Friday, December 30, 2005


Blake explains below the inspiration for this blog. Now I will discuss some of our goals, and the ground rules. We want to encourage and facilitate dialogue about this issues. This isn't going to be a conventional blog with a single voice or a main point of view. Blake and I will post regularly, at least at first, to keep it going. (Mostly Blake, I hope, since I have to take care of Stayin' Alive), but we want this to be a community project.

That means you too can post on this blog, so long as your posts are consistent with our mission statement (see top of the page). Just e-mail your proposed post to one of us (not both, please, that will just cause confusion). The editor will either post it for you as-is, ask for (or suggest) revisions, or tell you in a kind way why it isn't suitable but give you suitable encouragement. (Or, conceivably, if you deserve it, tell you something else.) Regular contributors who prove their mettle will get the keys to the kingdom and have the privilege of posting on their own.

Meanwhile, the comments are unmoderated and we invite everyone to comment. Disagreeing with the poster or with our mission statement doesn't make you a troll, but disagreement must be civil and based on facts and/or reason. Gratuitous insults (and that includes calling people ignorant), inappropriate language, and data free analysis are not welcome here. (We do reserve the right to delete truly offensive comments.)

But the more comments the better! Don't be shy! Let's hear from you. Personal stories are definitely okay -- we care about how the crisis in health care affects people, including you and the people you care about. Contributors don't have to be experts on anything more than their own lives. Experts on policy, social science and medicine are also more than welcome, but keep it accessible. This is about democracy.

So, boldly we go. Let's make it work, together.

Friday, December 23, 2005

Critical Condition-Introduction

Is US Organized Medicine Doomed?

Organized American Medicine as we know it remains in possible irreversible crisis. Former (canned) editor of the prestigious medical journal The Journal of the American Medical Association JAMA-George P, Lundberg MD use term “crisis” many years ago. See Severed Trust: Why American Medicine Hasn't Been Fixed by George D. Lundberg with James Stacey, 371 pp, ISBN 0-465-04291-0, New York, NY, Basic Books, 2000. The crisis is on many levels but none so indolent as the moral crisis of the profession. What once was profession embodying the most noble of human traits has now, because of greed, and intellectual stagnation has become a quintessential cultural paradox, which may actually be harming more people that it helps? Hospitals have become dangerous places as per the landmark IOM report of November 1999 “To Err is Human” Unnecessary surgery, procedures and testing abounds and yet a large and growing % of Americans experience no improvement in health outcomes or have no health insurance at all?

Nothing embodies this moral crisis in US Organized Medicine more than the recent revelations about the US or Multinational Pharmaceutical Industry, which has finally been both broadly chastised and had significant legal actions taken against it. This former miracle industry has “gone sour” through greed, excess, amoral behaviors and intellectual stagnation. They push pills for a variety of human social problems like unemployment, create markets for diseases that don’t exist (shyness, etc) and utilize unscrupulous marketing techniques such as physician “educational” dinners in very fancy restaurants, utilizing cheerleaders with possible sexual favors as sales “reps” and financially subsidizing “independent” research and presentations at highly visible medical conferences. Most egregious and paradoxical of all many of their products are not safe!

I worry about the end game. Vested interests are not changing fast enough. Yet bright, brave and moral leaders scientists and physicians from academia, The FDA, and pharmaceutical companies are beginning to step forward often at significant personal risk to their employability. We are very close to collapse and rebirth -not more failed incrementalism. Optimism remains a moral imperative.

For more physicians who are solution oriented go to Common Sense Medicine at and the Institute for Healthcare Improvement at Health Promotion Advocates
Also highly recommend Dr. Nortin Hadler’s book The Last Well Person (2004)