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AN URGENT PLEA TO END THE WAR AGAINST PHYSICIANS AND PATIENTS

Crimes against humanity are widespread on this planet, and too many to count.  Over the past decade diligent researchers (by diligent I mean those who verify sources and results) have uncovered the roots of some of our more persistent and frightening social problems, and published reputable accounts thereof.  Many such problems are actually the result of conspiracies set decades ago, like the rise of private prisons for the purpose of incarcerating a specific race of young people because of socioeconomic issues (read racism), and calling it a War Against Drugs.  But the drugs continued to take over our nation—not just because of those young people, but because of the greed for money and power in the pharmaceutical companies, insurance companies, and politicians that has grown exponentially, unchecked.  Nixon’s intended outcome—that of getting minorities off the streets and severely impacting their ability to live normal lives outside of prison—also suited well the baser needs of other groups in our society.

Other groups, in fact, began to see the financial success and knowledge of physicians to be a major threat to their own greedy plans.  They deduced that chronic pain patients, now acknowledged and receiving treatment for their pain, could be both blamed as a source of street drugs and used to help bring down honest physicians (and to support the pill mill “doctors” who supplied the patients with enough medicine  to both use and sell).  Eventually, we begin to see “statistical reports” that “prescription drugs” were the cause of abuse and overdose deaths in specific regions of our country.   For a short time, they may have been.  But when the deaths began to occur in White Middle-Class families, the outcry to increase the efforts of the War on Drugs became deafening.  There had to appear to be some effort to control the drugs, so we see draconian measures being set—in some states by law, in others by regulation—that were targeting the legitimate physicians who prescribed for pain patients, and ultimately the patients who were frequently cut off without warning from their pain treatment.  Despite the outcry against punishing patients and physicians, and the evidence showing the futility of this approach to the War on Drugs, this situation continues to threaten the lives of both patients and their physicians, every day.

Despite scientific proof that Substance Abuse Disorder (being addicted to a substance) is an illness of the brain and can usually be well managed by an addiction specialist, legislators and law enforcement officials alike still only see “drunks and addicts” and still, after DECADES of failure, claim that incarceration/punishment is the only way to fight the war on drugs.

Despite, also, the logic that if you are fighting a War against a crime, you go after the source rather than innocent bystanders.  If we don’t get rid of the sources:  drug cartels, the dealers, and the creators of the drug,  how much good is it going to do to punish the people who use them?  Sadly, these sources have never been the primary targets.  Just as now we see heroin and fentanyl actually being the greater cause of overdose deaths (because they are cheap and much more potent than earlier versions), we still hear and see stories about prescription drugs being the cause of these deaths.  We are still subjected to so-called charts describing dubious statistical proof that prescription drugs are the main cause of overdoses, when more reliable research shows that it is street heroin and fentanyl.

To that, I would ask the reader to please follow the hyperlink below.  The author of this piece has provided a thoughtful and well researched discussion of what is really causing overdose deaths, and why the propaganda we are getting is so dishonest:

https://www.acsh.org/news/2017/10/12/opioid-epidemic-6-charts-designed-deceive-you-11935

Having read this article, consider well the facts that every year more than 400 physicians commit suicide;  that thousands of chronic pain patients suddenly deprived of their medication have either committed suicide or gone to the streets to get their medication; and that many of these have also suffered unintended overdose deaths.

These measures that make practicing good medicine so difficult, and the law enforcement mentality that believes physicians are guilty until proven innocent,  are not the only reasons physicians are either opting out of practicing medicine, or opting out of life altogether.  The War on Physicians and on Patients is real, and it is devastating.  The pharmaceutical houses and insurance companies may actually believe that we can survive without trained doctors; Artificial Intelligence will be just as good if not better, they believe….but check out this article:

https://www.scientificamerican.com/article/the-social-life-of-opioids/.

We read here that there is well-researched, scientific proof that a caring and trusting relationship between patient and doctor is a necessary, (but not sufficient), ingredient for best medical practice—AND for healing!  As one incredible physician has noted:  “They (the patients) don’t care how much you know until they know how much you care.”  Artificial intelligence hasn’t managed the caring part, and even if it does I don’t see much healing effect to be expected from a robotic hug.

