1.
Featured Article: Of
Pills and Profits: In Defense of Big Pharma by Peter W. Huber, Commentary Magazine, July 2006.
The
more our health depends on their little pills, the more we seem to hate
big drug companies. In The Constant Gardener
(2000), John le Carré assigns to the pharmaceutical industry the role played by
the KGB in his earlier novels. A villainous pharmaceutical company is using
Kenya as a testing ground for a lethally defective drug, and people who find
out about it die, too. Four recent, non-fiction indictments of the industry
tell a similar story. Conflating the four into one, one might title them
collectively How Big Pharma Deceives, Endangers, and Rips Us Off, with the Complicity of
Doctors.
Two of these books are
by former editors of the prestigious New England Journal
of Medicine. Slamming the drug companies, Marcia Angell argues that Big
Pharma, as it has come to be called, "uses its wealth and power to co-opt
every institution that might stand in its way, including the U.S. Congress, the
Food and Drug Administration, academic medical centers, and the medical
profession itself." Slamming the medical profession, academics, and
professional organizations, Jerome P. Kassirer, Angell's former boss, labels
them Big Pharma's "whores." . . .
The bill of particulars,
drawn from the books cited above, goes something like this. Most of what people
believe about Big Pharma is just "mythology spun by the industry's immense
public-relations apparatus." Forget miracle drugs - Big Pharma is not a
"research-based industry," it is "an idea-licensing,
pharmaceutical-formulating-and-manufacturing, clinical-testing, patenting, and
marketing industry." As for "the few innovative drugs that do come to
market," these "nearly always stem from publicly supported
research" or are developed by small biotech firms. Big Pharma simply goes
"trolling small companies all over the world for drugs to license."
At most tweaking the chemistry of drugs developed by others, it advances
medicine by "waiting for Godot."
Moreover, these me-too
drugs "usually target very common lifelong conditions - like arthritis or
depression or high blood pressure or elevated cholesterol." Many just
aren't needed, because older drugs already work as well or better, or because
the new drugs are peddled to people who aren't sick. Big Pharma is thus
"primarily a marketing machine to sell drugs of dubious benefit." . .
.
So
runs the indictment. Now for a story. In an April 2005 obituary, the New York Times described Maurice Hilleman as the man
who "probably saved more lives than any other scientist in the 20th
century." What kind of genius does it take to get that on your tombstone?
Hilleman himself, it seems, "credited much of his success to his boyhood
work with chickens." He went on to use fertilized chicken eggs to grow
large quantities of bacteria and viruses that were then weakened or killed to
produce vaccines. The technique was known before Hilleman arrived, but
isolating and then safely breeding a pathogen requires the touch of a very
delicate artist. "Maurice was that artist," another scientist later
recalled; "no one had the green thumb of mass production that he
had."
By farming eggs, Maurice
Hilleman saved tens of millions of lives, and prevented deafness, blindness,
and other permanent disabilities among many millions more. No Albert Schweitzer
or Florence Nightingale could ever post numbers like his. Doctors and nurses
save lives one on one, and are paid by the hour. Hilleman saved lives by the
carton, at grocery-store prices - acres of cartons, hundreds of millions of
warm eggs replicating his genius around the clock. . . .
Manufacturing adds
another tier of expense and risk. Development of the vaccines that eradicated
polio from most of the Western world was funded mainly by the March of Dimes.
That charitable foundation also oversaw the first field trials establishing the
safety and efficacy of Jonas Salk's vaccine. It then handed the project to the
government, which licensed five private companies to produce the vaccine.
Although the government prescribed exactly how it was to be manufactured, the
instructions were not quite the same as those the foundation had promulgated
prior to the first trial. The Cutter Company, the smallest of the five
licensees, followed the government's instructions to the letter, but failed to
kill all the virus in the vaccine. Seventy thousand people suffered mild forms
of polio. Two hundred were paralyzed. Ten died.
