Articles by JCS

Response to RWJF

                                                                                                                                      

Word count: 3003

America’s Medical Mess

Response to Dr. Risa Lavizzo-Mourey

Healthcare problems remain paramount in the news ranging from the pros and cons of Obamacare to the recent horrific stories emanating from the inept management of the DVA hospitals.

Lost in this bureaucratic mess remain the core problems with the prevailing medical (allopathic) healthcare system itself. Even when full access to medical care improves, patients will still find themselves inside the most dysfunctional health care system in the industrialized world.

Indeed, the current medical dilemma seems to be the old adage of ‘throwing good money in after bad.’ Not only are accessibility and cost grave issues, but so is the quality of American medical care where misdiagnosis, mistreatments, and misinformation abound.

Despite its quest to appear as “scientific medicine,” the allopathic approach consisting primarily of ‘wonder drugs’ and ‘heroic surgery’ have not delivered the goods as promised. Indeed, despite its foolish mantra as the “best healthcare system in the world,” comparative studies on chronic degenerative diseases and longevity reject this claim.

To give credit where credit is due, medical care excels in the emergency rooms if the patient doesn’t die waiting to be seen as noted recently in the VA controversy.

But for the management of the other 90% of chronic disorders, including the huge arena of musculoskeletal disorders that plague 80% of Americans, the allopathic approach has failed miserably as the guidelines verify.

In fact, the huge burden of back pain can be laid at the doorstep of medical spine care that has been dubbed the “poster child of inefficient spine care” by Mark Schoene, associate editor of THEBACKLETTER, a leading international spine research journal. Mr. Schoene also warns that “such an important area of medicine has fallen to this level of dysfunction should be a national scandal. In fact, this situation is bringing the United States disrespect internationally.”[1]

The national scandal in healthcare extends beyond the medical mismanagement of back pain. Recently the Commonwealth Fund released its report: Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationally.

From its Executive Summary:

The United States health care system is the most expensive in the world, but this report and prior editions consistently show the U.S. underperforms relative to other countries on most dimensions of performance. Among the 11 nations studied in this report—Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States—the U.S. ranks last, as it did in the 2010, 2007, 2006, and 2004 editions of Mirror, Mirror. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last or near last on dimensions of access, efficiency, and equity. In this edition of Mirror, Mirror, the United Kingdom ranks first, followed closely by Switzerland.

This is not a new issue. Back in 2000 the World Health Organization released its findings that were also shocking.[2] WHO announced at its June 21, 2000, press conference that America ranked 37th out of the 191 countries in the United Nations in overall healthcare delivery systems, 72nd in overall population health, while number one in overall costs (grown to $2.4 trillion today).

Little was said by embarrassed federal government HHS officials, the various medical associations, or the media medical journalists to explain how this travesty occurred and why our health situation remains in dire straits today.

Indeed, it’s the 800 pound gorilla in the room no one wants to talk about.

Certainly more drugs, shots, surgery, imaging, and hospitalization are not the answers to improving the quality of health in America, yet the medical industrial complex fights tooth-and-nail those health practitioners that practice complementary and alternative wellness methods, aka, CAM providers.

A good example of this boycott occurred recently on June 25, 2014, when Robert Woods Johnson Foundation’s CEO Risa Lavizzo-Mourey, MD, MBA, discussed the challenges in healthcare in her keynote address, “We Will Have A Powerful Story to Tell: Building a Culture of Health in America.”

Outwardly she did a good job selling her quest to improve healthcare by spouting all the appropriate politically-correct buzz words, but she was way off target.

She spoke of a few peripheral efforts by NGOs, volunteers, and non-medical groups to improve quality and access, but she missed the bull’s-eye with no mention of CAM providers, those educated and professional practitioners who the public has already turned to for help away from the allopaths.

 Dr. Risa’s speech, while laden with kumbaya, was also disingenuous.  Her appeal to help those in need appeared to be false moralizing, hypocrisy, and a naively optimistic view of the medical mess. She danced all around the main issues while painting herself and RWJF as the solution to this dilemma without mentioning the actual cause of this medical mess is her own profession!

As a Harvard-educated MD, she also failed to mention the most likely source of help to change the culture of health in America – CAM practitioners. Ironically, in addition she failed to mention a fellow Harvard professor who years ago discovered this trend to alternatives.

