WTF DID WE THINK WOULD HAPPEN?

Medicine ain’t easy. It was never supposed to be, considering the human body is a very complex entity which exists in a constant state of flux, continually changing over the lifespan of an individual. The SCIENCE of medicine requires that we physicians understand and manage those complexities competently. The ART of medicine necessitates that we effectively adapt to the continual ebbs and flows of a mortal being’s internal and external workings. Add to that the diversity of humans in general, and it is not difficult to comprehend that expertise, creativity and resourcefulness is essential if we expect to master our craft and manage patients appropriately. We must perfect these skills because patients don’t always follow the book. It is our job as healers and teachers in medicine to become adept at interpreting each book. It is this aspect that drew many of us to medicine. The fascinating puzzle that is the human condition…and the challenge of how to heal its imperfections as best we can. We then take what we master and pass that knowledge on to those to whom we will eventually hand the torch. For one purpose only–to continue benefiting mankind.

Unfortunately, we permitted the entrance of the corporate cartel into our carefully and lovingly crafted House of Medicine, escorted by the sycophantic traitor trash ho’s inside our House who acted as their Trojan Horse. And the cartel set about bringing down the House. My question is:

WTF DID WE THINK WOULD HAPPEN?

Business people do what business people do, they focus on profits. Smart business people care about the product because if the product is good, people will keep buying it. But these heathens who invaded our House of Medicine don’t give a s**t about the “product”, which is the quality of care being provided. They view medicine as black and white. Volume is mo’ money. So focus on the volume of patients, not the value of care being meted out to the public. The patients are not human, they are commodities who supply the much desired end-result of revenue. In other words…they make it rain. Benjamins. The cartel(and insurance companies) monopolizes the market to make it as difficult as possible for the average person to have a choice in who cares for them or where they receive care. Place the public between the proverbial “rock and a hard place”, then tell them to choose–when neither choice is desirable. Bottom line: the cartel removed the patient’s choice. No one should be surprised by this.

WTF DID WE THINK WOULD HAPPEN?

But there was an inherent problem that impeded the business. Physicians. You know, the people who took a Hippocratic Oath and had a tendency to protect the patient-physician relationship. And we’re expensive to boot. The cartel had to find a way to diminish our role in order to remove not only our influence on patients, but on medicine as a whole. They had to convince us that we also had no choice but to follow their non-medical guidance. Not an easy task since docs tend to be confident creatures and we know medicine quite well. Nevertheless, the cartel recognized that is exactly where they needed to begin to gain control–break down our confidence. Lack of confidence instills doubt. Doubt is a physician’s Achilles heel. I will not elaborate further except to say that this article by Richard Gunderman, MD delineates the insidious methods used by corporations to accomplish what would have seemed to be the impossible(https://thehealthcareblog.com/blog/2014/09/18/how-to-discourage-a-doctor/). The next step was to get our a**es out of the House of Medicine and use unreasonable facsimiles to replace us because they were cheaper. Lo and behold, by effective and redundant propaganda, they managed to convince not only the public, but supposedly intelligent physicians and other healthcare professionals(HCPs), to use the abhorrent term “provider” to de-identify exactly who we were. It is there the conflations of previously transparent roles, and thus the intentional confusion of the public, was initiated. These were predatory business people who recognized the profitability in sickness and death and persuaded the healers to allow them to take over an honorable profession. When we allowed that,

WTF DID WE THINK WOULD HAPPEN?

Physicians, who have been training non-physician practitioners(NPPs) for decades to delegate and help extend care to populations or regions which had minimal to no access to health care, were now training their replacements. The altruistic beginnings that led to the creation of physician assistants(PAs) and nurse practitioners(NPs) was circumvented to become a tool manipulated by the cartel to enhance the bottom line. “Supervision” became notional as the calculated removal of physicians by corporate pimps left an intentionally planned staffing shortage. Unsurprisingly, the docs left behind were unable to supervise NPPs appropriately. That too was intentional. The cartel however, ensured the “training” of NPPs would continue by mandating it in our contracts, with no offer of compensation for our time and while practically guaranteeing that we would remain legally liable for the NPPs actions. Foolishly, we did it. When we “trained” NPs in particular, we thought we knew what we were doing, when we didn’t know anything about their curriculum(and most docs still don’t) which is distinctly different from ours. We fell for the hype that NPPs could do what we do. Despite that illogical premise, the lack of supervision subsequently became purposeful on our part and complacency set in. Sadly, the patients were left without advocates, their sentience and humanity all but forgotten while the business of algorithmic, cookie cutter medicine carried on. Eventually, more stories began appearing of preventable and inevitable tragic mishaps caused by NPPs who, despite possessing little to no formal training in the practice of medicine, were permitted to practice it anyway. With these individuals being left alone to manage patients in an urgent care, hospitalist service, ICU or ED unsupervised…again, I ask you,

WTF DID WE THINK WOULD HAPPEN?

Folks, when we allow people in medicine who have no business in our House, who then empower unqualified others to practice medicine by legislation and not education, we cannot feign surprise at the resultant consequences of those actions. They are foreseeable; thus we reap what we sow. The problem is the majority of the victims of the harm being done by this nonsense are lay people.The reality is that there are indeed health care “professionals” who see the public as lab rats on whom they can “play doctor”. They nonsensically subscribe to the false belief that abbreviated training programs and fly-by-night certifications invoke expertise. Their ability to feel remorse for the damage they do is not only blunted by their ignorance, but also by their lack of integrity, education, maturity and ownership of their patients. They objectify the patients who they perceive as existing for their purpose only. Authentic, empathetic health care professionals internalize and reflect on their mistakes, so they never occur again. They learn and grow. Charlatans have no understanding of this concept. They are bad for the public and for the entire health profession. They have to be put out along with their enablers, the corporate cartel and pimps who currently abound in medicine. Until we do, then we cannot behave as if we didn’t know what the f**k would happen. We know. It’s predictable.

In the land of the blind, the one-eyed man is stoned to death.–Joan D. Vinge

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