Articles by JCS

Medical Impeachment

MAKING A CASE FOR MEDICAL IMPEACHMENT

For the third time in our lifetime, a president has been impeached for “high crimes and misdemeanors.” By definition impeachment means “the action of calling into question the integrity or validity of something.”  

According to Alexander Hamilton, the “jurisdiction” of impeachment also extends to:

“…those offenses which proceed from the misconduct of public men, or in other words, from the abuse or violation of some public trust. They are of a nature which may with peculiar propriety be denominated POLITICAL, as they relate chiefly to injuries done immediately to the society itself.”

The current impeachment of Donald Trump brings to mind the abuse of public trust by another larger cultural authority happening over a longer period of time — the medical profession, the strongest and certainly the wealthiest political player on Capitol Hill that will be around long after Trump is gone.

MEDICAL HIGH CRIMES

Since 1930 there have been at least three “high crimes” committed by the medical profession that have “abused public trust” causing “injuries done immediately to the society itself” as well as enriching the medical industrial complex in clearly quid pro quo situations.

A close up of a newspaper
Description automatically generatedThe first egregious high crime began in 1930 when the AMA jumped into bed with Big Tobacco in exchange for millions of dollars in advertising—clearly a quid pro quo (this-for-that) situation. Smoking became socially acceptable because doctors endorsed cigarettes and said nothing to warn their patients for 56 long years to stop this high crime as cardiopulmonary diseases continue to dominate in our society. Nor has the AMA or MDs ever apologized for their bad action withholding important warnings of tobacco products. Instead, the medical professionals created a huge business for themselves treating cardio-pulmonary diseases that still proliferate to this day. Yet the same MDs regard themselves as the “guardians of our health.” Okay, stop gasping in disbelief!

The second high crime occurred after the AMA divested itself from its tobacco whore when it jumped into  bed with its next partner of illicit repute, Big Pharma, aka, the Drug Kingpin, with the egregious overuse of the antibiotics creating “Superbugs”— strains of resistant bacteria such as Clostridium difficile (C. diff), Neisseria gonorrhoeae, Carbapenem-Resistant Enterobacteriaceae (CRE), and methicillin-resistant Staphylococcus aureus (MRSA).

These deadly Superbugs each year infect more than 2 million people nationwide and kill at least 23,000, according to the CDC. Drug-resistant forms of tuberculosis, gonorrhea, and staph infections are just a few of the dangers. Roughly 700,000 people worldwide die from antibiotic-resistant diseases each year according to the BBC and the number of these deaths will jump to 10.7 million by 2050 and will outpace cancer as  the leading worldwide killer.

THIRD HIGH CRIME: OPIOID PAINKILLERS

Certainly the deadliest medical malpractice and impeachable offense we see today is the overuse of prescription opioid painkillers that may kill nearly half a million people across America over the next decade as the crisis of addiction and overdose accelerates.

The recent lawsuits in Oklahoma and Ohio testify to the deceit, harm, and outrageous profitability by Big Pharma’s culpability with MDs and pharmacists to seduce and profit from the gullible public addicted to their brand of medicinal heroin. Again, does this sound like MDs are our “guardians of health”?

And just like Mexican drug cartels, the American drug cartel will protect its lucrative market regardless of a few lawsuits, which are viewed as just the cost of doing business in the corrupt and lucrative for-profit American healthcare system. Transferring funds to offshore havens in the Cayman Islands is just one way Big Pharma copes to protect its ill-begotten profit.

This opioid epidemic was built on lies, deception, and greed that shows no sign of disappearing evident by a new wave of young addicts on the horizon. One in five high school students abuse painkillers with 2,500  teenagers starting every day.[1] Almost 50% of teens believe that prescription drugs are much safer than illegal street drugs — 60% to 70% say that home medicine chest are their source of drugs or buying them at school. [2]

Indeed, who needs “el Chapo” when we have “Dr. Chapo” or now even “Madre Chapo” supplying drugs?

DRUG KINGPINS, PIMPS, PUSHERS & DEALERS

If the illegal medical and media boycott of chiropractors were not still in effect and if patients had unfettered access to conservative care, this opioid crisis would not be the "worst manmade public health crisis in the history of our state and country" as stated by Oklahoma State Attorney General Mike Hunter.

