The Wisconsin Protests and the New Medical Ethics
During the recent Wisconsin protests pitting the public-sector teachers’ union against a governor attempting to rein in their overly generous benefits, several doctors were caught on camera apparently handing out fake work excuses to the protesters. Although this might seem an outrageous breach of professional ethics, it is actually entirely consistent with the new brand of “progressive” medical ethics currently taught to medical students. And these apparent breaches of professional ethics displayed in Wisconsin may be an ominous foretaste of future problems Americans can expect under ObamaCare.
In Madison, Wisconsin, the MacIver News Service spotted a group of people in white coats purporting to be physicians agreeing to sign “sick” notes for protesters in seemingly excellent health, thus allowing them to miss work without penalty. One doctor signing notes was apparently a clinical associate professor of medicine at the University of Wisconsin.
One blogger posted the fake “sick” note he received from the doctors. He observed, “I am not a teacher, but I managed to get a note. They did not ask for any identification or where I might teach. They were literally handing these out to anyone and everyone.”
University of Wisconsin law professor Ann Althouse spoke with one of these doctors who was completely unapologetic for his actions, saying that it was “not dishonest” but rather “an ok thing to do” because it was in the interest of “social activism.”
These sorts of moral rationalizations are an entirely predictable outcome of the new form of “progressive” medical ethics being taught to American medical students.
Most Americans are familiar with the traditional version of medical ethics, in which a doctor’s primary responsibility is to his patient. As Dr. Jane Orient explains, “Traditionally, medicine is practiced by physicians, one patient at a time…. The standard of care is the Oath of Hippocrates: providing treatment for the good of each patient according to the best of the doctor’s ability and judgment.”
In traditional medical ethics, a doctor’s primary responsibility is to tell his patients the truth and to treat his patients according to his best honest judgment, skill, and ability.
But a new form of medical ethics is being taught in medical schools that tells doctors to place the needs of “society” ahead of individual patients. At best, it forces doctors to juggle the truth and the interests of their patients alongside “social” considerations. At worst, it will give them license to sacrifice their professional integrity (and their patients’ interests) in the name of “society.”
In 2002, the American College of Physicians proposed a charter in which the three guiding ethical principles for physicians would be: patient welfare, patient autonomy, and “social justice.” In 2007, the AMA ITME (American Medical Association Initiative to Transform Medical Education) reported on the importance of training medical students to be better advocates for “social justice,” and proposed changes in the medical school admissions criteria and curriculum to address this perceived inadequacy.
As a result, medical schools are now increasingly admitting students based not on competence in the sciences, but rather on their commitment to “social accountability.” Medical school ethics courses are thus increasingly emphasizing “social justice” over traditional notions of ethics — or the individual patient’s welfare. But “social justice” is frequently just a euphemism for a socialist political agenda of leftist politics, redistribution of wealth, and heavy state controls over the marketplace.
This new approach to medical ethics was exemplified clearly by the young family medicine physician who told Ann Althouse that writing questionable work excuses was morally proper (“an ok thing to do”) because it served the greater “social” goal of helping the Democratic-backed government employee union against the Republican governor.
But what happens when this new breed of doctors start applying those same ethical principles in regular clinical practice? Under ObamaCare, many of these physicians will no longer work in traditional private practice but rather in large Accountable Care Organizations (ACOs) where they will treat patients according to government-specified “cost-effectiveness” guidelines. These guidelines will often be constructed to save money for the government entities paying the bills (such as Medicare and Medicaid), even at the expense of the patient’s well-being. We’ve already seen this in the government’s recently failed attempt to impose similar cost-effectiveness guidelines that would have restricted screening mammograms to women over age 50 (even though research has shown a clear medical benefit to starting screening mammography at age 40).
Fortunately, numerous doctors chose to ignore those guidelines and continue practicing in their patients’ best medical interests according to their traditional ethical training. And under pressure from outraged physician and patient groups, the federal government eventually withdrew those “cost effectiveness” mammography guidelines.
But what will happen under a new generation of doctors who have been taught that the individual patient’s welfare must be balanced with “social” considerations — such as the cost to the government or to “society”? Suppose you see one of these newly trained doctors at the local Accountable Care Organization because you are suffering from the worst headache of your life. He performs a brief physical exam, then tells you that according to the new ACO practice guidelines, you don’t need a MRI scan of your brain — just take two Tylenol and call him in the morning. Can you be 100% sure that he’s truthfully advising you in your best medical interest? Or might he be compromising your medical interests to satisfy the ACO bean counter who will reward him based on how many MRI scans he saves the organization?
The new medical ethics allows doctors to salve their consciences by telling themselves that restricting care to patients serves the greater “social” good. Most people have a powerful (and natural) need to believe that the work they are doing is morally worthwhile. Very few people can knowingly work in a fashion they believe to be ethically wrong. The new code of medical ethics gives doctors the internal psychological moral “cover” they need to allow themselves to continue practicing according to government guidelines. It allows them to act as agents of medical rationing, while telling themselves that “I’m just being socially responsible” — the 21st-century medical version of, “I was just following orders.”
The Wisconsin protests have shown how some doctors are seemingly willing to subvert their professional integrity to serve the political ends of government special interest groups. Under ObamaCare, when similarly trained doctors have to choose between practicing in their patient’s medical interests or in the political interests of their government paymasters, which side will they choose? And will you want this new breed of doctor taking care of you when you’re sick?
As a geriatric patient my biggest fear in choosing a new doctor would be if she/he subscribed to the new “social justice” goal, and how that might interact with and relate to my personal longevity, care and welfare. I’m guessing I’d really be a short-timer.
