Medical Tuesday Blog
San Mateo County Physician, President’s Message
WHY WE ARE HERE
Russ Granich, MD, President
We live through turbulent times for medicine. The government is trying to cut what they pay, they add on regulations, insurers are often difficult, etc. It is easy to get lost and focus on the business of medicine instead of the practice of medicine. It is always better to remember our goals and concentrate on the journey, not on the roadblocks.
At some point, while merely children, we decided to become physicians. And like most youth, we approached the world with hope and excitement as we embarked on the education that would define who we are in our community. We worked hard to achieve good grades, we set our minds on that goal to get into medical school. We felt that our skills and intellect could be used to aid and help others, to make the world a healthier place, to provide sustenance and take care of countless others who would rely on and trust us with their lives.
Do you remember what you wrote and said when asked by interviewers why you want to be a physician? That was a defining moment when we set our goals as to the type of person we want to be and to be remembered as. For most of us it was a more noble and glorious reason than as a way to make money or obtain security. Now, many years later, do you still feel the same way?
Actions speak louder than words, so look at your own actions and see how they define who you are. Does it match the definition you once created? . . .
When we graduated medical school, we all took an oath, the majority took the Hippocratic Oath.
The original oath was written more than 2,700 years ago. Many medical schools stopped using an oath over the years until after WWII. The medical community realized how some physicians deviated from what most considered obvious and eternal truths. We experimented on people without their consent, the Nazis did unspeakable and horrible things, all in the name of science.
During the Third Reich, medical students were prohibited from taking an ethical oath. In 1948 the World Medical Association revised the Hippocratic Oath and encouraged all students to take it or one of the other similar oaths. In 1964 it was modernized and became more secular. Let’s look at what is in the oath.
We will respect and share knowledge. We will do whatever we can to treat our patients but not to excess. Medicine is an art and as such, warmth, sympathy and understanding may be more important than drugs or procedures. Respect our limits and not be afraid to ask for help. Protect privacy. We treat a person, not a disease, and that includes how his illness affects his family and economic stability. Prevention of disease is better than cure. We are members of society and have a special obligation to all others, whether healthy or infirmed. And finally: “If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. . .
Take some time and sit down with your spouse, a friend or colleague. Leave the regulators, insurers and bankers outside the door. Share and discuss why you chose to be a physician and what it really means to you. . .
“Protect privacy” was our middle name under the Hippocratic Oath for 2700 years. In the 20th century our Government demanded that we now hold “HIPAA” sacred. It did nothing of the sort. Our patients’ records have been “sacred” for these 2700 years. The only thing that HIPAA did is make us look bad by getting the public to think our patient’s records were not kept confidential unless the government forced the doctors to take the HIPAA oath. This did not change how doctors kept their patient’s records confidential. It only allowed almost all government agencies that dealt with health care open access to our patient’s records. And when the government agency came in to copy our patient records, there was always a notice at the beginning of the request. Do not notify the patient. We have the right to do this by the Medicare, Medical, HMO, or insurance agreement that they signed. When we showed this to the patient, they were appalled that they had agreed to this. But it was too late for the patient to reinstate confidentiality. If they did, they would lose their health insurance coverage.
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