DIATRIBE ON DOCTORS
Roane, Stephen
I am holding what our Chinese friends would call a "Speak Bitterness Meeting" with my typewriter. The subject of my bitterness is Doctors; Medical Doctors, "Doctors Doctors." Doctors, as a...
...So they were given a cabinet of medicines in bottles labeled with numbers from one through whatever...
...That brings us back to our old friend, the witch doctor, and the cutandtry method...
...The medical societies, of course, like other trade associations, make no attempt to place any tolerable ceilings on fees...
...But what did Doctors do before the publication of the Merck Manual...
...Change to a more rational organization of medicine can be accomplished by public demand, but for the other problems the prescription must be Shakespeare's "Physician heal thyself...
...They were out to sea a long time...
...There are two general methods used by most Doctors, usually in some combination: the cookbook method, and the cut-and-try, or witch-doctor, method...
...They examine you, and if they find anything beyond a cold or a bellyache, they refer you to another specialist...
...Of course, medical research is being done by physicians and others (Pasteur and Fleming can be counted among the "others...
...But can we end human greed...
...This for the most part is true science and not the subject of the present discussion...
...The first thing that strikes the eye is that Doctors, like all priesthoods, have developed arcane words for ordinary things...
...The first felt all could be set right by removal of the "nuceiform sac...
...363...
...But all this has to do just with money...
...The more detailed and precise modern equivalent is the Merck Manual, a tome that permits any idiot to practice medicine, provided he has a license...
...The reason is clear: Doctors are ripping off a bigger and bigger chunk of the national wealth...
...Stimulating the phagocytes has in many instances given way to unstimulating them...
...Well, the first step is, obviously, to socialize medicine, and remove its practice from the realm of "free enterprise...
...Shaw play A Doctor's Dilemma...
...Well, again, not much has changed...
...So the societies are on the alert against fee-cutting as unfair competition...
...They do this by raising their fees unconscionably, and by increasing the occasions for which fees may be charged, such as forcing a patient to come to their office when information in a telephone conversation would suffice...
...You have what looks like a case of Logos on the Bogos...
...7, and so on...
...With the financial aspect removed, doctors might be freer to keep their minds on medicine in a more objective way...
...What of science...
...They must first abandon their medieval guild psychology...
...Most could be expressed in simple English...
...This, however, must be done by the Doctors themselves...
...In another industry this would be known as fraud...
...Beyond that, they content themselves with spreading blood-chilling lies about the British National Health, which has succeeded in raising life expectancy so dramatically, although it has not done so much for Doctors' incomes...
...SO, "WHAT IS TO BE DONE...
...And the skipper would so prescribe...
...Group clinics—where specialists to the extent that they are needed can be consulted on a patient's problems—is an idea whose time has come...
...The second was for "stimulating the phagocytes...
...Will sickness and death disappear from the earth...
...The question of why medical costs have shot up so much more than other costs is papered over with pieties to avoid mentioning the unmentionable and thus offending our new priestly caste, and their trade union, the AMA...
...Less legal but just as remunerative is the practice of the Private Doctor charging for all kinds of procedures actually performed by hospital personnel...
...He stared out over the desert and he wrote, "One generation passes away, and another generation comes, and the thing that has been, it is that which shall be, and that which is done, is that which shall be done, and there is no new thing under the sun...
...think we should start you on a 20 mg dose of ipso-ipecac...
...Because that's where most doctors will send your bills if they are unpaid for a couple of months...
...There is, of course, no such thing as a "nuceiform sac...
...Some mechanism must be found to encourage good Doctors, discipline bad Doctors, and help mediocre Doctors to improve...
...And green-gage plums have lost in popularity to cranberry juice and Vitamin C pills...
...The good Doctor sticks his head in the door of the patient's room every day, and says "How are yuh...
...It is conveniently arranged with little tabs...
...Doctors should be paid salaries, good professionaltype salaries, but their practice should be "businessized...
...The term "Doctor-Patient CollectionAgency Relationship...
...Marcus Welby...