In a recent lawsuit the judge ordered Johnson and Johnson to pay Oklahoma state $572 million, which was a far cry from the $17.2 billion sought by the AG. Although $572 million sounds like a lot of money, it is pocket change to J&J considering Johnson & Johnson’s net worth as of November 2019 was $345.3B

This award is also pale in comparison to a  state court jury in St. Louis that ordered Johnson & Johnson to pay $4.7 billion in damages to 22 women and their families who say the company's talcum powder caused their ovarian cancer.

It is also a pittance in comparison to a 2012 decision by a judge in Arkansas who ordered Johnson & Johnson to pay $1.2 billion in fines over its marketing for an antipsychotic drug, Risperdal. A jury found that J&J failed to properly disclose the drug's possible side effects such as weight gain, risk of strokes in older patients, and increased risk of diabetes.

Again, these side effects are minor compared to those from opioid painkillers. In both cases, no one died from the J&J products as over 40,000 annually did in the opioid case, nor were nearly as many people victimized with long term abuse, addiction, and death killing 130 Americans daily.

Mr. Hunter likened Johnson & Johnson to a “drug kingpin” that has targeted an unsuspecting public since the 1980s. “There were a lot of bad actors in this long chain of causality,” he said.

Using Mr. Hunter’s metaphor, If J&J is characterized as the “drug kingpin,” it’s fair to say its sales reps were “pimps” misrepresenting themselves as “pain experts with no training in addiction science or the practice of medicine” who bribed doctors. In turn, physicians were the “pushers” who prescribed narcotics to unsuspecting patients  who “in this long chain of causality” were sold dangerous narcotic painkillers by pharmacists, the “dealers.”

Mike Hunter put this medical malpractice into perspective:

“Our evidence will show, Your Honor, that in their zeal to provide a magic drug, they ignored well-documented scientific histories of deadly addiction epidemics, and embarked on a cynical, deceitful, multimillion-dollar brainwashing campaign to establish opioid analgesics as the magic drug.”

Hunter told the court, “How did this happen? At the end of the day, Your Honor, I have a short, one-word answer: greed.”

This greed was shared among all these bad actors who profited — MDs and pharmacists. Why weren’t these medical pimps, pushers, dealers, and co-conspirators also accused of malpractice along with J&J? if every primary care MD and pain management clinic were found guilty, there would be few MDs left except, perhaps, a few pediatricians.

This illegal and immoral practice is not new in the making. Thirty years ago, Big Pharma paid “thought-leaders” like Drs. Russell Portenoy, a New York City pain specialist, to chide wary MDs who resisted the use of opioids for chronic pain cases, accusing them as suffering from “opioid-phobia.” In 1986, Portenoy published a paper, “Chronic use of opioid analgesics in non-malignant pain: report of 38 cases,”[3] allegedly to determine the indications, course, safety and efficacy of opioid therapy and found no problems with this sales pitch:

“We conclude that opioid maintenance therapy can be a safe, salutary and more humane alternative to the options of surgery or no treatment in those patients with intractable non-malignant pain and no history of drug abuse.”

Dr. Portenoy claimed that the risk of addiction to opioids used to treat chronic pain was less than 1%; this figure was based on virtually no scientific evidence according to The Wall Street Journal.[4] Portenoy and other “pain doctors” who promoted the drugs now admit they overstated the drugs’ benefits and glossed over the risks. 

“Did I teach about pain management, specifically about opioid therapy, in a way that reflects misinformation? Well, against the standards of 2012, I did. We didn’t know then what we know now. I gave innumerable lectures in the late 1980s and ’90s about addiction that weren’t true.”

Dr. Portenoy said it was “quite scary” to think how the growth in opioid prescribing driven by people like him had contributed to soaring rates of addiction and overdose deaths.[5]  If this is not an impeachable “smoking gun” confession, what is?