The Cutter tragedy
helped spark changes in liability law that made it much easier to sue drug
companies for their failures, even in the absence of negligence. Today, some
liability claims are all but certain to be forthcoming when millions of users
pop the same pill, and every drug carries with it an inescapable risk of
bet-the-company litigation. Estimates of Merck's Vioxx exposure currently range
from $5 to $50 billion. Along with other vaccine manufacturers, Merck is also
defending claims that thimerosal, a mercury-based vaccine additive, causes
autism. It almost certainly does not, but juries cannot always be trusted to
get things right.
One influential writer
has explained the process well. Tort lawyers, who know how to "prey on
people's fears," "postulate increasingly obscure syndromes" that
"can't be studied systematically." Juries "usually have no
competence in the area," often "misinterpret science," and base
their judgments on "emotional appeals." Moreover, "losing just
one lawsuit can stimulate an avalanche of others, and each loss usually means
the stakes grow higher in the next case." For a company that "loses
just one of every ten or twenty cases, the costs can be enormous."
Litigation can thus "destroy thriving companies," shut down "an
important area of medical research," and even "threaten an entire
industry."
It is a pity that Marcia
Angell never mentions any of these consideration in her book touting "the
truth about drug companies." The omission is all the more regrettable
since she wrote the above words herself in Science on
Trial, her 1996 book about breast-implant litigation, and they are
as relevant today as they were ten years ago. . . .
Prescription drugs
currently account for well under 20 percent of the health-care budget. Within a
generation or two, they will undoubtedly account for most of it - which will be
another good thing. Pharma's biochemical cures always end up far cheaper than
the people-centered services they ultimately displace. Moreover, while much
hands-on care only drags things out or soothes, the best medicines really cure.
It is true that, early on in the pharmacological assault on a grave disease,
drugs also stretch things out and can fail to beat the disease, so we often end
up buying more drug and more doctor, too. But eventually drugs improve to the
point where they beat the disease and thus lay off both doctor and hospital.
None of this can be very
welcome to people who believe that the most important thing about health care
is that it be uniform and universal. If you like the way
Over the last decade,
extraordinary advances in bioengineering have transformed pharmacology. Sooner
or later, the industry and its pilot fish will surely find drugs that can halt
colon, breast, and lung cancers, that can curb obesity and thus heart disease,
and that will not merely suppress the HIV virus but purge it from the body
completely. A new pharmacology of the
brain may cure depression and stop the onset of Alzheimer's. These and other
once inscrutable scourges are now - essentially - becoming problems in diligent
engineering.
They are very difficult
and expensive problems, as engineering problems go. And government funding did
indeed pay for much of the underlying science, and continues to pay for it,
just as the industry's critics charge. Some 600 publicly traded pharmaceutical
and biotechnology companies worldwide, however, are now capitalized at over
$1.5 trillion. The industry's critics would subordinate current management to public-utility
regulation. We will fare better, much better, if we streamline regulation, curb
litigation, and unleash prices to make vaccines as alluring to Big Pharma as
Viagra and Vaniqa.
To read the entire
article, including the four book references, (subscription may be required) go
to www.commentarymagazine.com/archive/digitalarchive.aspx?st=advanced&By=%20Peter%20Huber
PETER W. HUBER is a senior
fellow of the Manhattan Institute. His contributions to include
"Telecom Undone - A Cautionary Tale" (January 2003), "Guns,
Tobacco, Big Macs - and the Courts" (June 1999), and, with Mark P. Mills,
"Getting Over Oil" (September 2005).
* * * * *
2.
In the News: The
Climate Debate Continues
There Is No 'Consensus' On
Global Warming By RICHARD S. LINDZEN, WSJ,
June 26, 2006
According to Al Gore's new film "An Inconvenient
Truth," we're in for "a planetary emergency": melting ice
sheets, huge increases in sea levels, more and stronger hurricanes and
invasions of tropical disease, among other cataclysms -- unless we change the way
we live now.
Bill Clinton has become the latest evangelist for Mr.
Gore's gospel, proclaiming that current weather events show that he and Mr.
Gore were right about global warming, and we are all suffering the consequences
of President Bush's obtuseness on the matter. And why not? Mr. Gore assures us
that "the debate in the scientific community is over."
That statement, which Mr. Gore made in an interview
with George Stephanopoulos on ABC, ought to have been followed by an asterisk.