The crime against pain patients who are now not only being vilified in news media, in pharmacies, and in social media, is certainly heartbreaking.  If you happen to be one of those pain patients, it is also a return to the terrors of intractable pain, inability to function productively in society, and a potentially horrible death.

If you are a physician who has spent at least half the normal human life span studying and preparing to make life better for those who suffer, life may be  becoming a nightmare.  Insurance companies dictate what treatments are allowable, how often, and how long such treatments will be permitted.  They do not refer to medical societies for their information.  They refer to bottom line profit indexes.  Legislators who pass laws (when medical board regulations would more properly suffice) that limit what physicians can prescribe, and how often—arrange that physician’s offices and lives will be disrupted, the physicians in question treated as guilty before having a chance to be proven innocent.  As usual, those who are charged with the felonies that have been put in place as a weapon in the War on Drugs never quite regain their previous status of innocence, even when proven so.

Does it matter to the insurance companies or the legislators that these laws have only created chaos and confusion, betrayal and mistrust?  Does it matter that physicians are already reeling from finding themselves backed into corners where they have to “sign on” to corporate health care entities that are run by non-medical administrators who decree when and how often they work, how many patients they will see for how long, and determine bonuses based on computer-run quotas and outcomes?  Does it matter that medical students are so disillusioned that they drop out, and that some commit suicide?

And finally, adding to the fears of losing their practices, their licenses, and the meaning attached to their life work, physicians in increasing numbers are being attacked and/or killed by frustrated, angry patients or their relatives.

Why is this ethically, morally, and even logically wrong approach to our drug crisis—which MUST be separated in our minds from medical care for chronic pain patients—continuing to exist as a modus operandi?  Why are physicians who serve our communities targeted as criminals at worst, and problem employees who must be managed at best?  Sociologically, physicians have historically belonged to one of the highest prestige vocations in America.  Their demotion to the present state is not through fault of their own, but through others’ sociopathic greed for money and power, combined with the attitude that allows so many to hate anyone who differs from themselves, to create this totally inhumane situation.

It is not “liberal” or “progressive” to respect and care for others.  It is Christian, and Muslim, and Hindi, and Jewish—it is a basic precept of many world religions and predates organized religion itself by centuries.  Of course, being human and egocentric, we do not always succeed in living up to these standards.

It is my opinion that the proof of our own individual humanity is the maturity, intelligence and self-motivation to care for others as we care for ourselves.

I could go on for pages about why so many people have lost the human characteristic of empathy, but there are enough people who retain it who could help our country become human again.  Who still respect the dignity of other human life, and who realize that “together, we stand; divided, we fall.”

It is definitely in our best interests to respect and protect the lives and experience of our physicians; it is also in our best interests not to stand by and leave them or their patients to live and die in misery when it is all so unnecessary.  And inhuman.

And, a last plea……

 

 

RESOURCES:

Alexander, Michelle.  The New Jim Crow:  Mass Incarceration in the Age of Colorblindness.  2012.  The New Press, NY

Bertram, Eva and Morrris Blachman. Drug War Politics: The Price of Denial.  1996. University of California Press.

Bateman, Dustin.  Neurobiological & Sociological Aspects of Addiction

Levinthal, Charles F.  Messengers of Paradise.  Opiates and the Brain.  The Struggle Over Pain, Rage, Uncertainty and Addiction. 

Meier, Barry.  A World of Hurt:  Fixing Pain Medicine’s Biggest Mistake.  2013.  New York Times Company.

Parsons, Talcott.  “Illness and the Role of the Physician:  A Sociological Perspective.”  American Journal of Orthopsychiatry 24 March 2010.  Copyright © 2010, John Wiley and Sons.

Quinones, Sam.  Dreamland:  The True Tale of America’s Opiate Epidemic.  2015.  Bloomsbury Publishing Plc.

Sternheimer, Karen.  Connecting Social Problems and Popular Culture:   Why Media is not the Answer. 2nd Ed.  2013.  Westview Press, Perseus Books Group.