...Among other terms are "eredema" for little red spots, "cardiac infarction" for heart attack, "edema" for a collection of body fluids, and so on .. Some medical terminology is doubtless useful to express medical concepts with precision...
...All this—together with fat salaries and "percs" paid to hospital executives, and unbelievable inefficiency and bureaucratism—leads to inflated health care costs...
...Perhaps I should end with the words of the old man who wrote so long ago before the salvations—those of Marx, or Freud, or Jesus...
...Layers of centuries-old customs, folkways, feudal and prefeudal attitudes, and psychology must somehow be abandoned...
...They now are "internists" (up go the fees...
...Other than that, things have remained about the same...
...Of course, the witch-doctor school had its faults, the most serious being a too universal application of a remedy...
...There are good and devoted Doctors, there are bad Doctors little better than medical racketeers, and there are the great majority who are somewhere in between...
...Curiously enough, many of these same jungle medicines, being of real value, are still in use...
...It's perfectly legal...
...Rubbish...
...Remember the famous trio...
...And who is stronger than those who have the power, real or imaginary, of life or death, sickness or health over us...
...Specialization is another gimmick in the medical ripoff...
...Will folly cease...
...Suggest a national health plan, and a whole series of other plans...
...He and his daddy or granddaddy had accumulated some rough statistics that told them a certain herb would reduce fevers or cure sores or whatever in 30 or 40 or 50 percent of the cases...
...For each of these "visits" he will charge a spanking fee...
...Perhaps he's not a doctor at all, but an actor appearing in the G.B...
...It's our economic system that brings out the worst...
...Thus, up to less than a century ago, you or I would have been bled to death if all else failed...
...There are no ordinary Doctors anymore (they used to be called "general practitioners"), at least outside of rural areas...
...The cookbook method is a more sophisticated version of the medicine practiced by the old whaling-ship skippers...
...If he's really conscientious he may even feel your pulse...
...He had no license, so he had to produce a reasonable number of cures or his witch doctorhood was at an end...
...Along with the cabinet came a manual listing various imfirmities such as bellyaches, coughs, and 362 convulsions, together with prescribed dosages: two tablespoons a day from bottle no...
...Under our system the economically strong exploit and mercilessly plunder the economically weak...
...They content themselves with lobbying vigorously against anyone else, governmental or private, who may try to limit fees...
...And—"Of course, we will need the results of the blood test for confirmation...
...Benjamin Rush, the father of American medicine, was great on bleeding...
...But it is in the hospital that they really get their hooks in...
...This comes under the heading of preventing interference with the sacred "Doctor-Patient relationship," which permits doctors to charge what the customer can't bear...
...The witch doctor was not a complete fool...
...A doctor has only the time it takes for the patient to get dressed and come into the office to compose and deliver his wisdom...
...How shall I end this "diatribe...
...Asked how these medicines worked, he could give a perfectly coherent explanation involving the interaction between the Sun God and the Rain God, and so forth...
...Better make that 25mg...
...Now watch the fees...
...When accompanied by the appropriate mutterings, of course...
...To be fair, it should be said that Doctors have abandoned this procedure in the intervening years...
...I have a modest suggestion...
...Well, what about the famous "Doctor-Patient Relationship" celebrated in song, story, AMA propaganda, and Dr...
...Clearly, as Clemenceau would say: "Health is too serious a matter to be left in the hands of the doctors...
...How to make medical practice more scientific, less benighted by cant, is a more complicated problem...
...Doctors, as a group, are no better, certainly no better, but also no worse than any other group of human beings...
...The third, with a poor clientele, expounded on the curative powers of greengage plums...
...Here we are speaking of medical practice, clinical practice...
...that would be "interference with free enterprise...
...Merck is not infallible...
...When our witch doctor next appears he has shed his nose bone and appears in the Victorian clothes of a Harley Street practitioner...
...Only the mutterings have changed...
...A good hedge...
...Blue Shield will pay...
...The wise old family doctor, listening to your troubles, giving homely common-sense advice, mopping your fevered brow...
Vol. 28 • July 1981 • No. 3