Two landmark studies by Dr. David Eisenberg from Harvard’s Osher Institute revealed more Americans were seeking non-drug, non-surgical solutions and made more visits to complementary and alternative (CAM) providers than MDs.

Baby Boomers made 427 million office visits to non-MDs in 1990 compared to 388 million visits to MDs; the follow-up survey in 1997 revealed that the numbers to non-MDs rose to 629 million while the numbers to MDs went down to 386 million.[3]

These two studies stunned the medical world; as many shocked medical trolls must have wondered, why Americans would choose “quacks” over “modern medicine”?

Apparently the threat to the monolithic medical profession was bigger than anyone had imagined once the researchers took a closer look, but still ignored by spokespersons like Dr. Risa as the natural solution to this medical mess.

Dr. Eisenberg noted how his own view of chiropractic specifically has changed from his early days to the present. He was taught in medical school that chiropractic was “irrelevant, worthless, a waste of money, and dangerous,” a view still professed by a Johns Hopkins professor, Steven Salzberg, in his article, New Medicare Data Reveal Startling $496 Million Wasted On Chiropractors, on April 20, 2014.

Eisenberg mentioned in the 1980s the various CAM  professions were “unproven, unorthodox, and unconventional.” After his study showing the huge usage of CAM, he noted that the terminology has changed from “complementary and alternative” in the 1990s, to “integrative” in 2000-05, and “comprehensive” in present-day.[4]

Upon seeing the huge number of Americans using CAM practitioners, Dr. Eisenberg concluded, “Maybe ‘alternative’ isn’t so alternative anymore.”[5]

Despite the growing popularity, medical spokespersons still ignore his findings as we witnessed with Dr. Risa’s presentation or the media attacks on CAM, such as we’ve witnessed on numerous occasions from Dr. Sanjay Gupta @ CNN who has no love lost for chiropractors.

An example how Dr. Gupta, CNN’s chief medical reporter, obviously suffers from professional amnesia occurred on his special program about Hillbilly Heroin, Deadly Dose, when he inexplicably failed to mention chiropractic care as a non-drug solution to the epidemic of back pain, the main reason why people use opioids.

On June 18, 2013, Dr. Paul Offit wrote an extremely biased op-ed article @ CNN.com, Opinion: Alternative healing or quackery?  Even the use of the “q-word” in the headline is the medical equivalent to the “n-word,” as I mentioned in my rebuttal, CNN Slams CAM.

Dr. Offit presented alternative therapies in a very contemptuous manner by describing CAM as “worrisomely popular” as well as his snide remarks that “the therapist makes a fortune off your misfortune,” and “the therapist promotes ‘magical thinking’.”[6] Is this not the pot calling the kettle black?

I found his comment “worrisomely popular” to be particularly indicative of his medical bias, aka, chirophobia in our case,  equivalent to a medical version of the proverbial Jim Crow attitude that bemoans the growing call for equality for women, fairness for minorities in our country or, in this case, equal opportunity for CAM providers in healthcare.

It’s troubling that the medical media has taken this anti-anything-but-allopathy approach considering America is stuck in the throes of a healthcare crisis that will eventually bankrupt our country.

Indeed, one would think the medical profession needs all the help it can get to fight the costly ravages of disease and impairment, but obviously the AMA is more concerned about cornering the market than free enterprise and enlisting the help of non-MDs.

Accept No Medical Substitute

In her presentation that showcased numerous civic organizations, Dr. Risa also failed to mention any inclusion of CAM in her vision of a culture of better health. I previously wrote to her about her preceding article, A Bird’s Eye View,” to improve healthcare by suggesting that chiropractors be integrated as America’s primary spine care providers, but never received a response from her. Nor did RWJF respond to my grant submission to fund a documentary about the medical war on chiropractors.

Ostensibly it seems to escape Dr. Risa why the US has the most expensive but least effective healthcare system in the industrialized world. Nor does she seek help from CAM rivals who undoubtedly have been disparaged by the arrogant Harvard medical establishment as unworthy.

This medical mess is not a function of bad luck or happenstance, but this dysfunctional system is the construct of two problems:

  1. The American medical industrial complex that has run amok for over a century to create its profitable albeit ill-begotten medical system that as led our nation to the brink of bankruptcy, and
  2. The allopathic (drugs, surgery) approach to health care itself is a sickness care system at best and a deterrent to preventative care and holistic methods provided by CAM practitioners.