What exactly is this debate that Mr. Gore is referring to? Is there really a
scientific community that is debating all these issues and then somehow
agreeing in unison? Far from such a thing being over, it has never been clear
to me what this "debate" actually is in the first place.
The media rarely help, of course. When Newsweek
featured global warming in a 1988 issue, it was claimed that all scientists
agreed. Periodically thereafter it was revealed that although there had been
lingering doubts beforehand, now all scientists did indeed agree. Even
Mr. Gore qualified his statement on ABC only a few minutes after he made it,
clarifying things in an important way. When Mr. Stephanopoulos confronted Mr.
Gore with the fact that the best estimates of rising sea levels are far less dire
than he suggests in his movie, Mr. Gore defended his claims by noting that
scientists "don't have any models that give them a high level of
confidence" one way or the other and went on to claim -- in his defense
-- that scientists "don't know… They just don't know."
So, presumably, those scientists do not belong to the
"consensus." Yet their research is forced, whether the evidence
supports it or not, into Mr. Gore's preferred global-warming template --
namely, shrill alarmism. To believe it requires that one ignore the truly
inconvenient facts. To take the issue of rising sea levels, these include: that
the Arctic was as warm or warmer in 1940; that icebergs have been known since
time immemorial; that the evidence so far suggests that the Greenland ice sheet
is actually growing on average. A likely result of all this is increased
pressure pushing ice off the coastal perimeter of that country, which is
depicted so ominously in Mr. Gore's movie. In the absence of factual context,
these images are perhaps dire or alarming.
They are less so otherwise. Alpine glaciers have been
retreating since the early 19th century, and were advancing for several
centuries before that. Since about 1970, many of the glaciers have stopped
retreating and some are now advancing again. And, frankly, we don't know why. .
. .
* * *
More recently, a study in the journal Science by the
social scientist Nancy Oreskes claimed that a search of the ISI Web of
Knowledge Database for the years 1993 to 2003 under the key words "global
climate change" produced 928 articles, all of whose abstracts supported
what she referred to as the consensus view. A British social scientist, Benny
Peiser, checked her procedure and found that only 913 of the 928 articles had
abstracts at all, and that only 13 of the remaining 913 explicitly endorsed the
so-called consensus view. Several actually opposed it. . . .
* * *
So what, then, is one to make of this alleged debate?
I would suggest at least three points.
First, nonscientists generally do not want to bother
with understanding the science. Claims of consensus relieve policy types,
environmental advocates and politicians of any need to do so. Such claims also
serve to intimidate the public and even scientists -- especially those outside
the area of climate dynamics. Secondly, given that the question of human
attribution largely cannot be resolved, its use in promoting visions of
disaster constitutes nothing so much as a bait-and-switch scam. That is an
inauspicious beginning to what Mr. Gore claims is not a political issue but a
"moral" crusade.
Lastly, there is a clear attempt to establish truth
not by scientific methods but by perpetual repetition. An earlier attempt at
this was accompanied by tragedy. Perhaps Marx was right. This time around we
may have farce -- if we're lucky.
Mr. Lindzen is the Alfred P. Sloan Professor of
Atmospheric Science at MIT.
To
read the entire essay (subscription required) please go to http://online.wsj.com/article_print/SB115127582141890238.html
To read responses, please continue below.
Earth's Climate Is Always Warming or Cooling, June 20, 2006
Roger C. Altman ("The Beltway's Energy1," editorial page, June 16), a Treasury official
in the Clinton administration, says he is no climatologist, but then calls for
energy policies that assume catastrophic global warming from carbon dioxide
emitted in fossil-fuel burning. He doesn't reveal his sources of information -
perhaps they are just various "experts" quoted in the press, or
perhaps even Al Gore. But Mr. Gore, in his movie and elsewhere, never asks the
key question: How much of current warming is due to natural causes? And how
much is really human-caused? Anthropogenic warming is simply taken for granted
as part of a claimed but nonexistent "complete" scientific consensus.
The current warming trend is not unusual: Climate is
always either warming or cooling, and ice is either melting or accumulating.
But thermometers can't talk and tell you the cause of climate change. This
requires a comparison of the patterns of the observed warming with the best
available models that incorporate both anthropogenic (greenhouse gases and
aerosols) as well as natural climate forcings.
