 million to settle claims that it paid its employed physicians too much. Sadly, Lexington is not alone. In the last year alone, another South Carolina hospital and two Florida hospitals paid the federal government $72.4 million, $69.5 million, and $118.7 million respectively to settle similar lawsuits. And there are many other stories where those came from.

So . . . what is going on?


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The Obamacare Dilemma

Having forcibly shoved Obamacare down our throats, the federal government now has a few very serious problems:

First, doctors, like everyone, cannot, and will not, work for free.

Second, the biggest consumers of Obamacare—that is, the previously uninsured and those who are in the country illegally—have no intention of paying any health insurance premium, no matter how ostensibly “affordable.” For its part, the federal government has no real recourse aside from penalties that those same folks likewise have no intention of paying. Anything more forceful is a political non-starter and would alienate their base of entitlement voters.

Third, because the biggest utilizers of Obamacare are not paying a dime for the privilege, they are spending other people’s money. And we all know how that turns out: costs escalate as quality plummets. It is a basic law of economics, markets, and human nature that no politician or government bureaucrat can overcome.

Between rising healthcare costs (of which physician salaries is a less-than-minuscule component), the need for subsidies, and the tendency of the subsidized to overspend (among other factors), any way you slice it, Obamacare is simply unaffordable.

To add to the government’s problems, healthcare is also notoriously difficult to regulate in the trenches. After all, the practice of medicine involves highly skilled and trained professionals making constant (and often snap) judgments involving both art and science. How is a government bureaucrat with a degree in political science going to keep up, much less catch the healthcare “bad guys” in the act, when he doesn’t even understand their language?

Finally, many in the country still respect physicians. Most actually love their own physician. With marching orders to divide and conquer, how is that same government bureaucrat to turn physicians into villains, much less public enemy number one?

The Federal Government’s Solution

All of these problems are solved by the federal government’s newest tactic in its 100-year war on physicians: Suing hospitals for paying their employed physicians too much. While the rest of the country argues over raising the country’s minimum wage, physicians are quietly being clubbed over the head by a federal government intent upon applying a “maximum wage” restriction to them alone.

Of course, such a thing is frankly unconstitutional. Of course, that never stopped the D.C. powers that be.

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This is how doctors will have their pay effectively lowered, and lowered, and lowered until such time as they become dramatically underpaid and thus are forced to quit practicing medicine. This, of course, will solve the Obamacare problem of physician compensation—especially when the government makes good on its promise to replace physicians with those with less training and experience, who in turn will accept lower wages—for a time. Then they will quit, and someone even less qualified will be hired. They, too, will accept less, until they, too, quit, at which time someone even less experienced—and less expensive—takes over. They, too, . . .

You get the point: It is a never-ending downward spiral of increasing ineptitude. After all, you get what you pay for. Health care is no exception to that universal rule.

You will be told that physicians are willingly leaving the country at the mercy of a doctor shortage because they are greedy and do not care about your needs or your health. In actuality, they are being forced out by a federal government that is driving them into forced servitude and personal poverty. When it comes down to a choice between practicing medicine and sending your children to college, or between practicing medicine and paying the light bill, then things can get very oppressive very fast. And for the nation’s physicians, they are—at lightning speed.

Calling in Reinforcements

The whistleblower nature of these lawsuits also solves the enforcement problem. By effectively incentivizing disgruntled physicians—who are in so short supply these days—to snitch on their colleagues for their own personal gain, it turns physicians into the federal government’s eyes and ears—and expert witnesses—on the hospital floors.

Nowhere is this effect more apparent than in the Lexington case. Lexington paid the federal government $17 million to settle claims that it paid its employed physicians to refer patients to the hospital for the care that they needed. One neurologist employed by the hospital collected a paycheck from the hospital, yet sent his patients elsewhere for care. Of course the hospital “pressured” him to utilize their facilities—they were paying his salary! After he was fired, he went to the federal government, which promptly filed a whistleblower lawsuit on his behalf. According to the government, paying the neurologist’s salary gave the hospital no right to pressure him into treating his patients at the hospital. That paid his salary. I kid you not.