Aside from the century-long war against CAM providers by political medicine, new proof abounds of my contention that Dr. Risa Lavizzo-Mourey and her own medical profession wants nothing to do with the inclusion of non-MDs or her “diversity in the mosaic of American culture.”

Dr. Risa simply needs to read the 2012 White Paper by The Physicians Foundation, “Accept No Substitute: A Report on Scope of Practice” to understand why her speech appears disingenuous.

 This new declaration of war to limit the scope of non-MDs clearly shows the medical industrial complex has no interest to enlist non-MDs into the healthcare battle against disease, pain and suffering; instead, it simply wants to maintain control of the market place by restricting any and all attempts for non-MDs to expand their scope of practice.

The Executive Summary clearly states the goal to maintain a medical monopoly:

One of the most persistent and vexing challenges facing practicing physicians and the organizations that represent them—and an issue with profound implications for health care in this country—has been the growing demand by a broad array of non-physician providers for state legislatures to expand their scope of practice into areas that until now have been restricted to physicians…Yet on the whole, physicians and their advocates have so far been remarkably successful in holding the line on many of these expansionary forays.

 

This White Paper cleverly outlined its game plan to obfuscate the true nature of its greedy objective.

Despite some differences among state medical society leaders regarding how confrontational to be—differences that most likely reflect different economic and political realities—most of those interviewed for this report are strong:

(1) support and advocate for a program of research to examine the broader impact of non-physician providers on the quality, safety and cost-effectiveness of patient care;

(2) develop a standardized central reporting system in each state to enable physicians to report negative health outcomes resulting from non-physician care;

(3) create a password-protected website to enable state medical associations and their allies to share information and “lessons learned” across states; and

(4) undertake a concerted effort to engage non-medical allies—especially patient and consumer groups—who could support physicians on scope of practice.

This last step could be especially important as a way of counteracting the corrosive perception that physicians are “only in it for the money.”

 

This White Paper clearly shows that fair competition on a level playing field is not the preference of the medical warlords who have ruled healthcare with an iron fist to the detriment of chiropractors, CAM providers, and patients alike. Rather than allowing the free market to prevail in healthcare, the medical industrial complex fights to maintain its control now as in the past.
  
         As Harper’s Magazine once said in 1949, it is time for the public to see the AMA for what it really is -- “the most terrifying trade association on ea
rth.[7]

Rise of the Medical Monopoly

Perhaps Dr. Risa needs a lesson in the rise and imminent fall of the medical monopoly considering the Commonwealth Fund and WHO stats surely are indicative of a failing medical system on its last leg struggling to keep hold of its power.

Over the last century, the AMA historically has attacked homeopaths, naturopaths, osteopaths, dentists, optometrists, podiatrists, psychologists, chiropractors, black MDs, and, nowadays, nurse practitioners are even under attack.

Indeed, anyone who might compete with MDs has come under fire from the medical guns as well as presidents calling for healthcare reform. Every American president from Teddy Roosevelt, FDR, Truman, JFK, LBJ, Clinton, to Obama who has tried to reform healthcare has found themselves at loggerhead with the AMA’s resistance to change.

Nowhere else in our society has one trade association held such power to exploit a market place. Although other monopolies have been broken up, such as AT&T and Standard Oil, the American medical industrial complex has acted as a de jure monopoly granted by our government. This status enabled the medical trade association to take over public hospitals and manage public healthcare systems with impunity and for their own profit.

The medical society effectively convinced legislators that healthcare was too complex for simple laymen-legislators to understand and, thus, became the sole arbiter of all-things-medical and thus became the fourth branch of government (albeit unelected, self-appointed, and self-serving).

This antitrust activity was carefully crafted by the American Medical Association starting in 1930 under the auspices of its director, Morris Fishbein, who was also known as the “Medical Mussolini” for his effective yet tyrannical leadership to corner the market by eliminating or defaming all competition.[8]

He was not coy when he wrote of his evil intention: “Scientific medicine absorbs from them that which is good, if there is any good, and then they die.”[9] Many alternative practitioners have died in the medical wars, and many more were left gravely wounded or emotionally scarred for life for the crime of helping sick people get well without drugs or surgery.