FOURTH IMPEACHABLE OFFENSE: MEDICAL SPINE CARE

There is another issue that needs to go public about medical abuse. As a chiropractor knowing how well my profession could have helped prevent this massive opioid crisis, let me give a simple solution that has not been broadcast in the medically-controlled media although the evidence is quite favorable for chiropractors.[6]

According to Kantar Media, a firm that tracks multimedia advertising, 771,368 such ads were shown in 2016, the last full year for which data is available, an increase of almost 65 percent over 2012.[7] In no way under no circumstances will Big Pharma, the major sponsor of television ads will allow a nondrug solution to any health problem be broadcast in its dime by its highly paid stooges—MD talking heads such as Dr. Sanjay Gupta.

Considering LBP is the #1 diagnosis for noncancerous chronic pain requiring the use of prescription opioid painkillers[8], neither MD hosts or Big Pharma will allow any accolades given to chiropractors concerning the opioid crisis although two evidence-based studies found that conservative chiropractic care has proven most effective. [9],[10]  

A RAND study by Patricia M. Herman, Complementary and Alternative Medicine in the Military Health System, found at those MTFs where chiropractic is offered, 59% reported a reduction in narcotic painkillers use. Another study by Dr. James Whedon, Chiropractic Care Reduces Opioid Use indicated a 57% reduction in opioid use when chiropractic care was utilized in treatment.

In fact, the Veterans Health Administration also found pain intensity does not decrease with opioid use for low back cases and are not effective for long-term pain control. As researchers further examined the opioid crisis, they found the most damning evidence that these narcotics have proven no more effective than simple Motrin. [11]  

If a new drug or medical procedure were as effective as chiropractic care, it would be heralded throughout the media as a new scientific breakthrough, but when hands-on adjustments achieve this feat at an astounding rate of 59%, nothing is said, evident of the prevailing chirophobia in the media.

MEDICAL RAILROAD

The present outdated models of medical care have proven to be a clinical catastrophe as well as a financial goldmine for the medical spine industry. As AG Mike Hunter clearly stated, a case can be made “there were a lot of bad actors in this long chain of causality”  not only with the railroading of gullible patients to addictive drugs, but the entire chain in usual medical spine care including ‘underwhelming’ steroid shots and risky spine surgery while bypassing the chiropractic detour heralded by every evidence-based guideline also indicate the greed of spine care professionals.

Mistaken medical lore about spine care still dominate in the public’s mind. “Bad disks” and “pulled muscles” are mistakenly diagnosed by inept primary care physicians who typically prescribe opioid painkillers, muscle relaxors, benzos, epidural steroid injections, and disk fusions that dominate “usual medical spine care” — none of which are recommended as initial treatments by new guidelines for the majority of nonspecific cases.

Major media reporters have already highlighted the issue of unnecessary spine surgery, setting the stage for a declaration to reevaluate the madness in spine medicine:

·         Highest-Paid U.S. Doctors Get Rich with Fusion Surgery Debunked by Studies” by Peter Waldman and David Armstrong, Bloomberg News, Dec. 30, 2010

·         Surgery May Not Be the Answer to an Aching Back,” by Joanne Silberner, NPR, April 6, 2010

·         Why You Should Never Get Fusion Surgery For Plain Back Pain” by Robert Langreth, Forbes, Jan. 10, 2011

·         “Tapping Into Controversial Back Surgeries” by Ben Eisler CBS News April 24, 2014

·         Worsening Trends in the Management and Treatment of Back Pain. Investigation in the JAMA Internal Medicine July 29, 2013

·         Outpatient Back Pain Treatments: Not What the Doctor Should OrderThe New England Journal of Medicine published an editorial, August 20, 2013, by Jaime Toro, MD, stating, “Treatment of back and neck pain increasingly relies on strategies that run counter to published guidelines.”

·         Spinal Fusions Serve As Case Study For Debate Over When Certain Surgeries Are Necessary by Peter Whoriskey and Dan Keating, Washington Post, October 27, 2013

"But at a broader level, the rapid rise of spinal fusions in the United States, especially for diagnoses that generally don’t require the procedure, has raised questions from experts about whether, amid medical uncertainty, the financial rewards are spurring the boom."