Webster, Lynn R.  The Painful Truth:  What Chronic Pain is Really Like and What it Means to Each of Us.  2015.  Webster Media LLC, PO Box 581113, Salt Lake City UT 84158.

WEB ARTICLES, including peer reviewed

Pain Medicine News – How Did We Get Here? http://www.painmedicinenews.com/ViewArticle.aspx?d=Guest%2BEditorial&d_id=351&i=March+2014&i_id=1042&a_id=26043&tab=MostEmailed#.U3PLVV6vdyI.twitter

Report: Chronic, Undertreated Pain Affects 116 Million Americans http://ti.me/AAfT7q  via @TIMEHealth

New Pain Management Rules Leave Patients Hurting http://seattletimes.com/html/localnews/2016035307_pain28m.html#.U2mA77bwJzQ.twitter

Chronic Undertreated pain affects 116 million Americans: http://healthland.time.com/2011/06/29/report-chronic-undertreated-pain-affects-116-million-americans/

Our Fear of Opioids Leaves the world in Pain  http://edsinfo.wordpress.com/2014/10/27/our-fear-of-opioids-leaves-the-world-in-pain/

MT @toni_bernhard: My new piece. It should be of interest to anyone whose illness is questioned: http://www.psychologytoday.com/blog/turning-straw-gold/201410/i-m-sick-what-is-wrong-me …Dr. Paul Christo @DrPaulChristo  ·  Oct 27

California Doctor….    http://paindr.com/california-doctor-unveils-painful-abyss-facing-patients-in-pain/

Physician Suicide:  http://t.co/4vhF63eD6N

Physician Risks:

The damage done by the war on opioids: the pendulum has swung too far http://www.dovepress.com/articles.php?article_id=16781 …

Trial Verdict:  Dr. Baldi Not Guilty on All Charges http://whotv.com/2014/05/01/baldi-trial-not-guilty-on-all-charges/

What are Patients to do when Law Enforcement Closes Clinics?  http://missoulian.com/news/state-and-regional/ravalli-county-health-officer-says-patients-of-raided-florence-clinic/article_cf2e1690-bac0-11e3-848e-001a4bcf887a.html

Killing Pain in Perry county http://www.kentucky.com/2009/12/12/1056711/killing-pain-in-perry-co.html

Patient role in helping physicians:

“Unless patients wake up and fight for the providers of care, we are headed for the sickest system in the world.” http://www.kevinmd.com/blog/2014/03/dissatisfied-doctors-provide-good-patient-care.html …


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ACA OR SINGLE PAYER? ACTUALLY, THAT ISN’T THE QUESTION

In the chaos of our present—and proposed—health care systems, it may seem strange to those who know me that I would speak strongly against repealing the Affordable Care Act in order to set up a Single Payer System. I am not even going to address the miserable excuses for alternatives to the ACA that our congress-turned-one party-turned-a handful-of-old-white-males tried to foist on our already suffering nation. That is not worth my time, much less yours. So let’s look at what we have (or what is left of it), versus what a growing number of our fellow Americans are claiming to want.

The Affordable Care Act, aka “Obamacare.” What is wrong with it? Well, since I am old enough to remember congressional debates and media discussions about it, let me share one clear memory. A certain congressman or senator (I am not here to name names and add to the hostilities) stood in front of his peers, with a binder of papers almost a foot high. That was the ACA, which congress was supposed to stop stalling and cast their votes for or against. The legislator was angry, as he slammed the binder down and asked how many had even read the proposed law. Then he stated that no one could possibly have read such a lengthy and dense document. It had been added to indiscriminately, without enough discussion to make certain that there were no contradictory sections of it. Yet our lawmakers were called upon to vote, and vote they would. And they did, and the Frankenstein monster they created was passed. And some named it Obamacare, in not very subtle derision. Then those same people hated it all the more because it carried Obama’s name. Just an aside: Some of us social science types stated in no uncertain terms that those old white Southern men in Congress were determined that no black man would tell them what to do, and they would do nothing to promote anything he tried to do. “Too harsh of you” others shushed us. Still think so?

Moving on, at the other end of the continuum of political positions we find another “older” white man (I say “older” because I am older than he is, and I don’t want to downplay his energy and passion for his job by putting him in the same age category as me and the old white Southern men). Unlike his counterparts in Congress, he has worked and fought tirelessly to benefit the nation. Actually, I err by pushing him all the way to the left end of the continuum. He is a Liberal, yes—a social democrat. By the way, have you read the biblical book Acts of the Apostles? The part where it describes how communities of Christians lived? They joined the community by pitching in all of their money and other resources, and everyone in the community lived on the combined wealth: “To each, according to his need,” regardless of financial contribution, or lack thereof.

I digress. Sorry. The social democrat of whom I speak has called repeatedly and passionately for Single Payer Insurance, and whether or not it was intentionally in the spirit of the Book of Acts, it was certainly in the spirit of “all {men} are created equal, and endowed with certain rights.” I can’t fault his reasoning for wanting National Health Care (that is what we are actually talking about), but I am very afraid that it is misplaced in time.

Having experienced National Health Care when I was injured in Israel, I can say that I know at least some of its problems. Having experienced National Health Care in South Africa for seven years, I also know many of the benefits. In the former situation, at the age of 43 I fell off of a mountain in Israel and broke my ankle in three places, anteriorly displaced the ankle, and pulled a major tendon off the bone so cleanly there was no bone left on it to regrow and heal in place. My Harvard-trained Israeli physician refused to operate. “You are too old” he told me, “and regardless you will be in a leg brace for the rest of your life.” I could not get a second opinion, nor could I afford to pay cash if he would have done the surgery despite his recommendation. So I called the orthopedic surgeon back in the States with whom I had worked, flew home after a lengthy search for an airline that would take me, and I haven’t ever worn a brace. I do have to admit, being told I was too old to have my broken ankle fixed was almost as traumatic as the injury.

On the other hand, in South Africa for seven years a very reasonable deduction was made from my paycheck to pay for National Health Insurance. I was hospitalized once for three days and paid not a cent; saw 2 or 3 doctors of my choice at any given time and never paid more than $10 copay for a visit, and not more than $2.00 (I am using US equivalents to the Rand, at the time) for medicine. I was well taken care of, even when I suffered a bout of pneumonia, and never had concerns about what would happen to me. The big problem in South Africa, of course, was that “National Health Care” only applied to people who had jobs, or whose employers paid into the system. Others were given cash at the end of a day, or a week, with no benefits. The color of their skin made all the difference.

So National Health Care is not always perfect. People in Canada seem to love it; in England, not so much, but they don’t hate it, either. Again, having the cash to pay for what the government won’t take care of always helps.

The point I have been working up to with all this foreplay is that National Health Care is only going to work when you have a government that is attuned to the needs of the nation it serves, and in some agreement or reasonable compromise about how best to serve those citizens. That does not even come close to describing our government. Putting them in charge of our health care, given their record of misgoverning for at least the past three decades, would be like putting a family of drug dealers in charge of a national pharmacy. The knowledge and expertise—even the Will–required to make good financial decisions about medical care for ALL citizens simply does not exist in our political system.

PLEASE!!! DO NOT EVEN CONSIDER NATIONAL HEALTH CARE IN THIS COUNTRY UNTIL WE CAN CARE FOR EACH OTHER, AND HAVE THE GOOD SENSE TO ELECT A GOVERNMENT WE CAN TRUST TO ACT AS ONE “BY THE PEOPLE, FOR THE PEOPLE” ETC.

We HAVE a health care plan. It needs fixing.  SO FIX IT!!! Work together, work in the best interests of the citizens of this country who have, according to our constitution and bill of rights, the right to these good things. There is much more to say about this, but that is for another blog post. First, and foremost, I say to the members of Congress: Do your jobs, fix the mess caused by earlier versions of your peers, and get together like real human beings and give us back our beloved country–the one where we were finally just beginning to accomplish equal rights for everyone.