In the Prime post up over at the Courier-Journal: The difficulty of judging others

Judging other doctors is tough. You are torn. On the one hand, as a member of the profession, it’s hard to read stories of misdeeds of fellow cardiologists and remain neutral. You want to call out the foul. You want to set the record straight. That doctor did wrong. Justice needs to be done. I am not like that, and neither are my buds. You are especially sensitive to the perception that doctors take up for their own. You are scared that if you don’t stop the bad kids from misbehaving, the whole class will be punished.

But on the other hand, this whole human doctoring thing is pretty fragile, isn’t it? You have a lot of thoughts in your head. Things like, how perfect am I? Do I respond to financial incentives? Have I always made the best decision for my patients? In hindsight, could another doctor be critical of decisions I made in real-time? The word righteous’ worries me. And not to introduce religion into a medical blog, but it would be deeply disingenuous not to admit that one can wonder about the existence of Karma.

That tension was why I had originally decided to let the most recent story of  doctor-misconduct rest. But this one hails from Kentucky. The alleged misdeeds made the front cover of the Courier-Journal and was also covered in the USA Today.

You have heard the storyline before: Cardiologists, perhaps conflicted by financial incentives from their hospital, performed unnecessary cardiac procedures on hundreds of patients over many years. A lawsuit involving more than 280 plaintiffs is ongoing. A little city in rural Kentucky is now in the national news.

I changed my mind about posting some thoughts. It is a local story. The breakdown of trust is one of the reasons why we have a healthcare crisis.

I hope you want to read more. It’s published on the In the Prime Blog over at the Courier-Journal.

The title of the post and link are: When doctors break the public trust.

JMM

3 comments

  1. It’s hard to know who to trust. It’s easy to be skeptical. You always hear the bad news, and there does seem to be a code of silence that lets things like this go on too long.

    Patients are wary. The waiting and shuffling and rescheduling wears on us.

    Some of it might be the news cycle, popular media, or a few bad apples.

    Most of it I think comes down to responsibility. Few patients can point to a Doc these days who they know is with them at every step of the way. Instead we get passed from person to person, never knowing who’s in charge or who’s taking responsibility.

    Patients want to id that one person whose job it is to look after us. If everyone is responsible, it feels like no one is responsible.

    With no one taking responsibility, who is there to trust?

    Maybe it’s just the way medicine is there days – complicated, team oriented, larger practices, shift work and interchangeable parts.

    It weakens the human bond and takes a toll – on both patients and Docs I suspect.

  2. From my perspective as a layman, much of what doctor’s do is a big scam. CABG and angioplasty are particularly good examples of unnecessary harm for the financial gain of the medical industry including doctors.

    I read that there is plenty of evidence that appropriate diet and exercise will prevent and essentially cure the arterial blockages that these surgical procedures supposedly fix (and how long do they stay “fixed” with a bad diet and little exercise).

    Read what Dr. John McDougall, Dr. Dean Ornish, Dr. Caldwell Esselstyn, and others have written on the subject. It appears to me that a diet that contains the following properties will prevent almost all cardiovascular problems on the type being treated along with greatly reducing cancers:
    1. Whole food — the whole grain, the whole vegetable and fruit with the skin.
    2. Low fat — no added fat to the diet with the except with some raw nuts or seeds if one is at a healthy weight.
    3. Lots of raw or lightly cooked vegetables — like kale, spinach, cabbage, broccoli, cauliflower, tomatoes, carrots, etc.
    4. No animal products — no meat, no dairy, no eggs, no fish, no poultry.
    5. No added sugar (included no fruit juices — see 1. above).
    6. A minimum of 60 grams of fiber each day.

  3. My everyday diet (my wife eats almost the same):
    Breakfast — a mixture of wheat brain, oat bran, ground flax seed, and a whole grain high fiber cereal — the cereal is cooked but the others are added raw.
    Lunch — red cabbage, kale, and carrots blended with 4 cups of water in a Vitamix. Two apples or two oranges.
    Supper — a vegetable curry stew containing tomatoes, green beans (and/or zucchini in season), eggplant, and red onion. I add raw garlic and raw ginger root after the stew is cooled to warm. Cooking time is only about 8 minutes to keep everything nice a crunchy.

    We are in are early 60’s and have been eating this way for 17 years. As my wife always says — don’t eat what you like — eat what is good for you. But I learned to really like this way of eating.

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