Friday, October 23, 2009

Medicine: where it went wrong

If one reads a great deal, and reads widely, it becomes clear that every serious social problem that confronts us, either sooner or later, has been described and forseen in the cultural works of the nation.
For example:
Teacher In America by Jacques Barzun, published in 1945, contains these lines in the first chapter: "Meanwhile I dwell on the necessity of teaching, that is to say on the need for teachers....The "call" (to teach) cannot be strong if a teacher will leave the classroom to floorwalk in a department store. Doctors are poor too, but they stick to their rounds and their patients." (Italics mine.)

"Are These Our Doctors?" by Ellen Barkins, published in 1952, contains these lines: "This is the time, therefore, for the public to take stock. This is the time to realize that Specialist Medicine, these past years, has been a sociological flop. Without rendering adequate scientific gain, it has done great harm. It has distorted the role of the general practitioner and the specialist in lay minds, thus causing both economic and professional waste.
It has reduced the human element and dignity in treating patients; and without gaining for them even half a world, it has forfeited the public's soul. It has gravely weakened the relationship between the two groups concerned..."

"The Last Angry Man", by Gerald Green, published in 1957, was a best selling novel that revealed the life of Dr. Samuel Abelman at work in New York City as a GP. The novel is a compelling story of his work for the poor and underclass, of his arguments with his patients for their inability to care for themselves, of his arguments with fellow doctors who became specialists for the money and status involved, and his arguments with himself for not doing more for himself and his wife. As one of the main characteers puts it: "There aren't enough people left who get mad, plain mad. Mad at all the bitchery and fraud. We take fraud for granted. We like it. We want to be had. That's where Abelman was different. He knew he was being cheated and he didn't like it one tiny bit. He was the last angry man."

"Coming Of Age" by Studs Terkel, published in 1995, contains an interview with Quentin Young, M.D. who was director of medicine at the Cook County Hospital, Chicago, from 1972 to 1983. Dr. Young says this: The darkest development in our troubled health care system is the advent of corporate medicine. The AMA had all sorts of laws - they still exist - against corporate medicine being practiced, yet these laws have been ignored. Large conglomerates came in.
Public hospitals, which were improving until about fifteen years ago, have become the absolute dumping pit. The system has always dumped on the public sector everything that had no profits in it. Today, it has become the specific behavior called 'prudent management.'"
The last sentence of Dr. Young's interview is the expression of a frightening vision: "An industrialized system, controlled by five or six monopolies, care allocated, excision of the unworthy or unfit, as we move toward a euthanasic society."

Enough said. Read it and weep.

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