Fortunately, the U.S.-Climate Change Science Program,
funded at $2 billion annually, has done just that in its first report: www.climatescience.gov/Library/sap/sap1-1/finalreport/default.htm2.
http://online.wsj.com/article_print/SB115076981006584829.html
Grease Guzzlers These Folks Fuel Their Diesel Cars
With Cooking Oil. by Allan
In these days of
eye-popping gas prices, Mike Leahy gets fuel for his Volkswagen Beetle at the Barking
Dog, a popular Bethesda pub. Shane Sellers fuels up at a Chinese restaurant in
Frederick. And Ben Tonken heads to a Tex-Mex eatery in the District.
"There's a bit of a
smell when you get out," said Leahy, a D.C. lawyer. "A slight french
fry smell. I kind of like it; it's kind of sweet. It smells better than
diesel."
Welcome to the world of
greasel -- the shorthand some use for grease and diesel. Leahy and the others
are among a tiny but growing band of environmentalists and thrifty consumers
who are turning to restaurants for free, used vegetable oil to fuel their
diesel-engine cars.
With a little filtration
and a car conversion kit, oil that once fried potatoes, egg rolls or tortilla
chips is ready for its second act: air pollution fighter. . . .
To read more about this unusual alternative with
diesel drivers burning 30 gallons of canola oil a month, go to www.washingtonpost.com/wp-dyn/content/article/2006/06/30/AR2006063001765_pf.html.
* * * * *
3.
International
Medicine: Is socialized medicine the prescription for better health?
Where Would You Rather Be Sick? By DAVID GRATZER, WSJ,
June 15, 2006
Is socialized medicine the prescription for better health?
A recent study comparing Americans and Canadians, widely reported in the press,
seems to suggest just that. But there is much less here than meets the eye.
The study, based on a telephone survey of 3,500
Canadians and 5,200 Americans (conducted by Statistics Canada and the U.S.
National Center for Health Statistics), was released by the American Journal of
Public Health. According to it, Canadians are healthier and have better access
to health care than Americans, and at lower overall cost. So is the Canadian
system, where the government pays for and manages the health-care system,
superior? "Our study," says co-author Dr. Steffie Woolhandler,
"is a terrible indictment of the
It is not so clear that the survey data back up these
claims. Consider access. According to the survey, Canadians are more likely to
have a regular physician, to have seen a doctor in the past year, and to be
able to afford medications. But the data are ambiguous; Americans are more
likely to have received a pap test and mammogram, as well as treatment for high
blood pressure. Moreover, Americans are generally more satisfied with their
health care. (The survey did not ask about access to specialist care or
diagnostic imaging.)
So how does American health care actually measure up?
If we look at how well it serves its sick citizens, American medicine excels.
Prostate cancer is a case in point. The mortality rate from prostate cancer
among American men is 19%. In contrast, mortality rates are somewhat higher in
Canada (25%) and much higher in Europe (up to 57% in the U.K.). And comparisons
in cardiac care - such as the recent Heart and Stroke Foundation of Canada
study on post-heart-attack quality of life - find that American patients fare
far better in morbidity. Say what you want about the problems of American
health care: For those stricken with serious disease, there's no better place
to be than in the U.S.
Socialized health-care systems fall short in these
critical cases because governments strictly ration care in order to reduce the
explosive growth of health spending. As a result, patients have less access to
specialists, diagnostic equipment and pharmaceuticals. Economist David
Henderson, who grew up in Canada, once remarked that it has the best
health-care system in the world - if you have only a cold and you're willing to
wait in your family doctor's office for three hours. But some patients have
more than a simple cold - and the long waits they must endure before they get
access to various diagnostic tests and medical procedures have been documented
for years. Montreal businessman George Zeliotis, for example, faced a year-long
wait for a hip replacement. He sued and, as the co-plaintiff in a recent,
landmark case, got the Supreme Court of Canada to strike down two major Quebec
laws that banned private health insurance.
Dr. Karen Lasser, the study's third author, says that
"Based on our findings, if I had to choose between the two systems for my
patients, I would choose the Canadian system hands down." Perhaps she
would. But as a physician licensed in both countries, I'd disagree.
