The Best a Doctor Can Be by Pat Conrad MD

It’s a simple recipe, actually, tried and true for decades.  Pick an action or event so awful that no sane person could disagree with trying to oppose or eradicate it.  Then attach your own politics or ideological goal, and attack any opposition to it as somehow supportive of the original awful occurrence.  Then add nuts (optional).

 A Stanford University pediatric anesthesiologist named Alyssa Burgart knows how to work this formula.  As an academic with the Stanford Center for Biomedical Ethics, she knows that certain pronouncements from preferred sources brook no disagreement.

 Dr. Burgart is ostensibly taking on the topic of physician-initiated sexual assault, a horrible act that no sane person could accept. 

She cites a study of 280 ethical violations over an 8-year span, 95 of which were sexual assault.  Burgart references the fashionable #MeToo craze, stating, “It should come as no surprise that 100% of the cases DuBois and colleagues found were perpetrated by men, and greater than 85% of victims were women.”  Okay, rapists are far more likely to be men than women, and their victims more likely to be physically weaker females. 

 She cites the Agency for Healthcare Research and Quality as defining “sexual assault in the health care space as a ‘never event,’ an event that should never occur and is always preventable.'”  But since that is already a gruesome crime, who cares what the AHRQ thinks?  Bureaucrats, apparatchiks, and attention seeking academics, that’s who.  Burgart says, ” A broken system forgives doctors in every state,” and states there is “a lack of clearly defined consequences” for doctors who commit assault.  Obviously that is wrong, and those states should correct themselves immediately.  The article cited by Burgart is chock full of awful, completely inexcusable anecdotes, the perpetrators of which, we can all agree, should not be practicing medicine any longer. 

 So why did I say “ostensibly?”  Burgart:  “In a sample where 100% of perpetrators are men, I know one thing for certain: More men in leadership positions in medicine is not the solution.”  So we are to believe that the depraved, often insane, criminal assaults of a very few result in a lack of proper leadership?

 Burgart:  “Egregious ethical violations by individuals are the downstream symptoms of the systemically gendered culture of medicine, from training to the bedside to the boardroom. For women, who are affected both as physicians and as patients, we are in a unique position to see how the bigger picture of gender inequity is harming us — physically, emotionally, and professionally.”  Uh-oh.  So the problem is that there are too many men in medicine?

 Burgart:  “A growing body of evidence indicates that patients in the hands of women are safer: Women’s patients have lower readmission rates … and lower mortality… and more women in operating rooms promotes cooperative behavior (a quality essential for preventing medical errors).”  Apart from practicing all the lines for MOC exams and mandatory state license renewal CME’s, this colleague is flatly stating that men are the problem in medicine. 

“The medical profession has a moral imperative to achieve gender equity in our highest echelons. The sooner, the better, for every patient’s safety and well-being.”  So this about making medicine safer for patients, and who could oppose that? 

 Except it’s not.  Burgart:  “Fear of sexual harassment, sexual assault, and being dismissed for being a woman are the hidden curriculum of girlhood.”

– “Men have historically dominated medical leadership, and continue to do so, with 85% of department chairs still occupied by men. The #MeToo and #TimesUp movements have society finally acknowledging that men do not understand and cannot represent the lived experiences of women and that it is costing us human capital.”

–  “Gender equity is the moral imperative. Women deserve equality and patients deserve a safe haven. Women physicians protect patients in their practices, and any organization that fails to root out inequity is effectively shortchanging its patients and their safety. Women physician leaders protect patients and health care workers by promoting a perspective that is sorely lacking today.”  

This is not about protecting patients.  This is about gender politics and using a criminal act to justify quotas.  That is a dubious position for an ethics expert to take.

In a time when all physicians are being targeted from every direction, we should be able to count on each other as colleagues, without counting quotas or worrying that we’ll get blackjacked for being born with the wrong chromosome.  Dr. Burgart’s credentials are impressive, and I’m sure she is an excellent physician.  It’s too bad that she, by her own words, would be unwilling to assume the same about so many of us.

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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] 

  3 comments for “The Best a Doctor Can Be by Pat Conrad MD

  1. mamadoc
    February 1, 2019 at 9:28 pm

    Well, I’ve been in the profession 40 years, have my own collection of ‘me too’ stories, and I call BS. There’s bad apples of both sexes, always have been. More of them were men because most physicians were men, a situation I expect will change as the numbers of women increase. And as for women in medicine being harassed more than those in engineering or science my engineer daughter and immunologist niece would likely disagree.

  2. Steve O'
    January 28, 2019 at 10:48 am

    By implicitly taking the high ground, the advocate completely silences other forms of inappropriate behavior and sexual conduct. The California Law Review in the article “Real Rape Too” states: “But the real problem is this: In arguing for reform, feminist scholars have legitimized and contributed to the very gender distinctions of which they have been so critical. In response to one form of subordination, they have entrenched another.”
    In the US Department of Justice, The Bureau of Justice Statistics (BJS) has initiated …projects to identify, develop and test the best methods for collecting.. data on rape and sexual assault in the community at large, as well as in the incarcerated population. See Link. A majority of prison staff sexual misconduct occurs between female corrections OFFICERS and male PRISONERS. “An estimated 1.5% of prison inmates and 1.4% of jail inmates reported that they had sex or sexual contact unwillingly with staff as a result of physical force, pressure, or offers of special favors or privileges. An estimated 1.4% of all prison inmates and 0.9% of jail inmates reported they willingly had sex or sexual contact with staff. Any sexual contact between inmates and staff is illegal, regardless of whether an inmate reported being willing or unwilling…” BJS But now the culture has changed. The days of female rape just being brushed off with “you know she was asking for it,” have become the times of “you know he was just asking for it,” and the toxic myth that men are always willing to have sex.
    This goes for child rape as well. In juvenile facilities, “Among the estimated 1,390 (incarcerated) youth who reported victimization by staff, 89.1% were males reporting sexual activity with female staff and 3.0% were males reporting sexual activity with both male and female staff. In comparison, males comprised 91% of adjudicated youth in the survey and female staff accounted for 44% of staff in the sampled facilities.” Juvenile Facilities.
    If Alyssa Burgart with the Stanford Center for Biomedical Ethics denies the existence of female perpetrators and also male victims of unwanted sexual contact, she is perpetuating the rape culture under another standard. Is Dr. Burgart completely innocent, or is she a #metoo perpetrator hiding as a white knight?
    Phonies are sometimes easy to spot, because they are unable to handle the complexity and reality of situations. They are willing to demonize a subgroup of people as being inferior. My test for this sort of behavior is to replace the filthy phrases of the Third Reich with the complaints of today. Here’s how Reichsleiter Burgart’s reads:

    Jewish doctors have historically dominated medical leadership, and continue to do so, with 85% of department chairs still occupied by Jews. The #NSDAP and Nazi movements have society finally acknowledging that Jews do not understand and cannot represent the lived experiences of Aryan and that it is costing us human capital.” (ugh..human capital? what an inhumane phrase)
    Racial fairness is the moral imperative. Aryans deserve equality and Aryan patients deserve a safe haven from Jews. Aryan physicians protect Aryan patients in their practices, and any organization that fails to root out inequity is effectively shortchanging its Aryan patients and their safety. Aryan physician leaders protect patients and health care workers by promoting a perspective that is sorely lacking today.”

    I think I’m gonna vomit.

    • PW
      January 28, 2019 at 11:20 am

      But, equality of opportunity does not equal equality of outcome.
      I’d say Dr. Burgart has a pretty sexist approach.

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