Holy crap! And to think that has to be one of the questions you now need to ask a doctor. I’m 60; guess the phrase “short-timer” has taken on a whole new meaning in my life now. I remember a day when truth, ethics and principles were important; anyway, that’s how I was raised.
Aside from the fact that the seven deadly sins apply to all human beings, doctors included, I feel it is only fair to note that the working conditions of doctors have required compromises with ethics for a long time now. Long before there was Obamacare there were medical insurance rules that tempted doctors to cut corners on patient care. They still do. Medicare is even worse about this. What treatments are covered and which aren’t? How much time can you spend with a patient? How many samples did the rep leave with you?
Gotta leave w/ a joke:
Q: What’s the difference between doctors and God?
A: God doesn’t think he’s a doctor.
“Medicare is even worse about this.”
Yet another good reason to phase out Medicare.
And BTW: excellent article, Dr. Hsieh. You have a real knack for explaining the wider principles behind the news of the day.
Doctors In Name Only; DINOS
How is the Change and Hope working for you America?
Very funny but sad and scary as well. That is an acronym I will be using a lot in the future along with the recently coined ” fleebagger “
Yep, both those terms are keepers!
Soon we will have a choice. Doctors who pratice medicine because they love money, county clubs, yachts, big homes etc. or doctors who practice medicine because they want to help people get well and live longer.
These doctors have a conscience.
And yes.. it’s ALL goverment employees against the GOP. Nation wide.
Goverment employess like city, county, state, federal workers. This is your teachers, firemen, law enforcement, military, etc.
<<Soon we will have a choice. Doctors who pratice medicine because they love money, county clubs, yachts, big homes etc. or doctors who practice medicine because they want to help people get well and live longer.
These doctors have a conscience.<
This is the completely false socialist response. Doctors would work for little pay, and that would motivate them to have a social conscience.
Utter tripe.
Growing up, I knew doctors that DID have money and big homes, but they saw a LOT of patients every day, got up early to make rounds at the hospitals, and would stay late into the evening at the office to make sure everyone was seen that wanted or needed to be. They worked HARD, they knew their patients, they loved what they did. And yes, some made good money from it, but fees were tolerable and they could make home visits, and they knew your family and you…and then the government came in and the lawyers and between the fear of malpractice for bad outcomes and insane government interventions hat ruined medical delivery economics, and now we have a dysfunctional system.
YOU want to give us Soviet style care; doctors were paid little in the SovUnion, and the care was commensurate with the reward.
Now, if you can make the job of being a doctor 9-5, and get rid of the ever-present fears of malpractice, ever-building paperwork, and a lot of other unneeded stressors, then fine, don't pay much. Oh wait, that surely won't attract the brightest bulbs into the profession anyway.
Hey Rich39, what do YOU do for a living, and could you do it for 1/2 the money? I'm sure you could. And you'd probably do just as well. Think how that would help society!
Ah, yes, the doctors with a conscience. The magnitude of your naivete is impressive. And I’m sure, when your personal physician opts to avoid exposing you to a costly treatment and divert those resources towards the greater good, you will sit up on your death bed and cheer. As for those docs who wish to be rewarded for their efforts; expensive education, long work hours, disrupted family lives, etc, etc, etc….they, for the most part, earn every penny they make. Probably underpaid if required to care for such a sorry specimen such as yourself. My recommendation is that you avoid physicians altogether. And under no circumstances reward those evil big pharma companies by using their products. Go herbal.
These doctors have their conscience, but that does not relieve them of any burdens imposed on those with conscious-ness: the need to take a medical history, the need to document their interactions with their patients, their need to arrange for continuity of care. I’ll give them the benefit of the doubt and assume that these requirements are hammered into them every day during their medical training just as they were in mine. In fact, my state (Texas) has a medical jurisprudence exam that requires all aspiring medical license holders to prove their familiarity with the requirements of state medical laws, including recordkeeping and fraud. These are things these physicians are *conscious* of, until they elevate their conscience above what they know to be the standards of their profession.
There is a reason for the professional standards you praise them for violating. Those standards are the collective wisdom of other physicians who have made mistakes in the past and passed down the avoidable errors they have made. You praise their “conscience” when it leads them to disregard those standards for a “higher” purpose you favor, but you do not consider the downstream effects of ignoring ethical and professional standards in future interactions. Will they maintain confidentiality in the future, or will their conscience drive them to violate that standard if “social justice” demands it? Will they treat each patient as an individual with a medical problem, or will they under-treat people their conscience labels as class or race enemies? These are questions you cannot answer, but by excusing violation of ethical and professional standards they become not just possible scenarios, but probable ones.
People willing to violate ethical and professional standards are…people willing to violate ethical and professional standards. Period. Giving them a pass because their arrogance happens to coincide with your view of a “better” society may give you some short-term pleasure, but long-term it is a disaster. Is this the kind of Change you were looking for, Rich39? These physicians are welcome to exercise their conscience, but that does not absolve them of responsibility for their actions before the state medical board, the ACGME, or the Wisconsin Attorney General. They need to face all of those bodies and take responsibility.
Oops. I said “responsibility”. I hope you don’t find that uncivil.
Well said, Darren. You, I’d love to have as my physician. The sham doctors handing out false “medical excuses” in Wisconsin, not so much.
On an hourly basis, I probably make 3/4 of what a typical doctor makes. However, I choose to work less than they do. These doctors may make good money, but they live very busy lives, with much longer hours than most of us.
Even if they made several times what I earn for every hour they practice, I do not begrudge them their money any more than I begrudge some pop star for his insane money, or some business owner for his.
Anyone who puts up with the risk, the debt, the effort and the stress of being a doctor deserves to be paid whatever the market will bear. And who are you to say they deserve less?