Dr. Gratzer is a senior fellow at the Manhattan
Institute.
To read the entire article, please go to http://online.wsj.com/article_print/SB115033718636680826.html.
Canadian Medicare does not
give timely access to healthcare, it only gives access to a waiting list.
--Canada's Supreme Court
* * * * *
4. Medicare: The Fiasco of Castro's Socialist Medicine
Over The Profit-Driven Capitalist Kind
Doctors Flee South
America Sick Man Because It Was Political Rather Than Medical
Fidel Castro's vaunted
overseas "free" medical program for the poor, which sent doctors to
the slums of Caracas and elsewhere, is falling apart as doctors choose
defection, says Investor's Business Daily (IBD).
- In
Bolivia, at least 30 Cuban doctors out of 719 defected to freedom,
according to Bolivian media.
- In
Venezuela, 4,000 Cuban doctors out of 15,000 also fled the country, Union
Radio reported.
The result of the
defections can be seen in the remnants of the program:
- In
western
- Along
the old Caracas/La Guaira highway, three more of the distinctive Cuban
brick compounds, one after another, also were recently seen boarded up.
- In the truly poor Caracas slums, known as
ranchos, where cardboard boxes and corrugated steel serve as housing, no
Cuban doctor kiosks are there at all.
It's no surprise why
they did it, says IBD. Defecting doctors say they are essentially
there for a political purpose rather than to practice medicine. Their
"free" medical care amounts to industrial "dumping,"
putting real doctors out of business in places such as Venezuela, Bolivia and
Central America.
Instead of showing the
"humanity" of socialist medicine over the profit-driven capitalist
kind as Castro intended, the current fiasco has shown that "free"
medical care is as much in shortage in Caracas as it is in Havana, explains IBD.
Source: Editorial,
"Doctors Flee South America Sick Man," Investor's Business Daily,
July 15, 2006
For text (subscription
required): www.investors.com/editorial/IBDArticles.asp.
For more on Health: http://www.ncpa.org/iss/hea/.
Government
is not the solution to our problems, government is the problem.
- Ronald Reagan
* * * * *
5.
Medical Gluttony
: Patients reading their own report can cause excessive medical costs.
We recently saw a patient who brought in multiple lab
tests, including a Dexa Scan. She was extremely anxious as to what it said. The
top line under the doctor's justification for ordering the scan read: Rule out osteoporosis.
The details of the report were totally normal and the
impression read "
The patient refused to be comforted. She kept pointing
to the first line, which she felt was her life threatening diagnosis. After
repeated explanations, she finally left the office saying to the receptionist,
"I might have to find another doctor who will treat my osteoporosis."
* * * * *
6. Medical Paradox: Solve the ER crunch by driving
patients to the highest possible cost center.
Painful
predicament: Crowded ERs are diverting more patients to nearby hospitals
despite health risk, by Tomio Geron and Charlie Emrich, Sacramento Bee,
July 2, 2006
Suffering sharp back pains,
Kari Wolff had been waiting at UC Davis Medical Center's emergency room for two
hours. Although the waiting room was not jammed, the pace at which patients
were being seen was sluggish at best.
Long
waits are common at hospital emergency rooms, but knowing that did not make
Wolff feel any better. Her ailment did not seem life-threatening, but the pain
was severe enough to prevent her from sleeping at night.
Wolff,
a 41-year-old who lives in Natomas, was upset. "I'm really concerned about
the fact that I hurt right now," she said.
According
to a recent widely circulated report, patients nationwide are experiencing
similar, if not worse, delays in obtaining emergency room care.
The
study by the National Academy of Sciences'
Emergency
rooms throughout the United States are chronically overcrowded, underfunded and
inefficiently managed -- even as demand grows for their services.
Although
many emergency departments have closed nationwide, in the growing Sacramento
region several hospitals plan expansions of their emergency rooms.
These
include Kaiser Roseville, Kaiser South, Marshall in
Many
of the reasons for emergency room crowding are out of hospitals' control,
administrators and doctors say.
For
example, some patients visit the emergency room not because they are seriously
injured but because, lacking health insurance, they feel they have no other
options. . .
