Harry Markopolous was an American portfolio manager working for Rampart Investment Management in Boston when he first discovered the massive Ponzi scheme behind Bernie Madoff’s investment management business. He first reported his concerns and provided evidence to the Boston office of the Securities and Exchange Commission(SEC) in 2001 and was ignored. He continued to report his suspicions multiple times to SEC regulators, to no avail. Madoff was finally called to account after the crash of 2008, when he could no longer mask his criminal acts.
Roger Boisjoly was a mechanical engineer for Morton-Thiokol, the company that manufactured the solid rocket boosters(SRBs) for the Space Shuttle program. Mr. Boisjoly and his engineering team advised Morton-Thiokol managers that the planned Challenger launch should be postponed because of concerns regarding the O-rings which formed a seal between two sections of the SRBs. Knowing the night before that outside temperatures would be below freezing, Mr. Boisjoly was concerned that it could cause the O-rings to dysfunction, thereby allowing hot gases to escape and lead to a potential disaster. Initially, Morton-Thiokol managers agreed and made those recommendations to NASA. Under pressure from NASA, the managers re-convened to have another private discussion, without the presence of Mr. Boisjoly and the engineering team. They changed their decision and the inevitable occurred when the Challenger was engulfed in flames shortly after takeoff and seven astronauts ultimately lost their lives.
Brooksley Born was a derivatives attorney who was appointed chairperson of the Commodity Futures Trading Commission(CTFC) by President Bill Clinton. The CTFC was the federal body that oversaw the futures and commodities options markets. Included under that umbrella was the over-the-counter derivatives market. Ms. Born appealed to Congress for more transparency and regulations in the derivatives market as they presented a risk to the economy by their instability. This was vigorously opposed by Federal Reserve chairman Alan Greenspan, treasury secretaries Robert Rubin and Lawrence Summers and former SEC chairman Arthur Levitt. Greenspan in particular believed that the market would “right itself” if anything untoward should happen. In 1998, a trillion-dollar hedge fund, Long Term Capital Management(LTMC), whose business was almost entirely based on derivatives, was near collapse. The entire economy hung in the balance. The crisis was prevented when the Federal Reserve intervened. Neither Greenspan nor Congress learned anything from this event. Instead, Congress, under pressure from the financial sector, passed legislation prohibiting the CTFC from the regulation and oversight of derivatives and Ms. Born resigned from her position. Ten years later the worst financial crisis since the Great Depression occurred, largely due to the derivatives market.
All of the above individuals represent whistleblowers who tried to warn the appropriate agencies of impending events that would affect the public and/or the economy. There have been others–in healthcare: Dr. Li Weinling, an opthalmologist who notified the world of the novel coronavirus, Dr. Mona Hanna-Atisha, the pediatrician who exposed the Flint water crisis, Jeffrey Wigand, a biochemist who blew the whistle on the tobacco industry’s disregard for the public’s health and safety when they introduced known carcinogens in tobacco products, etc.
What they all have in common is they paid the price for doing what was ethically and morally right. For their actions they were harassed, threatened, ostracized, jailed, demoted, fired or forced to resign. It would have been easier to do nothing and say nothing. But they couldn’t ignore what was in front of them. Their consciences would not allow it. And they carried on. They did not view themselves as heroes. Just people with integrity.