I can’t say this about all doctors, but a good friend of mine is one, specializing in infectious disease. He earns roughly 10 times what I do- and we talked about that a few times, as it turns out, he works 12-16 hr days, 5-6 days a week, is on call 2-3 weekends out of the month (which actually means he works those weekends), and until last year, could only take a week’s vacation in the year. That’s in private practice.
Does he earn a lot of money? You bet. He also works his ass off.
What is always funny to me is that people knock doctors for earning a high hourly wage- a highly trained, highly educated professional, with a huge amount of responsibility, not to mention liability, exposure to diseases and/or contamination, and people get upset with their pay scale. TV actors make 10s of thousands up to millions per episode, baseball players take in millions per season, 3rd rate artists pull in hundreds per crappy painting (seriously, have you seen the prices of “art” recently?) but a doctor who might just be saving your life, delivering your child, or working to ease the suffering of your grandmother takes in a decent 6 figures per year, and he or she is a greedy pig? What’s wrong here?
That ship has already sailed and what launched it is health insurance. Are there still good doctors? Yes, but it is because of love and the Hippocratic Oath; it is despite health insurance. The massively inflated doctors’ incomes caused by health insurance are a chimera, as costs have back-filled to the point that many doctors are going bankrupt or are working long hours to avoid bankruptcy. Medical school, equipment and supplies are bad enough, but then you add ambulance-chasers being able to randomly raid their bank accounts with so-called “malpractice” suits and sleazy “malpractice” insurers seeking protection money and the “high income” becomes fragile enough of these high costs that “economizing” by health insurers can easily lead to a net negative income.
Do you want to reform medical care in this country? The first and necessary step is to ABOLISH HEALTH INSURANCE!
Some of us have major medical issues, and cannot pay out of pocket. the insurance companies, for a fee based on risk, will pay for you. we need insurance companies, although they should be reformed to allow for more competition.
Those who see their religion as multicultural, progressive, secular socialism-collective justice-will regulalry and easily compromise medical ethics for their other master-’social justice’.
Wisconsin shenanigans has proven many things, not least of which is the nexus being ‘social justice’ and its natural progression of immoral behavior-using doctor shock troops in the service of union thugs.Medical ethics gone amok!!
When a doctor uses his/her hard earned skills, having NO problem with giving out FALSE medical excuses, one has to assume that this toxicity will enter into their medical calculations within their own practices.
Thus, it is no leap to suggest, under Obamacare, these doctors will be more likely to be in sync with ‘death panels’ and all its ramifications, due to their fealty to progressive tenets, as opposed to non prejudiced medical calculations.
Under Obama, even doctors have become morally compromised, which is an end result of ‘social justice’ without ANY moral underpinnings-the end justifies the means.
Thank you.
Excellent analysis.
Gerry.
That’s one (among many) problems with statist solutions–programs such as Obamacare will become subject to political influence. We have all read horror stories about treatment denied because of some bean counter’s decision and I have no doubt many such stories are true. But we are going to add another influence, that of the politically connected and influential, and we may yearn for the days when all we had to worry about was accountants.
This isn’t even a guess as to what’s going to happen. How many exceptions to the Obamacare program have been granted and of those, how many have been secured due to political influence?
“an ok thing to do” because it was in the interest of “social activism.”
And I am absolutely certain that particular rationale has been used before to justify some truly horrific medical atrocities too.
“University of Wisconsin law professor Ann Althouse spoke with one of these doctors who was completely unapologetic for his actions, saying that it was “not dishonest” but rather “an ok thing to do” because it was in the interest of “social activism.”
“Social activism” or just plain SOCIALISM? What’s the differnence? It’s funny how the far left will not use certain terms for fear of alienating the bulk of the American people who really know better. They are too afraid to call this what it is, a socialist uprising. Instead they try to camouflage it as something else, such as “collective bargaining,” “social justice,” or “worker’s rights.” All of it is just plain socialism. So why don’t they just come out and say it? Why aren’t they just honest about it and say what they are, which are socialists?
Because they know that’s NOT what this country is all about. They know that people have had enough of socialism and have concluded that it just doesn’t work. If it did, then why are Social Security and Medicare in such horrible financial shape? We are at a crossroads now. We either go all the way down the path of socialism, or we quickly reduce our spending and reform our entitlements before we really go bust. We can continue with this massive social welfare spending and, like Europe, jump off a cliff and go bankrupt, or we can go back to some sane spending principles and start living within our means. The choice really is up to us. But I think the people of Wisconsin have already made up their minds, which is why the protesters in Madison are NOT getting the massive popular support they wanted.
I have been practicing for over 40 years. Medical Ethics is an entirely contrived “specialty” that reflects the values of the ethicist. The AMA has made itself irrelevant to all but around 12% of practitioners. Under even the most liberal of criteria, the issuing of fraudulent documents to financially defraud the employer for conduct cannot be condoned or justified.
That said, these “doctors” should all be required to appear before the Board of Medicine. Those that are residents should also have the information submitted to the appropriate Board through the ACGME as they are unfit for Board Certification in any specialty.
The second part is the conspiracy to commit fraud. Both patient and doctor should answer to the Attorney General of WI for this criminal conduct. While undoubtedly a settlement will be reached the evidence is overwhelming as soon as the excuse is actually used in an attempt to gain payment for the absence. Until then only conspiracy can be alleged.
Orient, on camera, states that they are ‘diagnosing’ (clearly they weren’t diagnosing anyone) emotional distress as the reason for the protesters to be excused from work. This comes awfully close to violation of federal privacy rights law. I suppose that she and other such ‘doctors’ will feel perfectly free to release any and all private healthcare information to anyone they deem to need to know in the interest of ‘social justice’. How nice. Not only will they be willing to compromise patient care but also the right to keep our most personal information private.