Even
people who are covered by insurance sometimes use the emergency room because
their regular doctor is unavailable or lacks specialized equipment, according
to Dr. Mark Smith, president of the California Health Care Foundation and a
member of the committee that wrote the national report.
"If
you have a doctor (and) next Tuesday is the earliest time he can see you,
you're gonna go to the ER even if it's not an emergency -- if you're in
pain," Smith said. "And I don't blame you."
This
was the case for Glenda Lowe of Vacaville, who waited 2 ½ hours at the UC
Davis Medical Center emergency room to be treated for staph infection in her
sinuses.
"I'm
about ready to leave and drive home," Lowe said, exasperated.
Her
condition was not life-threatening, but she could not get through to her
doctor. . . .
Of
course, those visiting the emergency room with real medical crises will get
seen promptly. "If you're critically injured, you will get attended to
immediately," said Dr. Nathan Kuppermann, chair of emergency medicine at
UC Davis Medical Center.
But
those who are not seriously injured will find themselves increasingly steered
toward appropriate care.
For
instance, Kaiser screens patients while they wait and sends non-critical cases
to an onsite medical treatment unit, equipped to handle 30 percent to 40
percent of the people streaming into the emergency room, officials said. . . .
www.sacbee.com/content/news/story/14274202p-15084104c.html.
About
the writer: The Bee's Tomio Geron can be reached at (916) 321-1041 or tgeron@sacbee.com.
[This article does not make any attempt to evaluate whether
the patient took the first step in alleviating the pain. Did any of them take a
pain pill before going to the ER? We see patients on emergency almost daily
with severe pain stating that their pain is far too severe to consider such
mundane treatment as Tylenol or Motrin. However, when we give them two extra
strength Tylenol tables at the beginning of the evaluation, in many instances
the pain is relieved before the conclusion of our evaluation. Many emergency
evaluations are performed with the patient's expectation that their pain
warrants thousands of dollars worth of testing and MRIs. In most instances,
conventional pain therapy will give the patient and the clinician the best clue
as to the severity of the pain. This attitude will not change as long as health
insurance covers the first dollar cost of medical evaluation. If the patient
had to pay the first 20 percent or 30 percent (several hundred dollars of the
expected several thousand dollar evaluation), health care costs in this country
would drop precipitously over night. It would then become affordable.]
[The answer to the painful predicament: Start taking pain
pills. If two ES Tylenol don't relieve the pain, take two more after two hours
and then call the doctor. Don't go to the emergency room for non-emergency
conditions. Don't force hospitals to add millions of dollars of construction
and expand unnecessary services.]
Why
is it so difficult to instill reason into health care? Because expensive
unnecessary evaluations are nearly free and, therefore, used irresponsibly.
* * * * *
7.
Overheard in the
Medical Staff Lounge: Huge Pay Hikes for Government Workers
Dr. Sam was livid after reading about the 18% pay
raises for California's state top elected state officials. Elected officials
received salary boosts of $23,625 to $31,500 per year. The governor does not
accept state pay - but if he ever changes his mind, the hike would boost his
salary to $206,500 instead of $175,000 if he were to take his salary. He
donates his time and energies to the People of California as a public servant
and in the public service. Legislative salaries received an additional two
percent, on top of the 12 percent they recently received, making them tops in
the nation by more than $30,000 per year.
Dr. Sam notes that his pay has been level for about
the same period of time and now Medicare is trying to reduce his fees by 14
percent.
Jim Sanders, BEE Capital Bureau, Sacramento BEE,
Saturday, June 24, 2006, FP. www.sacbee.com/content/politics/ca/story/14271383p-15082000c.html
* * * * *
8.
Voices of
Medicine: Abusive Peer Review
[Abusive Peer Review is a serious problem for
physicians. We regularly feature two organizations that are involved in
correcting this abuse. To review the issues and to read some horror stories
against physicians, please go to www.delmeyer.net/HMCPeerRev.htm, or www.delmeyer.net/hmc2006.htm or www.peerreview.org, or www.semmelweissociety.net/, or www.semmelweis.org/. Here's another heart felt "Voice of
Medicine" from a hurting physician suffering from professional homicide.]
