Articles by JCS
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.
The 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 Order, The 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 RK, Foley 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
[5] See more at: http://www.thepoisonreview.com/2012/12/16/the-money-and-influence-behind-pain-as-a-fifth-vital-sign/#sthash.yyt9dxmA.dpuf
[6]
This is the subject of my book, To
Kill a Chiropractor: the media war against chiropractors
[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.
[11]
2018: Treatment of Low
Back Pain with Opioids and Nonpharmacologic Treatment Modalities for Army
Veterans
[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