As far back as the sixties Madison,Wisconsin was a red city, a center of anti military activism which promoted violence against the USA. Teachers are the biggest supporters of red socialism and this combination makes one admire the shear guts of the new governor to take on the revolutionary vanguard in the USA who get their marching orders from their god president Obama. We are approaching civil war with the red unions and their friends in the government controlled media. The future is shaky; there are too many reds in the education industry. As a retired teacher I know of what I speak.
Uh, that should be sheer guts, Johann.
Please don’t say shear guts in connection with this courageous governor. I think some of the libs might get ideas….
http://dictionary.reference.com/browse/sheer
http://dictionary.reference.com/browse/shear
Univ. of WI and Madison is not the only “red” univ/town. Almost all such places have become cesspools of socialist/communist activism and subversion. They are legion–Berkeley, Boulder, Eugene, Austin, Ann Arbor New York City, Boston, and San Francisco (just to name a very few). The list goes on and on so you can add your own disgusting examples. We know that the left and the progressives will support these places because that is where they find the stunted intellects to indoctrinate and to support their rape of America. Alumni who still have some semblance of intelligence should refuse to send a penny to any of them. These institutions are broken, diseased and they no longer serve any appreciable redeeming purpose outside of their professional, scientific and engineering departments. And even some of these are decayed–U. of WI. Med. School, comes immediately to mind. Fight the liberal/left/Democrats as we must, but the sickness and the decay begins in our educational system–particularly in higher education (a growing oxymoron!) These places need to be destroyed and rebuilt from the ground up–the idyllic ivy halls of intellectualism are a lie. I know, I was once a faculty member at a couple of them until I started to realize what was causing my indigestion. I quit and have felt fine ever since. And no, I don’t contribute a nickel to old alma mater (either of them) and never will.
Isn’t this consistent with the liberal prescription of medical marijuana?
The physicians who handed out bogus sick leave excuses should be brought up before the appropriate medical society disciplinary board and suffer the consequences. The teachers and other public employees who deserted their responsiblities should forfeit pay. The teachers who abandoned their students should be forced to pay restitution to parents whose workdays were disrupted caring for children unable to attend school.
Or fire the lot of them.
@carla
“The teachers who abandoned their students should be forced to pay restitution to parents whose workdays were disrupted caring for children unable to attend school.”
Any suggestions for how restitution would be paid to the mother who lost her job after staying home with her children for 3 days while their teachers failed to show up to teach, closing the schools?
You betcha. Sue the teachers union. That’s where the $$$$$$$$$$$ is. Sue for breach of contract and professional malfeasance.
As a Canadian married to a physician, all I can say to my American friends is to get ready for the “new morality” in medicine, where consideration for the public good encroaches upon excellence.
Never Fear, we will DESTROY Obamacare before it destroys us.
Excellent piece, Paul! The fraud being perpetrated by those doctors and teachers against the public is grotesque on its face but, you’re right, the implications go much further.
America is a nation of liars,thieves and murderers and I was born and raised here. We are self centered and think only of self. Our so called professionals are liars,cheats and pedophiles and we have the audacity to be critical of other nations. Doctors lie,cheat and commit fraud. Teachers lie cheat and molest children. Our government encourages this and on top of that it sanctions the murder of unborn children and even goes as far as committing murder on American soil against its own citizens. I dare anyone to dispute my words with proof.
Jaames
Either you are taking too much medicaton…or not enough
“I dare anyone to dispute my words with proof.”
…where’s yours?
I do believe everyone in America would kick in to send you to live in ..say..Libya..China..or… We wouldn’t want you to spend one unnecessary moment in this country you so despise.
you sound juvenile and inexperienced in the world of reality.
JamesA beats his wife and rapes goats.“I dare anyone to dispute my words with proof.”
OK so he doesn’t really do what you allege but it is highly likely that he does! He might prefer groundhogs instead! It is so hard to tell tell the difference between some animals. Heck he might like fish to diddle with!
You’re asking me to believe a liar?
If these are University docs, they are likely on the same retirement system as the teachers union. If so,they are not only unethical in the misuse of their profession, but are acting out of self interest not social interest.
In a way it is fitting that these doctors in Wisconsin were found helping out the teachers. A leftist takeover of the teacher training colleges (by requiring applicants and trainee teachers to spout more and more elaborate and extreme versions of leftist dogma in order to be admitted or graduate) is exactly how the teaching profession has been turned into an army of paid political activists over the past forty years. We’re a generation of idiots who deserve what we get if we let allow the same process to wreck our system for training doctors. It should be obvious that doctors who don’t believe in individual rights are even more dangerous than teachers licensed by the same ideas.
Please remember that if you don’t answer the “ethics” questions correctly you will NOT get your doctors diploma.
Perhaps ethics should be left out of the equation and morality taught
instead.
I’m going blue in the face – need to breath soon.
Gerry
The basic problem stems from the special treatment doctors receive from society. This special status is totally undeserved and the best and simplest way to do away with it is to eliminate government licensing of physicians. Government licensing is a relic of the early progressive era and is no longer necessary for checking on the credentials or to confirm the level of training and competence of a physician. We have all manner of advanced communications that can actually do it better than the little certificates we hide behind. Think about it. This is going to happen anyway. Companies are already beginning to doubt some of the information they get from certain physicians and are tracking their activities both billing-wise and medical-judgment-wise; they just don’t release the information to the doctor or the public. When the government system collapses they’ll be ready to fill their needs. The rest of us will have to play catch-up. Or, rather, YOU will. The way this applies to the current situation is that, in the absence of the govt certificate, employers will feel it necessary to get an electronic documentation of the transaction or visit that necessitated the absence. This documentation will include any access necessary to confirm the graduation and specialization certification of the practitioner and their level of competency.Any physician that is found to have acted in a fraudulent way is not reported to an agency of govt that (obviously) will not respond; instead, the consequence for playing around like this will result in the future non-use of said practitioner. People tend to act more reasonably in a world of real consequences.