DID PRESBYTERIAN HOSPITAL DISCRIMINATE? YOU DECIDE!
On September 1, 1995, Presbyterian hospital called me
to their imposing corporate Board Room in Charlotte, NC and dropped a bomb on
me. They said they were summarily
suspending my hospital privileges at 4 pm that day!
Suspension from a hospital is a kiss of death for any
physician! I knew that I would never be
able to deliver any more babies nor take care of women who needed gynecologic
surgery. The future of my family went
bleak in front of my eyes.
I knew that they had been reviewing my charts for
several months now. But I had no idea
that they would not even give me a chance to present my side of the story with
regard to any of those charts before taking such Draconian action. This was truly a stab in the back.
"We do not have to tell you what the charts
are." Said then CEO of
Presbyterian hospital and chief of ob-gyn.
They simply stated that I had 24 "problematic" charts, as
determined by the peer review committee.
I had received my M.D. from New Jersey Medical School in
1985 and finished my ob-gyn residency from Temple University hospital in
1989. I had come to Charlotte in 1990
and become a member of Presbyterian hospital medical staff as an ob-gyn
physician.
On December 1994, I had a surgical mishap. Inadvertently, I punctured the external
iliac artery in a patient during laparoscopy.
This was unfortunate but a known complication of such a procedure. I immediately proceeded to laparotomy. I summoned a general surgeon and a
cardiovascular surgeon to assist me with the repair. The patient went home after a few days stay in the hospital. My malpractice insurance company as well as
several independent reviewers determined that I met the standard of care in
this case. However, citing business
reasons, the insurance company later decided to settle the lawsuit for 300K.
Following the incident, Presbyterian hospital went on
a fishing expedition of my charts from over a two year period. Most of these charts had been filed in the
hospital archives as having had no problems with them. Anyway, a departmental "peer
review" committee headed by Dr. X somehow managed to label 24 of them
"problematic" out of my 102 charts reviewed.
Did Dr. X have more experience than I as an
ob-gyn? No, we both finished medical
school and residency in same years. The
difference is that he is a good old Southern boy trained at Chapel Hill while I
am India born, with my residency from Philadelphia. He was later promoted to the position of the chief of the ob-gyn
department.
Although I repeatedly asked the hospital for an
independent external review of my charts, the hospital did not grant that
simple request. The Medical Board of
North Carolina asked an experienced ob-gyn physician from Charlotte, Dr. Y to
review my cases. He as well as several
other reviewers found my charts to be within the standard of care.
According to a letter circulated by Dr. Z in October
1998 among the hospital's medical staff, I was the first physician to be
suspended in 20 years at Presbyterian hospital! Was it just a coincidence that I was the first ob-gyn physician
of Indian origin at Presbyterian hospital?
I decided to do a little research starting with the local courts. I found out the following facts, which are
true to the best of my knowledge. To read more about the lethal actions of a
hospital that generally is protected from civil court review, please go to www.delmeyer.net/hmc2006.htm.
* * * * *
9.
Cinema
Review: "Guantánamo": Torture,
Blowback, and Innocence by James J Murtagh, M.D.
Warning: movie spoiler alert. If you
have not seen Guantánamo, consider seeing the film before reading further.
However, most people know this is a docu-drama about mistreatment of prisoners,
this spoiler alert may not be necessary.
"They said
we will make you wish to die and it will not happen"
- Ameen Saeed
Al-Sheik, detainee No. 151362,
Does Innocence Matter? Does truth matter?
Can American democracy spread through torture camps?
The searing documentary
"Road to Guantánamo" shows Americans the vivid depictions of
beatings, torture, interrogation and death in the American gulag just 90 miles
from our shore. This is the story of the "Tipton Three," British
citizens in the wrong place at the wrong time, captured and sent to American
camps "X-ray" and "Delta" with absolutely no due process,
and absolutely no evidence of any wrongdoing.
Worse, the film reveals none
of the roughly 600 detainees in Cuba have been found guilty of crime, and not
one piece of usable intelligence was obtained. This reflects what courageous
European journalists like David Rose have written in acclaimed books.