Few Americans realize the AMA’s persecution of chiropractors as a “dangerous, unscientific cult threatening the public welfare,” a concept I refer to as ‘chirophobia’, led to over 12,000 chiropractors being arrested over 15,000 times in the first half of the 20th century.

To empower his medical dynasty, in 1930 the Medical Mussolini required money to fund his war chest and inexplicably jumped into bed with the tobacco industry that paid him millions to advertise cigarettes in his medical journals, maintain vendor booths at his AMA conventions, and he allowed physician images in public ads of tobacco products.

Ironically, the media turned a blind eye to the so-called ‘guardians of health’ in bed with the largest killer ever known to mankind that symbolized the dastardly ethics of the AMA to do whatever was required to maintain its domination of the healthcare marketplace.

You may be old enough to remember when cigarette ads used images of MDs; if you don’t remember, simply log on to “The Doctors’ Choice Is America’s Choice” The Physician in US Cigarette Advertisements, 1930–1953, or view vintage cigarette ads @ 10 Evil Vintage Cigarette Ads Promising Better Health.

MDs hawking cigarettes lasted until 1986 when public uproar over the connection between tobacco and cardio-pulmonary diseases forced the AMA to divest itself of tobacco sponsors. Undeterred, it quickly switched bed partners to Big Pharma where it remains conjoined today, which explains why Americans are now the most over medicated society in the history of the world as physicians hand out meds like Halloween candy despite the serious side-effects, costs, addictions, and deaths.

Re-inventing the Healthcare Wheel

Instead of accepting the American way of free enterprise in healthcare as a solution to improve outcomes and lower costs, today the medical cartel fights to maintain its political domination via the AMA’s House of Delegates that voted to pass its Resolution 241 to repeal Section 2706, the non-discrimination clause in Obamacare.

Such medical hate speech has always been an acceptable form of prejudice among the medical writers who ignore the evidence to spew their bias as we have seen from the Institute of Science in Medicine, the home of current online medical trolls such as Harriett Hall, Stephen Barrett, and the infamous Edzard Ernst. Their myopic stance is eerily similar to medical McCarthyism, if you will.

If RWJF and Dr. Risa want to improve the quality of healthcare in our country, I suggest she’s missing the point that her own medical industrial complex stands in the way to solving this problem.

As well, the solution does not rest with peripheral volunteers. If she wants the best help, Dr. Risa must enlist the help of the thousands of CAM providers who already are trained in wellness methods.

Dr. Risa does not need to re-invent the wheel nor does she need to appear as the sanctimonious leader in this charge that has been fought for over a century by CAM providers despite the warfare waged by the AMA under false pretenses.

If and when Dr. Risa and her medical friends at RWJF stop chanting their kumbaya, I urge them to seek the advice of chiropractors, acupuncturists, homeopaths, naturopaths, nutritionists, exercise physiologists, therapeutic massage therapists, and other CAM providers who know exactly how to improve naturally the general health of all Americans without drugs, shots, or surgery.



[1] US Spine Care System in a State of Continuing Decline?, The BACKLetter, vol. 28, #10, 2012, pp.1

[2] WHO: The World Health Report 2000—Health systems: Improving performance. June 21, 2000.

[3] DM Eisenberg, RC Kessler, C Foster, FE Norlock, DR Calkins, TL Delbanco, “Unconventional  Medicine In The United States--Prevalence, Costs, And Patterns Of Use,” N Engl J Med 328 (1993):246-252.

[4] DM Eisenberg, “Practicing within Mainstream Healthcare,” seminar held at the Massachusetts Medical Society headquarters, Boston, Nov. 18, 2006.

[5] Ibid.

[6] Opinion: Alternative healing or quackery? By Dr. Paul Offit, Special to CNN,  June 18, 2013

[7] MS Mayer, “The Rise and Fall of Dr. Fishbein,” Harper’s Magazine (Nov. 1949):76-85.

[8] JH Donahue, “Morris Fishbein, MD: The ‘Medical Mussolini’ and Chiropractic,” Chiropractic History, 16/1 (1996): 39-48.

[9] Morris Fishbein, Medical Follies, New York, Boni & Liveright (1925):43.


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