I see your point, but the licensing currently performed is not just a progressive-era relic. Most people not trained in medicine operate at a significant information disadvantage when selecting a physician. They often confuse a radiologist with a radiology tech, an office assistant with a nurse, etc. Having a medical license issued by a state at least provides documentation of a minimum standard of medical knowledge and exposure to training, having hospital privileges documents a further level of training and ability as judged by other physicians who practice at the hospital. This system is not perfect, but neither is healthgrades.com or any of the other systems currently available that augment the training and licensure system for documenting competency.
Dropping licensure is throwing out the baby with the bathwater. It is an invitation to charlatanism. There are valid reasons beyond turn-of-the-century progressivism that the current system of licensure and training was developed in the United States, and it has served admirably so far. Social networking in the area of medical competence is not something I object to, it is a good idea but is not ready to fill the information gap faced by patients in the way the licensing procedure does. It also is not ready for punitive action against bad actors the way that the medical licensing system is. A lot of what you read on the Internet is BS, why would negative or positive online comments about someone claiming to be a physician be perceived as any different? At least licensure is an objective standard.
I’m a person who’s suffered chronic pain for over a decade, and I’ve seen many, many doctors. It took me ages to find a doctor that believed I even had a problem, and by then the medical industry was catching up with this phantom called Fibromyalgia. But in that time, I was able to discern which doctors were the good ones. They’re invested, they ask lots of questions, they treat patients like the people they are, and they would never, EVER have signed a doctor’s note without knowing what it was for.
What terrifies me the most about the new health care bill is actually not the fact that they passed the bill without knowing what’s in it, not the fact that it’s a giant, ridiculous mess- although those are certainly HUGE concerns. What worries me the most is the idea that everyone will be ‘taken care of’ while the government continually takes our choices away. Will I, really? Should I be thanking my lucky stars that fibromyalgia ‘exists’ now, so I’ll only be called a liar occasionally? What about other people with odd problems that are hard to diagnose? Are they just going to be out of luck and out of options, thanks to the consequences of ‘social justice’?
At michellemalkin.com, there is a breakdown and spreadsheet on the pay and benefits these ‘educators’ are receiving.
http://michellemalkin.com/2011/02/17/watch-wisconsin-part-iv-the-salary-info-big-labor-doesnt-want-you-to-see/
Wisconsin; The Dairy State, with a teat on the cash cow for any bloated union sucker.
‘Atlas Shrugged’ – read it. And don’t go to that doctor!
“Social justice” is taking over everything. It’s no surprise when people give up reason.
I am also getting to the age where I have to wonder if my doctor will treat me according to my own welfare, or decide that treating me at my age just isn’t worth the effort and expense any more.
Is there a way to easily identify doctors who have had this indoctrination? For instance, avoiding those who received their training after 2002, which the article indicates is when a lot of this social justice nonsense starting sprouting up? Avoiding those from specific schools?
Nonsense such as this will only further push doctor-patient relationship from one of trust to suspicion. Someone let me know how that’s going to improve medical outcomes, please.
Talk to your doctor. The indoctrination will become apparent. Remember that those who believe the whole social justice thing see nothing wrong with the decisions that it produces. It’s very hard to hid attitudes that you believe are right.
My current doc, late sixties and nearing retirement, makes no secret of his priorities. This year, as a direct consequence of articles like this, I plan to discuss his recommendations for who I should see when he eventually retires. He’s been my doctor for over 30 years. During periods when he wasn’t a “member physician” of my various health insurers I paid out of pocket to keep him. I will lay these concerns on the table, and he will address them openly and honestly with me. That is what a doctor patient relationship is about. He has the bedside manner of a grizzly bear, but he is honest with his patients to a fault.
I’ll find myself a responsible doc in his forties. He should out last me and thats all I really need.
Obamacare will bring rationing in its quest for social responsibility; it won’t be admitted (“best practices”, “care guidelines, “end-of-life counseling” etc) but diagnoses won’t be made and patients won’t be treated, just as they aren’t in any national system. There are already entities that don’t do routine screening for prostate cancer in older men, despite the fact that treatment is highly successful (95%-plus survival rate- double that of Britain); treatment costs money. Breast cancer, other cancers, heart disease, joint replacements, kidney dialysis; don’t count on treatment. Check the Canadian wait times for specialist appointments, diagnostic tests and treatment and realize that the whole upper tier of the US serves as an escape valve for Canada. I’m sure the women in labor (MSM reports in last few years) who had to be flown to big cities like Missoula, MT and Grand Forks, ND, because there were no NICU beds in Canada, enjoyed the experience immensely.
Excellent essay.
It’s tragic – and revolting – to see the virus of Progressivism spread so widely and strike so deep. Clearly, the only long-term solution is to reclaim the educational system and once again teach individuals to think well. That will take much more than defeating unionists in Wisconsin, but it’s a start.
The alternative is Rome circa 450AD.
This is why we fight the creep of Socialism. Government is political, every inch of it. Any profession that falls under the government becomes an extension of it, sooner or later.
Medicine on the basis of political connections is right around the corner.
@28
LOVE it pashley!
Lets viralize your new addition to the
298 names of Obama,
three time those of allah!).
THE CREEP OF SOCIALISM.
Dr. Hsieh makes good points about the “social activism” of these doctors. But to be consistent, one should also oppose the “social activism” of pharmacists who refuse to fill prescriptions for birth control devices or the morning-after pill.