Undoubtedly this scam in medicine that has gotten increasing attention, most recently with the notorious $650,000 spine fusion highlighted by CBS Evening News:

                 ·         Back surgery saved him from paralysis. Then the bills arrived ...

No one really knows what anything costs in health care — and too many people are getting surprise medical bills for thousands of dollars. In a new series, "Medical Price Roulette," CBS News will ...

·      Tapping into controversial back surgeries - CBS News

Back pain is one of the most common reasons Americans go to the doctor, and one of the fastest growing treatments is spinal fusion surgery. From 2001 to 2011, the number of spinal fusions in U.S ...

·      Spinal Surgery Goes Awry Three Times at Hospital - CBS News

Spinal surgery is incredibly delicate and difficult, and therefore there are a number of safety procedures in place to prevent causing injuries during operations on the human nerve highway

·      CBS This Morning "Controversial" Spine Surgery Report: 5 ...

On April 24, 2019, CBS This Morning aired a report titled "Tapping into Controversial Back Surgeries," examining fusion rates around the United States. “Back pain is one of the most common reasons Americans go to the doctor, and one of the fastest growing treatments is spinal fusion surgery. From 2001 to 2011, the number of spinal fusions in U.S. hospitals increased 70 percent, making them more frequently performed than even hip replacements.”

·      CBS News also did an expose on its  CBS 48 Hours/ Whistleblower program concerning another bogus spine surgery affair using fake screws.

PATIENT TRAFFICKING

This malfeasance can also be considered not only medical clinical malpractice, but patient trafficking.

The public and press are fully aware of the problem of human trafficking since Atlanta has become a hotbed of sex trafficking nationwide, second largest trafficking only to the illicit drug trade.

What the media is unaware is the trafficking of patients on the medical railroad from addictive drugs to unnecessary spine surgery without giving the gullible patients any “informed” detour to conservative care as the guidelines recommend may constitute the largest amount of trafficking considering the millions of people taking opioids, millions of people in pain getting steroid injections, and the hundreds of thousands victimized by unnecessary spine surgeries.

It’s past time to bring this problem of patient trafficking into the light to expose this corruption of railroading patients with spine-related problems along the destinations of NSAIDs, opioids, benzos, ESI, and MRIs to justify the eventual dead-end destination of spine surgery. Indeed, MDs don’t follow guidelines, they follow the money and for millions of suffering patients, there is no escape until they finally hit the inevitable dead-end.

Considering the many spine surgery clinics in greater Atlanta such as the Emory Spine Center, a case can be made of patient trafficking since these lucrative practices continue to ignore the evidence-based guidelines as well as constitutes a violation  of  Informed Consent law when patients are not told of their “practical alternatives” as the Georgia State law demands.

Although primary care physicians typically refer to a PT or PMR (pain management clinic for opioids and epidural shots) to fulfill the requirement of “practical alternatives,” ironically, these are the very offices that brought us the pandemic of opioid painkillers and should now be considered as impractical alternatives to avoid.

Researchers have revealed medical primary care physicians are actually least educated to diagnose and treat musculoskeletal chronic pain problems.[12] Dr. Scott Boden at Emory admits primary care providers are untrained in musculoskeletal disorders[13] while editor Mark Schoene believes the “most perilous setting for the treatment of low back pain in the United States is currently the offices of primary care medical practitioners—primary care MDs. This is simply because of the high rates of opioid prescription in these settings.”[14]

This is another huge legal problem when MDs refuse to follow Informed Consent laws by not mentioning chiropractic care for musculoskeletal disorders (MSD) as a “practical alternative.” Unless chiropractic care is mentioned, a case can be made the physician has not given the best “practical alternative” regarding spine-related injuries. Instead, MDs most often give patients the “voodoo” diagnosis to scare them from seeking chiropractic care.

Case law now suggests it is not enough to only mention those alternatives the doctor may prefer personally, but those not preferred. This decision extended the rights of the patient with regards to alternative medical treatments in general and “medically reasonable alternatives that the physician does not recommend;” certainly for biased MDs, this includes chiropractic care.

