Doctor, heal thyself
Luke 4:23
Since I retired I have watched a lot of financial TV. In the past, speakers would give advice on what to buy or sell pretending to only have the best interest of the home viewer in mind. Of course, most speakers were actually “talking their book”, that is promoting or trying to sell you some stock they already own. After a few major scandals, the networks decided to require disclosure of what the speakers owned.
As questionable as the ethics of this situation might be, it turns out doctors “talk their book” all the time. When you go to a doctor with a problem, they routinely recommend the treatment or therapy that they perform, and get compensated for. It is not considered unethical for a doctor to evaluate a patient, and recommend his own therapy, without requiring an opinion from another expert. One of my favorite recollections from practice was attending the weekly tumor boards. After patient was presented, and it was not unusual for the Surgeons to recommend surgery, Radiation Therapists to recommend radiation, and Oncologists to recommend chemotherapy, all for the same condition. Experts in their own field would selectively quote the literature to support treatments that would benefit the doctor, as well as the the patient(presumably).
One wants their doctor to be confident in his own ability to treat, but the perverse financial incentives and unrestrained egos have gone too far. Patients, insurance companies, industry and the government are aware of this ethical lapse of the part of physicians. I feel much of the decreasing respect and negative reactions to physicians can be traced to this loss of our moral integrity. Even the perception that doctors are more concerned with their own bottom line than patient well being is extremely damaging.
More important is the resultant impact upon healthcare in general. If physicians can bend the truth for money, why not drug companies, vitamin salesman, insurance companies, and faith healers?
The article today addresses the enormous amount of medical information on the internet that is unverified. People in search of medical information are bombarded by undocumented and frequently false information promulgated by the complete range of sites, from true experts to complete cranks. Unfortunately, the inability of physicians to control their own avarice makes it much harder to point fingers at those attempting to exploit patients for financial gain.
In my next post I will discuss a truly heinous example, the physician who fabricated a paper on the link between autism and vaccines, in order to make money, causing the death of many children.
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