The tattling physician’s take? A cool $4.5 million for doing absolutely nothing. He will never have to work another day in his life. He also gets his revenge against a former employer. No doubt, he was motivated by bitterness over the hospital’s having purchased his practice and turned him into an employee. Of course, the necessity of such a mutually distasteful employment arrangement was the fault of neither the hospital nor the neurologist. If you must blame someone, blame Obamacare—and the same federal government that shook down Lexington for $17 million while throwing a “finder’s fee” of $4.5 million to the newly wealthy tattle-tale. It’s a sweet deal for both. For you and me? Not so much.

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Finally, lawsuits like the one in South Carolina assist the federal government in its never-ending quest to vilify doctors and hospitals so that it can continue to punish and control them at will and with the public’s approval. They allow the federal government to take a public “victory lap,” at the same time giving the public the impression that it is “cracking down” on “bad doctors” and “bad hospitals.” You know the drill: Publicly vilify your target, excoriate them in the oh-so-compliant press, then take them out. That is what is happening here.

And best of all for the government, it is a rigged game—an unfair fight. Since they are the federal government, they simply pressure the hospitals until they have to settle. The hospitals have no choice. Guilt, and the breaking of laws, has nothing to do with it.

Show Us the Money—Or Not

In case you were wondering, absolutely none of the money collected from these sham lawsuits will be used to fund the care that you receive. Instead, it will go straight into the pockets of: (1) the government bureaucrats who approve the lawsuits; (2) the government lawyers who bring them, pretending to practice law while knowing that all of the cases will settle; (3) the judges who approve these forced and planned extortions masquerading as settlements; and, of course, (4) those who contribute nothing yet continue to receive Obamacare subsidies while the rest of us working stiffs are priced out of the insurance marketplace altogether and, eventually, denied the care that we need for our troubles.

This, of course, allows for greater redistribution. It works out for everyone—except you and me.

Bad Medicine

None of this improves the quality of your health care. Nor will it lower the cost of that care. But then again, as I have warned many times over, Obamacare has nothing to do with the quality or cost of your care. To the contrary, the law is designed to destroy the care that you receive. And it is doing just that.

Here is the point:

Hospitals are now being sued by the federal government for paying their employed physicians too much.

How can that be?

So-called “whistleblowers” make millions of dollars—for some, tens of millions of dollars—for doing nothing more honorable than snitching on their former employers—again, for ostensibly committing the “new crime” of paying physicians too much for doing one of the most difficult jobs in the world.

Ask yourself: Exactly how much is too much? How much is a good physician worth? Is physician compensation one size fits all?

What if we suddenly said that CEOs could not be paid “too much” regardless of their qualifications and value to the companies they run? Or attorneys? Or painters, plumbers, or roofers? Or the guy who mows your lawn? Or you?

That’s right: No one would stand for it.

Somehow, when the victims are physicians, it is just fine. Go figure.

So . . . In a world where employed physicians’ salaries are already dropping precipitously, how long will it be before physicians are making less than any other professionals? Or, for that matter, your local manual laborer?

That’s right: Not long.

And when that happens, how many of the best and the brightest academics are going to choose to go into medicine in return for a government-mandated “maximum wage?” How many are going to be willing to go through decades of medical training, stay up endless nights, work countless weekends, miss important events in their own families, and risk being sued at every turn—again, in exchange for a government-mandated “maximum wage” that will be far less than their college classmates are making? How many will forgo caring for their own family’s needs so that they can care for the needs of others?

Most importantly, how many will be there to respond to the call when you need them?

That’s right: None.

Welcome to rationed care, compliments of the federal government.

The Obamacare ride is getting bumpy. Better hold on tight.

If Hillary Clinton wins in November, things will get much worse. Brace yourselves. As the liberal Democrats get their wish of a McDonald’s minimum wage that starts at $15, is indexed for inflation, and goes steadily up from there, physicians—your physician—probably won’t be paid enough to live on.

What do you think that will do to the care that you receive?

That’s right: It will destroy it.

Welcome to Obamacare. You’re going to hate it.

Please let me know your thoughts.