Unfortunately, despite the books in evidence, the US press has been slow to
alert the public to the true problem.
Ameen Saeed Al-Sheik said
the prisoners at Abu Ghraib and at Guantánamo were told
they would wish for death, but not be allowed to die. Can there be a better
description of true torture? More than sixty Guantánamo prisoners at least
attempted suicide testifies to the Ameen's accuracy.
Identical torture methods
have been exposed at Guantánamo and Abu Ghraib. It is clear torture was
systematic, planned, and sanctioned by the highest Dept. of Defense officials.
Torture was not from a few "bad apple" low ranking solders. As David
Rose exposed, Guantánamo was actually the prototype for American torture camps
elsewhere, including Abu Ghraib.
High-ranking U.S. officials
decided in 2001 that torture would be used as an instrument of American policy.
Administration apologists
try to redefine the meaning of torture, or to redefine the Geneva convention.
But these same apologist officials lost all credibility with their claims of
"Weapons of mass destruction." Fool me once, shame on you. A series
of supposed "slam-dunk" evidence proved absolutely false.
Americans can now see what
happens at Guantanamo, and hear the words of the Tipton trio. Americans know
torture when they see it, and no amount of artful dodging from Rumsfeld can
change the stark, brutal fact of unjustified American gulags.
The victims of torture at
Guantanamo and Abu Ghraib suffer, but so do our own soldiers who are forced to
inflict the torment.
"Blowback," the unintended consequences of
secret military operations on US society at home, was examined in the recent
film, "Why we fight." Torture incites the worst of all possible
blowback, and we will all suffer the consequences. Torture not only inflames
our enemies, it inflames our friends, and it inflames our own citizens to
despair on our own pledge to support "justice for all." To read the
entire review, or to read other Op-Ed reviews by Dr Murtagh, please go to www.delmeyer.net/CinematicOpEdReviews.htm.
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10. Hippocrates & His Kin: Burglars Have the Right to
Be Protected from Householders
Burglars Need Protection From Violent Citizens? JOYCE
LEE MALCOLM , WSJ,
In response to the July 1 Letter to the Editor
disputing my June 17 editorial-page commentary "Mad Dogs and Englishmen": Clearly, Barry Watts is not a regular
newspaper reader. He prefers to dismiss as "total nonsense" my reference
to the British Home Office policy of letting offenders of 60 different crimes
off with cautions; nevertheless, the policy was confirmed by an official report
in March. Cautions have been used, if more selectively, for some time. In 2004,
40 rapists were let off with cautions. As for Tony Martin, the farmer jailed
for shooting two career burglars who broke into his home in the dead of night,
government lawyers advised ministers that "as members of the public,
burglars have the right to be protected from violent householders." Not
surprisingly, a study reported by BBC News found 67% of house burglars agreed
that once inside a property, burglary was "virtually risk free." http://online.wsj.com/article_print/SB115231942644601325.html
Any Doctors Interested in Cross Training into Virtually Risk Free Profession?
Did You Know That 37 Percent Of Malpractice Claims Did
Not Involve Medical Errors?
The New England Journal of Medicine reports in its May
11, 2006 issue that 37 percent of malpractice claims did not involve a medical
mistake? Even more surprising is that 3 percent of malpractice cases had no
medical injuries? For every dollar spent on compensation, 54 cents went
to administrative expenses (including those involving lawyers, experts,
and courts). http://content.nejm.org/cgi/content/abstract/354/19/2024
Since most of the money from malpractice cases never
reaches the patient, the best malpractice reform would be to place every trial
attorney on a salary, say the average doctor's salary of $150,000, reduced
yearly by the same rate that the Feds reduce Medicare reimbursement each year and then give all patients that feels
they have been injured, a life time health insurance plan, Medicaid, our
welfare card, which gives our poorest 20 percent (6 million of our 30 million
Californians, for instance) access to more extensive care than the UK's
National Health Service.
Anyone Want To Figure Out The HealthCare Cost Savings
From This Approach?
To read more Hippocrates in the archives, please go to
www.healthcarecom.net/hhk1999.htm.
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11. Organizations Restoring Accountability in Medical
Practice, Government and Society: