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” http://www.iom.edu/report.asp?id=5575. 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 http://www.commonsensemedicine.org/ and the Institute for Healthcare Improvement at http://www.ihi.org/ihi Health Promotion Advocates www.healthpromotionadvocates.org
Also highly recommend Dr. Nortin Hadler’s book The Last Well Person (2004)