#27 Jeff P. : “The alternative is Rome circa 450AD.” Not sure what that is all about. The Roman Empire did not end in 450, 476, whenever. The Eastern part of the Empire survived and thrived for centuries after the so-called end in the West.
“In ’450 A.D.’,
Rome had exhausted her options, and had a couple of centuries of mostly miserable governance ..The taxes were too high, to pay for the army that was losing all the battles, and a bunch of freeloaders in government, and of course, and to pay for thousands of civil servants..”
Although the “Eastern Roman Empire” was never truly Roman after the reign of Constantine I, a fact that became painfully obvious after the reign of Heraclius I.
Of course, if you want to offer the suggestion that the Roman Empire never really fell, but just went through the mother of all Chapter 11 re-organizations, emerging as the Catholic Church, you could make a case…
The insidiousness of “social justice” is that it gives physicians a moral justification for sacrificing individuals. The Nazi euthanasia program began the same way. Physicians were not ordered to euthanize the chronically ill—-simply given legal and moral permission to do so. Hundreds of thousands were murdered as “lives not worth living.”
More on “Medical Ethics and Social Justice”
Dr. Hsieh is correct in saying, “…“social justice” is frequently just a euphemism for a socialist political agenda of leftist politics, redistribution of wealth, and heavy state controls over the marketplace,” but let’s add the motivation underlying this: the morality of self-sacrifice.
Everything that drives this agenda is the destruction of the individual in the name of the collective. Under this kind of politics and morality, you are nothing — the State, the “Volk”, or just your local community and neighbors and even your government-run HMO are more important. Any group of any size is more important than you are. Any ambition, any happiness, any achievement and any judgment you may ever wish to exert can be sacrificed to *any* one who claims that *he* represents “the people” or whatever other tribe they are pidgeon-holing you into.
You are a pidgeon to them, after all. Just part of the flock. Have some more seed — or take an aspirin instead of an MRI.
Even doctors are amorphous non-entities under this kind of morality, like the social-activist doctors in Wisconsin. Everyone is sacrificed to everyone else: patient’s health and lives are sacrificed to “budget savings,” and doctor’s judgment and integrity and just remuneration for excruciatingly difficult years of study and practice are sacrificed to sate the power-lust of “community organizers”, bureaucrats and those quasi-governmental professional organizations that have been seized by the collectivists. (Who include not just Leftists but too many do-gooders on the Right, too.)
And so it goes.
Play this out across the nation and across the world, in every profession and every realm of human action. In Ayn Rand’s words, “the world is perishing from an orgy of self-sacrifice”.
It is.
The dignity of the individual needs to be reclaimed — including the individual doctor, the individual patient, and the individual doctor-patient relationship. Expel the government from any involvement in medicine, at any level, for any purpose. Expel the government from *all* aspects of dictating the economy, and us. In the words of Rand’s hero, John Galt, from Atlas Shrugged: “Get the hell out of my way!”
The key word here is “professor “. The only doctors in the country buying Obamacare are the academics ensconced in cushy tenured positions themselves. They walk around in white coats that never get dirty. They are haughty, arrogant and have an over inflated opinion of their intelligence and huge egos. They are used to telling people what to do. What they are not used to is managing an office budget , paying for overhead and hiring employees. Running a business like other doctors. The ones out in the real world who see what Obamacare is doing to our health care system and hate it. When Obama touted AMA approval of Obamacare it was these clowns he was talking about.
The doctors in Madison are engaging in fraud when they hand out false excuses; it is not fraud for a pharmacists to refuse to dispense a particular medicine. They might both be acting on the basis of a deeply felt belief, but one is fraud and the other is not. It would be fraud if the pharmacist dispensed a sugar pill and called it the morning after pill. It would not be fraud for the doctors in Madison to carry signs in support of the teachers.
With Obamacare ensuring that Affirmative Action doctors will be implemented into the medical-care system, a visit to the doctor will be a very scary thing indeed. If there was any sanctity within the doctor/patient relationship, that will disappear and unravel rapidly as doctors become more and more beholden to unknown/unnamed federal bureaucrats’ ideas of what is the ‘proper care’ for patients as mandated by a litany of rules and regulations for cost-saving rather than life-saving.
Patients will stop trusting their doctors and will start withholding information out of fears that their doctor won’t treat them if they are honest about their own activities and when sloppy “affirmative action” doctors leave a few too many sponges in, lop off the wrong limbs or perform an ‘accidental’ lobotomy…well, good luck trying to get justice for any malpractice done by “government hired doctors”. The decent and good doctors will find this utterly unacceptable and leave their practices or work under the table for cash.
Oh happy day!
Choices? Stay healthy or get really wealthy.
That conduct strikes at the ehart of what patients have always expected octors to be: honest, near unimpeachable sources of treatment and advice on what is best for you.
Don’t these “doctors” consider for a minute the damage they do to their profession? How would we regard judges who shave due process to help the govenment?
I had no idea we had “activist” doctors. I guess I want older docs uncorrupted by the new “ethics.” Or I have to approach a younger doctor as a partial advesary.
Do these “sidewalk docs with pre-printed notes” expect to ever testify as as expert in court?. If the “patients” fall ill within a year and blame the doctor who “examined them,” what will the doctor say? “You knew it was a fake exam?”
But of course that would be their response! Now what to do with the (doctors) in question? REVOKE LICENSE and the governor should be able to do that!
My god, all of you! Please see the Spencer Tracy movie “Judgement at Nuremberg” to see what happens when a government takes control over the medical institutions of a country.