It would be so much easier for me to ignore what is occurring in medicine in permitting individuals with little to no training in the art and science of medicine to practice it. On the public. Unsupervised. WITHOUT oversight. WITHOUT accountability. WITHOUT real consequences. I wish I could ignore it because I would have less heartburn and aggravation…but I can’t. My conscience simply won’t permit it. I get no peace or respite when that small voice is nagging at me, day and night, about the absurdity of this medical charade and the consequences associated with it. Because human beings are affected. I refuse to subscribe to the balderdash that healthcare professionals with master’s degrees are equivalent to physicians with medical degrees. The illogical reasoning and mental gymnastics it must take for legislators, physicians, administrators, non-physician practitioners, etc. who believe that s**t to pass and/or support laws making what is illegal for anyone else, legal. My best friend has a master’s degree in Child Development…perhaps she can now practice as a pediatrician since she has been in the field for over 20 years. And it doesn’t stop there. The explosion of sham for-profit online doctorate programs are an attempt to add credibility to the non-credible. Mandating Capstone projects a high school student could complete. The National Organization of Nurse Practitioner Faculties(NONPF) has made it a “commitment to move all entry-level nurse practitioner education to the Doctorate of Nursing Practice(DNP) degree by 2025”. What kind of degree is worth the toilet paper it is written on if every NP can obtain it? Eighty-five percent of DNP degrees are non-clinical. So why not make it a goal that they all get PhD’s? Why the sham DNP that anyone with a pulse can obtain? Because it enables them to call themselves “Doctor”, that’s why. That is all it is needed for, without putting in the vast amount of work it actually takes to earn a PhD, MD/DO, DDS, DVM, EdD, etc. But NPs supporting Full Practice Authority(aka FPA, aka “independent” practice, aka practicing medicine without a medical license) will convince vacuous legislators that it is equivalent to those doctorates when it isn’t. Not even close. The same with the Doctor of Medical Science(DMSc) degree for physician assistants. Is it not apparent that the DMSc sounds very similar to “Doctor of Medicine”? What fool believes this is not an intentional manipulation of words and a mockery of education? Add the Full Practice Authority(FPA) and Optimal Team Practice(OTP) agendas and it becomes apparent that every bit of this masquerade is designed to convince the public, our patients, that non-physician practitioners(NPPs)are as good as physicians. That’s it. So they can play doctor with the unsuspecting public as lab rats. And if a mistake or error occurs, as it inevitably will with people who are not licensed or trained in the practice of medicine? The go-to typical trope, “Meh…doctors make mistakes too…” , as if that somehow justifies the damage done. It doesn’t. They know this s**t is wrong and they do it anyway. If you went to school to be a nurse/NP, then be a f***ing stellar nurse/NP and be proud of it. If your desire was to be a physician assistant, then be the best PA you can be and be proud of it. Own it. Accept and respect that medicine must be led by the ONLY professionals trained and licensed to practice it. Physicians. Why the bulls**t with the studies that you are “as good as…” and claiming “equivalent outcomes” to physicians? How the f**k can we have equivalent outcomes when we are three different disciplines with unique responsibilities and roles on the team? Saying it doesn’t make it so. Sloppy “studies” don’t make it so. Fantasizing about it may cause a wet dream but doesn’t make it so. Certainly doesn’t occur by osmosis or materialize out of thin air by rubbing a Genie’s bottle. And there is not one physician on God’s green Earth who is so spectacular that he/she can “teach” a NP or PA to practice medicine with the same depth of knowledge and clinical acumen as a properly trained physician who has completed the appropriate, standardized, educational process to become one. That physician does not exist. Thus, the false equivalency just doesn’t make sense. And if it doesn’t make sense, it ain’t true.
In the meantime, while all this conflation and distortion is transpiring, who the f**k is protecting the public? Not the trollops in the legislature who can be bought and sold on damn near anything if the price is right. Not the health care professionals who oppose, yet indirectly sanction this corruption of medicine because their fear of speaking out causes them to be impotent and ineffective. Certainly not the inept medical and nursing boards who permit these ridiculous laws to pass unopposed. However, there are a select few individuals and one organization, Physicians for Patient Protection(PPP), who are willing to take the heat and suffer the inevitable consequences of doing what is right because it is just f***ing right and BLOW THE WHISTLE on this misrepresentation of and in medicine. They educate the public as to what is occurring so they can better protect themselves. Because an informed patient IS an empowered patient. It really should not be this hard to do the right thing folks. What the f**k happened to our integrity?
“When you’re a liar, a person of low moral fortitude, really any explanation you need to be true can be true. Especially if you’re smart enough. You can figure out a way to justify anything.”–Samuel Witwer
***THIS COMMENTARY CONSTITUTES ONLY THE OPINION OF NATALIE NEWMAN, MD. IT DOES NOT NECESSARILY REPRESENT NOR SHOULD IT BE CONSIDERED AS REPRESENTATIVE OF THE VIEWS OF THE PHYSICIANS FOR PATIENT PROTECTION OFFICIAL ORGANIZATION***