Am I A Government Agent? by Pat Conrad MD

Based on the recent news, those of my cynical bent would be excused, and perhaps thrilled, to quickly attack Pres. Obama’s targeting of firearm possession by making all physicians “extenders” of his aims.  So gleeful I would be to notch another “told ya!” regarding an autocratic power swipe, but…how does one take something that has already been freely given?

The administration’s initiative, per the AMNews, “encourages doctors to talk to patients about gun safety and warn law enforcement about threats of violence…Obama clarified that the Affordable Care Act does not prohibit doctors from discussing gun safety.”  In due fairness, this seems less a new intrusion, than a free speech issue, since organized medicine has long since ceded their moral authority to their government masters.  In 2001, then-AMA prez Richard Corlin said,  “We as physicians and as the American Medical Association have an ethical and a moral responsibility to do what it is we can to stop this epidemic.”  Dutifully, current AMA baron Jeremy A. Lazarus, MD, “said the clarification from the president on the issue “reinforces the importance of unfettered medical discussions about relevant health and safety risks.””  The heroes over at the AAFP have repeatedly published a policy since 1987 that specifically recognizes violence as a major public health concern; and since 1998 have pushed legislation that requires use of trigger locks and that requires storing firearms locked away and unloaded.

Pres. Obama is not taking anything that was already not, sadly, given.  Herein, the larger question:

Public officials with ever-increasing zeal are finding new ways to get into affairs once thought private.  New York’s Mayor Bloomberg, based only on the eternal statute of good intentions, sees trans-fats, salt, smoking, and Big Gulps as fair topics of inflicted compassion.  Here in Florida, the do-gooders got rid of indoor smoking in private establishments (depriving me forever of the ability to enjoy a good cigar after a great steak dinner in my favorite Irish pub).   Anytime a public official wants to enact a public good, he trots out a photo-op stage full of the white-coated and stern-faced who support the prevailing politics.  Can doctors properly be public advocates?  Certainly, but to what extent?  We all supported hand washing even before the latest moronic MOC module, and none of us want our towns devastated by the next zombie virus, so public health is a good thing.  But does it have any limits?  Should doctors support public efforts to ban video games, in an effort to curb childhood obesity and pre-pubescent pre-frontal programmed affinity for violence?  If a study correlates that later closing hours for bars correlate with casual sex known to be proximally causal to unwanted pregnancy and STD’s, should doctors advocate earlier closing times?  What about those of us who like killing video zombies and having wee hours drunken trysts, and the business owners who sell us the means?

Or should physicians deal with these and myriad threats to health and happiness in a private, individualized way that both respects the integrity of the counselor and the autonomy of the individual patient?  Put more bluntly, should doctors revisit the ancient art of minding their own damn business?

Physicians should be free to ask about anything and everything in the privacy of the exam room, based not on political pressures but on their own rational judgment.  Patients should have the reassurance to expect their physicians to be operating in their interest and not as government agents.  And if they don’t like the questions, they can walk.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected]

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4 Responses

  1. mamadoc says:

    Dude, in my state practically everybody has a gun. It’s a non question.

  2. Jerry O'Grady says:

    I like Irish pubs here in Florida—–one of the big reasons being I don’t have to put up with tobacco smoke—especially that from cigars.

  3. Pat says:

    Yeah Lance, actually, my entire underlying theme is that big government has no valid role in the mass delivery of care. The forewarnings to idiot collectivist thought leading to eugenics and worse are there for all to see, and with a scary historical precedent.

  4. Sir Lance-a-Lot says:

    I agree wholeheartedly, Dr. Conrad.

    Whether my patient has guns, knives, pointy sticks, or french fries is no darn business of mine, so long as he isn’t pointing any of them at my face.

    When I had a patient not long ago for a “gunshot wound” (abrasion) from a ricochet off a rock while shooting targets in an old quarry, I gave him “the look” and suggested that maybe shooting toward rocks wasn’t the best idea. In hindsight, he could only agree. That’s common-sense patient education, and you know he’ll pass it on to his friends.

    I would suggest “zooming out” from your vantage point for a “bigger picture,” though. A little-recalled point regarding the Nazi rise to power in Germany (see Robert Jay Lifton: “The Nazi Doctors”)was how German doctors willingly shifted their focus from the individual patient to the “body” of patients as a whole (ie: “the population”), and their goal from that of the health of the individual to that of the health of the Volk (“the People”) or, in other words, of the State.
    Once the shift in viewpoint had been made, the next step, of seeing and treating some people as less desirable and others as more desirable, was easy.

    I see this push toward doctors seeing “the whole country” as their patient as leading, sooner or later, in the same direction.
    It starts small, with asking people about guns and other “dangers,” and before you know it, you’re mandated to fulfill a string of non-medical governmental requirements “for the good of the country (or was that “the Homeland?”), and if you stand up and shout about it, Hmmmmmm… How badly did you want to renew that medical license?

    Those of us who are conscientious need to draw the line on this crap, before it becomes impossible to do so.

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