Paul,
This change in medical ethics could get physicians, and the health care industry, killed in court. The law concerning medical ethics, obligations and standards has not changed. Juries and the medical malpractice plaintiffs’ bar will destroy doctors whose lapsed ethical standards compromise patients’ care.
Given the trend in medical practice towards employee status, as opposed to private practice, the burgeoning health care systems who employ physicians should be very careful about the ethical training, as well as the medical training, of the physicians they employ because that will affect their medical malpractice rates.
More importantly, the exemption from punitive damages claims granted health care practitioners is premised on their maintenance of the highest ethical obligations. The public granted that exemption, can revoke it, and might well revoke it if the medical profession publically ignores its end of the bargain.
Employers of physicians would be especially exposed to punitive damages in such an instance, as those can be based on the employers’ income as opposed to that of the individual physicians.
In most national medical systems, doctors cannot be sued. Given the power of lawyers in this country, and the complete absence of tort reform in the Obamacare bill, I fear that we will have the worst of both worlds; government care AND ambulance-chasing lawyers.
Paul, on second thought, state legislatures would create a simple, but highly frustrating for physicians, means of dealing with this problem. There’d be new state laws mandating state-approved. old-style Hippocratic oath-based, ethics training for physicians and possibly nurses. This would be in addition to the quite-contrary lefty ethical relativism taught in medical and nursing school. With mandatory refresher courses.
Employers of physicians could retain their health-care provider exemption from punitive damages with proof that their health-care staff had satisfied this state-mandated ethical training. Including the refresher courses.
Of course the salaries of their staff would be somewhat decreased to pay for their time off from productive employment taking these new state-mandated ethical cleansing (pun intended) courses, i.e., cleansing them of their leftist school ethical concepts. It might also be that they would simply not pay their medical staff for their off-time taking these courses.
But it would keep employers from being liable for punitive damages.
What’s not to like about it? This creates a new government-mandated industry, teaching doctors what medical school used to teach them!
wait until THE DOCTORS unionize…
In the US at least, that is not an option for the vast majority of physicians. The NLRB has declared physicians to be “managers” and therefore not subject to unionization. The only exceptions are some residency training programs in a few states, where state labor laws allow resident unions. New York and Massachusetts are two that I know of, and then only at public hospital residency programs.
In fact, one doctor discussing insurance contracts with another physician that they are not in a significant financial practice relationship with (e.g., same group/practice entity) is viewed by the government as an anti-trust violation, the same as if Exxon and Chevron colluded to set gasoline prices. Each doctor or physician group is an island unto themselves, as far as the government is concerned.
doctors are soon to become government employees and since this is not lost on their ability to gain income, they are sticking with these other government employees to further both their interests.
As Thomas Sowell once remarked (paraphrasing): when the Left seeks to negate the meaning of a term, they prepend the adjective “Social” to it.
“Under ObamaCare, many of these physicians will no longer work in traditional private practice but rather in large Accountable Care Organizations (ACOs) where they will treat patients according to government-specified “cost-effectiveness” guidelines. These guidelines will often be constructed to save money for the government entities paying the bills (such as Medicare and Medicaid), even at the expense of the patient’s well-being.”
I don’t see how this is much different from how insurance companies work now, denying people based on their own cost-effectiveness guidelines.
No point in explaining it to you then
The difference is you can say “Screw my insurance company” and just ask your doctor to bill you and get the procedure you need/want and scramble to pay off your medical debt somehow without the help of your crappy insurance company. With 0bamacare it will be like other ‘socialized’ medicine in the UK & Canada where you are either outright refused a procedure (even if you can pay for it on your own) or you will be put on a waiting list that wastes precious, life and limb saving time.
With 0bamacare, it won’t be the ‘refusal’ of treatment that will kill people as much as the ‘waiting’ for treatment that will. Anyone 50+ will be put at the back of the bus for many operations and life-saving procedures. The nearer you get to ‘retirement’ age, good luck having any ‘socialized’ doctor saving your @ss when you are no longer economically ‘viable’ for the ‘greater good’ of ‘society’.
I wise old family Doc told me what to tell a patient that wants a fraudulent work excuse: “If I lie for you, how do you know that I won’t lie to you?” It is advice I have always followed.
As a pre-med student, and someone who has dreamed about the day she would become a doctor since, practically, birth, it is scary and disappointing to see that this is what I will be ‘raised’ with in the medical world. I already work in the medical field and have/am seeing things change. I may not have a job within a year because of Obamacare.
I hope if/when I am in medical school that I am able to differentiate between what is truly moral and what is socially expected. I have faith in my abilities, but lack faith in potential teachers/administrators allowing me to be the best doctor my future patients will need, not the best doctor that the money bank needs.
I have to say, for lack of better words, it sucks that this is what I get to look forward to. Seems like a futuristic novel come true!
Best of luck Megan! Follow your dream and damn the torpedoes. It’s an honorable profession even if populated by a percentage of dishonorable individuals. At worst, you can practice on the black market, if things come to that. At best, you’ll have an unforgettable experience learning about your passion… and you can always get a TV show afterward.
Hang in there!
If all available or assigned doctors in you area were approved by this system, what if you are notoriously non-PC? We are already getting doctors demanding to know, for instance, whether you have a gun in the house. Those comments about, “Governor Walker, your child is in my class” brought these thoughts to my mind; they sounded like implied threats.
And what if a massive unionized government workers movement occurs in an area where the cops are unionized, and the cops act as union muscle? That incident of the union workers who terrorized the 14-year-old son of a bank executive, they were accompanied by unionized police.
My doctor says he does two-three hours of paperwork every evening, and that that is the one thing that is getting him down about being a doctor. He is in his mid 60s and could easily retire. I pray he does not but would never blame him if he did. My brother-in-law’s doctor closes his office on Thursday every week to do paperwork all day long. I know this is the norm for doctors, already. What will it be like under full-blown Obama-care?
