In my career I have seen two sea-changes in medicine. The first occurred almost 50 years ago when I was a medical student. Those were the days of 40 bed wards in charity teaching hospitals, filled with mostly poor people who could not afford to seek care in private hospitals. There was little privacy. Many of them had a profound distrust of hospitals, thinking that they were place where people went to die.
I remember having discussions with some of them, trying to convince them that they were wrong. Hospitals were the places where people went to be healed! Many didn’t believe me.
In those days, the patients were pretty much in the hands of the medical students and house staff. Yes, there were “attendings”, but their presence was, for the most part, a hit or miss thing. Real decisions were often made without their input. Thankfully, those days ended. Care was no longer primarily based on the ability to pay or the insurance plan of the patient. The 40 bed wards were converted to semi-private and then fully private rooms. No longer were there “resident cases” and “attending cases”. Every patient had an attending. It wasn’t perfect, but it was a significant step forward. Most patients lost their fear of the hospital as a place to which one went to die. For the majority of my practice, the hospital was indeed a place of healing…a place of dignity…a place of care from the physical and spiritual dimensions. I felt that my profession was indeed making progress. We had placed our focus on the care of each individual patient. I was wrong!
Twenty years ago, when I was employed as a Professor in a major teaching institution, I was Director of Resident Education in our department. All of medicine was transitioning from a structure-based education to a competency-based education. It was not enough to merely spend a certain amount of time on specified areas. We were to assure that all these core-competencies were imparted:
• Practice-Based Learning and Improvement
• Patient Care and Procedural Skills
• Systems-Based Practice
• Medical Knowledge
• Interpersonal and Communication Skills
• Professionalism
I remember very clearly the instructions from our specialty society of the teaching of ethics. We were given a syllabus and case discussions. One of those was on the unethical behavior of accepting gifts from drug companies. No longer were medical students allowed to accept the “doctor’s bag” that Eli Lilly used to give to every student. Lunches provided by drug companies were forbidden. So were such innocuous items as pens with the drug company name on it. This memory has come back to haunt me…...
The bottom dropped out in 2020 when medicine transformed into something I can no longer recognize. But there were warning signs along the way. It’s just that we didn’t see them for what they were.
It started with the best of intentions. We began to base our care on “the evidence”. Unfortunately, the evidence consisted solely of conclusions from written papers. Medical experience and individualized care were pushed to the background as everything was based on the good of the herd and care for the “average” patient. The wisdom of Tricia Greenhalgh was largely ignored:
Intuition is a decision-making method that is used unconsciously by experienced practitioners but is inaccessible to the novice.
It is rapid, subtle, contextual, and does not follow simple, cause-and-effect logic. Evidence-based medicine offers exciting opportunities for improving patient outcomes, but the ‘evidence-burdened’approach of the inexperienced, protocol-driven clinician is well documented.
Intuition is not unscientific. It is a highly creative process, fundamental to hypothesis generation in science. The experienced practitioner should generate and follow clinical hunches as well as (not instead of) applying the deductive principles of evidence-based medicine.
More and more we became “inexperienced, protocol-driven clinicians”. We lost our ability to think critically. As physicians became almost exclusively employed, the will of the employer, not the good of the patient, intruded more and more into clinical decision-making.
In 2020, the collision of titanic forces came to a head with disastrous results. Critical thinking was replaced with group-think. Economic blackmail was employed to cow any professional who disagreed with “the protocol”.
Four separate events in the past few weeks solidified my realization that we had crossed into treacherous waters:
• I watched the 5 part series on The Holocaust, “Never Again”, produced by the Children’s Defense Organization:
• Multiple authors have linked to this paper, published in January 2023, by David Morens, Jeffrey Taubenberger and Anthony Fauci, https://www.cell.com/cell-host-microbe/fulltext/S1931-3128(22)00572-8#%20 In this, they admit that the mRNA agent formulated against COVID may not be successful in preventing infection or blocking spread
• In spite of the above admission, just a few days ago the Advisory Committee on Immunization Practices (ACIP) recommended that the antiCOVID agents be added to the list of vaccine recommendations.
Yes, a gene-therapy agent that the chief promoters admitted will probably not work, was just added to the list of recommended vaccines. This is in spite of the huge numbers of adverse effects and deaths and the boasting of a Pfizer executive that this was a cash cow for the company but not good for the public, as exposed by Project Veritas….
https://www.projectveritas.com/
I can’t help but think back to those days when I was expected to teach that it was unethical to accept a pen from a drug company…. In 20 years, the world changed, and for the worse.
It is easy to think that the problem is limited to the incestuous relationship between the Public Health elite and Big Pharma and once that is changed, the problem will cease to exist. Unfortunately, nothing can be further from the truth. The problem is huge, and spreads beyond the regulatory agencies and into the practice of medicine itself. This is how an influential member of our COVID research group framed it:
The real measure of indoctrination will be if the newly minted doctors take up the mission of ideological policing on their own, which would mean mounting persecution and expulsions of their colleagues on ideological grounds.