The Supreme Court of New Jersey ruled on the need for full disclosure for Informed Consent in the case of MATTHIES V. MASTROMONACO [Supreme Court of New Jersey. 160 N.J. 26, 1999]:

“For consent to be informed, the patient must know not only of alternatives that the physician recommends, but of medically reasonable alternatives that the physician does not recommend. Otherwise, the physician, by not discussing these alternatives, effectively makes the choice for the patient…By not telling the patient of all medically reasonable alternatives, the physician breaches the patient's right to make an informed choice.”

Obviously, the law of Informed Choice / Consent has not been practiced or enforced here in most states, but the travesty of medical spine care evident by the opioid crisis and the new evidence-based guidelines demands us to revisit this problem.

This is a PR angle just waiting to be told to cast a new light on the medical boycott of chiropractors. This medical war not only hurts our profession, it was a violation of Informed Consent laws leading to millions of unsuspecting patients who were collateral damage in this on-going medical war against DCs.

To this day MDs continue to lie to patients about the superiority of chiropractic care for the pandemic of nonspecific back pain, which is the main reason for the present opioid crisis. Considering the numerous evidence-based guidelines recommending chiropractic care for LBP, it’s a clear case of malpractice when MDs discourage patients to seek our brand of conservative care and ipso facto defy the Informed Consent law is a clear case of malpractice.

A case can be made: the failure of medical spine care, the lack of Informed Consent, the refusal by MDs to refer to DCs, the tsunami of underwhelming ESI and risky back surgeries add up not only to medical malpractice but, if you will, to patient exploitation and trafficking when naïve patients are railroaded to ineffective, dangerous, and expensive medical spine care.

This trafficking starts with gullible back pain patients misdiagnosed by inept primary care physicians that leads to the perils of mistreatment with  drugs and ESI at pain management clinics to MRI imaging centers detecting ‘incidentalomas’ and eventually to spine surgeons fusing the ubiquitous ‘bad disks.’

Greed characterizes the entire chain of causality by trafficking patients without Informed Consent on the medical railroad. None of these links in the medical chain have proven clinically or cost-effective, yet each link profited as they left a trail of abuse, addiction, disability, and death in its medical wake.

This is a scam that must be stopped. After a century of lies by the AMA telling the public chiropractic care is a scam, now the research and law falls on the other foot. It’s time for courageous DCs to speak up and stop cowering to the medical monarchy. Do you have the backbone to save patients from this racketeering or do you just don’t want to make waves?



[3] Portenoy RKFoley KM, “Chronic use of opioid analgesics in non-malignant pain: report of 38 cases,” Pain. 1986 May;25(2):171-86

[4] Thomas Catan and Evan Perez, A Pain-Drug Champion Has Second Thoughts, WSJ, Dec. 17, 2012

[7] Think You’re Seeing More Drug Ads on TV? You Are, and Here’s Why, By Joanne Kaufman, NY  Times, Dec. 24, 2017

[8] Denise Boudreau, PhD, Michael Von Korff, ScD, Carolyn M. Rutter, PhD, Kathleen Saunders, G. Thomas Ray, Mark D. Sullivan, MD, PhD, Cynthia Campbell, PhD, Joseph O. Merrill, MD, MPH, Michael J. Silverberg, PhD, MPH, Caleb Banta-Green, and Constance Weisner, DrPH, MSW. “Trends in De-facto Long-term Opioid Therapy for Chronic Non-Cancer Pain,” Pharmacoepidemiol Drug Saf. 2009 December ; 18(12): 1166–1175. doi:10.1002/pds.1833.

[9] Complementary and Alternative Medicine in the Military Health System:  RAND study found at those MTFs where chiropractic is offered, 59% reported a reduction in narcotic painkillers use.

[10] Chiropractic Care Reduces Opioid Use indicated a 57 percent reduction in opioid use when chiropractic care was utilized in treatment.

[12] AD Woolf, B Pfleger, “Burden of Major Musculoskeletal Conditions,” Bull World Health Organ 81/09 (2003):646-656.

[13] S Boden, et al. “Emerging Techniques For Treatment Of Degenerative Lumbar Disk Disease,” Spine 28(2003):524-525.

[14] The BackLetter, volume 30, number 10, 2015

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