How would I ever be able to trust a left-wing, gov.-doc? I am 60 and have Type II Diabetes, also retired, so no longer “economically productive”.
Since my youth, I have watched profession after profession deteriorate as leftism gained an increasing foothold, as law, journalism, teaching, in some denominations, the ministry, and now medicine have been politically subverted by the left.
To give just one example, the teaching of English (grammar, writing, and literature) is absolutely pestilential with leftism and has been for many years. The English courses my daughters were required to take in public HS were horrific, 10 years ago.
The left has infiltrated the universities, the courts, the schools (both public and private, and many churches. And now, it’s the “long march through the institutions” coming soon to a hospital or clinic near you.
Oh come on now. Those teachers are just very lucky that all the doctor did to them was give them a faux note. He could have taken their tonsils out for a few bucks -just ask the master of this entire charade in the White House, he’ll tell it like it needs to be seen.
Let’s be real. We get upset because this profession hands out a few faux notes? This is the same profession that has altered their oath to do all they can to save life 180 degrees and has now embraced the immoral taking of life – with the tally in America of 53 million innocents (it’s diabolically called healthcare; believe it or not) In Christian Holland, doctors are taking involuntarily the lives of 1 of 11 people, they have decided should die. Sarah was exdactly right about the death panels because human live -made in the image of Nature’s God, has become a throwaway to the ideologies of the great state.
Doctors, teachers, even priests; Just look at our morally corrupt culture – you can’t make a meal in a filthy garbage can and not expect it to be contaminated.
This is why the Obama Administration is trying to get rid of the CONSCIENCE CLAUSE!
This is why the Obama Administration is trying to get rid of the CONSCIENCE CLAUSE for Medical Professionals!
Excellent article tying current events to a very dangerous probability. As one who is indebted to medicine for saving my life and the life of loved ones, I hope this article is spread far and wide!
The prospect of these new “ethics” driving medical school admissions alone is a chilling one, never mind the lethal combination of these ethics with a government monopoly on health care! Thanks again, Dr. Hsieh, and PJTV, for another informative and important article.
There’s another matter here: The physicians handing out falsified work excuses are not only ethically tainted, they are legally tainted.
Medical malpractice cases often hinge on the presumed veracity and integrity of the physician. If any one of these individuals is ever sued, a reasonably competent attorney will call into question the accuracy of their medical records, using their own words and images against them.
Once professional ethics are breached in this fashion, it is essentially impossible to repair the damage caused. As a physician, I would utterly avoid these people at every level. I’ve put too much into my reputation to risk any association.
Your first sentence is factually wrong. The governor of Wisconsin has already been given the concessions he needs to close the budget gap — the unions have agreed to accept his proposed pension & benefit adjustments. What he’s trying to do is permanently strip the unions of collective bargaining authority. You should try to tell the whole story, not just the preferred GOP narrative.
It may be as you say, however the problem is that the unions, with Democrat support, have built an unsustainable salary and retirement system for teachers for instance, that is unrelated to the education-results, which are pitiful.
It appears that collective bargaining as Government employees is at fault on one side, and the Democrats they overwhelmingly elect are at fault on the other side, since together they refuse to bargain for a financially sustainable system.
The Governor must fix it now, no matter what party the governor is from. No one has any confidence in the Democrats ever fixing anything, they just borrow more money and postpone the inevitable, from the President on down.
If the teachers for instance wish they may go into the private sector and join a union there, but financially unsustainable results will be no better there, and will likely be fixed more drastically.
There is the truly terrifying flip side of this — the same college doctors who are willing to hand out sick notes can get conservative students involuntarially committed to the psych ward. And it is happening a LOT on some college campuses.
If a doctor says the student is crazy, the student is crazy — no appeal, no recourse — kid is booted if not shipped to the psych ward and it is all over. So much for due process.
And it is only the conservatives that have to fear this. Yep, social justice agenda…
Thats quite an extraordinary claim… That doctors are forcing involuntary mental care on students because of their political stance. In order to commit someone you have to prove that they are a direct physical threat to themselves and/or others, and you have to be ready to stand behind this claim against a board of other doctors.
Somehow I think you are mistaken. Not too many people would risk their career to try and get some people with a different political stance committed.
Unions for EVERYBODY or Unions for NOBODY. We do not tolerate preferred and privileged classes in our society. ABOLISH UNIONS.
There are millions of Mexicans or Indians ready to take their jobs for half of the SALARY
uuuhhh… talk about a non-sequitor… a couple of doctors are handing out fraudulent sick notes and suddenly this leads to the corruption of the medical profession and the sky falling?
The issue in Wisconsin is that the government employees don’t want to give up their collective bargaining rights. The governor somehow thinks that these rights will impact their budget. The unions have already agreed to the cuts, assuming that they don’t lose their collective bargaining.
As for obamacare… Everyone seems to forget that it’s insurance, not direct control over doctors. If you can afford private health insurance, then the health care reforms will not affect you. Most of the reforms are about stopping private health insurers from abusing their clients. The others are about getting the uninsured under some government plan. Ultimately the goal of health care reform is to make sure that every person has health insurance in some form, so that at no point are hospitals stuck with the bill.
Private health insurers are out to make money, it is in their best interest if you pay a lot and take a little. If they could, a private health insurer would drop coverage on anyone as soon as they get a disease that would cost more than the person will pay in the future. If a private insurer can get out of paying a cost, it is in their best interest to do so.
Public health insurers have no such objective. Instead they need to keep their system working well enough that it is not called into question if there isn’t a better way to do this.