I wonder what the ordinary folks think? Do most of us even trust the CDC or FDA anymore? Did we ever really trust doctors? When we did, why did we trust them? It was almost always a singular, personal relationship with one or more providers (in my life I've been lucky to have effectively miraculous, and truly saintly doctors) and we arrived at the judgment that we could trust them based on a personal relationship. A good doctor that you really trust is sort of like a spouse, definitely like a good friend, at the very least like a bus driver you see often, absolutely someone you at least kind of know.
With your spouse and your friends, you trust them to love you as much as they can and always tell you the truth within reason. With the bus driver, you still trust them to get you where you're going. In a way, doctors had a mission even more important than our spouses, yet simpler than what we ask from a bus driver, and they have failed on both counts.
I am haunted by the possibility that if people find out what has happened, they will never trust doctors again. Why would they? Better to just try your own luck.
Let me frame this from the personal viewpoint: If I were to become sick and need hospitalization, I honestly do not know where I would turn. All the hospitals at which I used to practice before retiring from clinical medicine in 2017 joined the unthinking obedience to the dictates of the CDC, NIH and FDA. The State Medical Licensing Board has made it clear in written communication that it will root out any physician who does not obey their dictates, on this one disease. Physicians are free to use their clinical judgment, at least for now, on every other disease but COVID. They remain expected to deliver Informed Consent to their patients on every other disease but COVID, as well as the risks, benefits and alternatives to classical vaccines, but not for COVID.
So, like Diogenes searching for an honest man, I have been searching for an honest healthcare professional who can treat my wife and I and not blindly follow irrational dictates because his or her employer demands it. Even having spent a lifetime in this community, both in private practice and as a Professor at the local medical school, the task has not been easy. The few individuals I found were reluctant to treat us because of the close personal relationship. Even if they agreed with me from the ethical and medical standpoints, they were constrained by the hospital and/or medical group that employed them.
I think I have found a solution:
The Wellness Company https://www.twc.health/.
I have no relationship with this company but do with a number of the founders and leaders. They are people I trust. Unfortunately, if or my wife need hospitalization, they cannot help with that, but I will cross that bridge when we come to it.
The ultimate solution is a revolution in the way we educate health professionals. Amazingly, the American Association of Medical Colleges (AAMC) has a list of competencies they recommend for incoming medical students:
Critical Thinking is among these core competencies. This is ironic, as critical thinking has taken a back seat to intellectual orthodoxy in virtually every medical school in this country. If you watch the documentary from the Children’s Health Defense Organization linked to earlier, you will see how incredibly ironic this is:
The complete lack of self-awareness on the part of the medical education elite is astounding. Unfortunately, we will never be able to depend upon them to right this wrong as they are too invested in the problem to admit their own lack of critical thinking. We will absolutely depend upon early education of healthcare professionals, at the undergraduate level at the latest, but hopefully even at the secondary school level, if we are to extricate ourselves from this pit into which we have fallen. Then, and only then, will people trust their physicians again….
I totally agree with what you have said in this article. As a retired RN, I have watched this happen over the course of the last 50 years. The pitfalls of this evolution became evident with the COVIDcrisis. I no longer know who I can trust to care for me and my husband.
Outstanding article. I have a hard time seeing a path forward until “people in charge” (bureaucrats, administrators, ALL of us) openly admit what we learned about ourselves.
Covid taught me I owe it to my fellow citizens to speak up when I see individuals being bullied by the monolith (agencies, government, employers, etc). In the past, I would tell myself “not my monkey, not my circus” and “stay in my lane”. I never took the vaccine or mocked others who did. But I wore a mask during peak Covid despite “knowing” it was all theater, and I could have pushed back harder at my work or where I shop against the nonsense precautions. I’m embarrassed.
All the dancing TikTok nurses, pro-jab finger waggers, and silent doctors must ask themselves why they were so quick to promote “Covid precautions, keep everyone safe” vs advocating basic steps like diet, exercise, bloodwork, Vitamin D, avoiding drugs/alcohol, etc.
Hopefully we ALL take this opportunity to get better/stronger/smarter.
I totally agree with what you have said in this article. As a retired RN, I have watched this happen over the course of the last 50 years. The pitfalls of this evolution became evident with the COVIDcrisis. I no longer know who I can trust to care for me and my husband.
Outstanding article. I have a hard time seeing a path forward until “people in charge” (bureaucrats, administrators, ALL of us) openly admit what we learned about ourselves.
Covid taught me I owe it to my fellow citizens to speak up when I see individuals being bullied by the monolith (agencies, government, employers, etc). In the past, I would tell myself “not my monkey, not my circus” and “stay in my lane”. I never took the vaccine or mocked others who did. But I wore a mask during peak Covid despite “knowing” it was all theater, and I could have pushed back harder at my work or where I shop against the nonsense precautions. I’m embarrassed.
All the dancing TikTok nurses, pro-jab finger waggers, and silent doctors must ask themselves why they were so quick to promote “Covid precautions, keep everyone safe” vs advocating basic steps like diet, exercise, bloodwork, Vitamin D, avoiding drugs/alcohol, etc.
Hopefully we ALL take this opportunity to get better/stronger/smarter.