Exploitation of trust

Once upon a time, the tobacco industry was guilty of conducting a widespread, systematic, highly organized campaign to deliver their product to as much of the unsuspecting public as possible.

As clinical data mounted linking smoking and health problems like cancer and heart disease, tobacco producers labored fiercely to counter these claims despite darkening public sentiment. When individual company executives were questioned on why they continued to perpetuate the industry’s scandalous practices, the invariable justification offered was “Well, I had to pay my mortgage.” That tidy ends-justifies-the-means rationalization has a familiar ring when you examine the behavior of those in the heart "industry."

Things are not what they seem. The hospital, once an institution to serve the sick, a place for clergy, volunteers, and other altruists, has evolved into a business serving a thriving bottom line. You are the “product” they seek. The cardiologist, ostensibly in the service of alleviating heart disease, instead seeks to grow his checkbook by performing procedures that have nothing to do with lessening the burden of heart disease. He dives into the water to save drowning victim after drowning victim, but fails to simply toss in the life preserver that has been close at hand all along.

The woeful family practitioner, who is expected to bear undue responsibility for the broad spectrum of health, ignorantly permits heart disease to grow under his or her nose and, by default, allows heart disease to become the exclusive province of the proceduralist. Worse, the family practitioner or internist in the employ of the hospital (a situation that has quietly grown to encompass 80% of all primary care physicians) labors to fatten hospital business by directing patients into hospital services. The comparative lowly incomes of the primary care physician are substantially supplemented by participating in this huge revenue-generating machine called heart care.

The astounding grasp of the system has caused one of every 10 adults in the U.S. to have undergone a heart procedure. The lemming-like procession to the hospital creates a crowd mentality among some sectors of the frightened public. “My friends and neighbors have all had bypass operations. Sooner or later I guess it’s going to be my turn.”

Tragically, the system has grown through the exploitation of trust. The faith we have in doctors, hospitals, and the institutions and people associated with healthcare has been subverted into the service of profit. Many practitioners and institutions choose to operate under the guise of doing good, but instead capitalize on the public’s willingness to accept as fact the need for major heart procedures and all its associated costly trappings.

Comments (5) -

  • Diabetes Supply

    7/25/2008 5:16:00 AM |

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  • Jenny

    7/25/2008 11:13:00 AM |

    Thanks for drawing attention to this very real problem.

    As you may have read in my blog, I went to my local hospital last December because I'd inhaled a small piece of peanut and the ER doctor and hospitalist did all they could to turn that visit into a cardiac emergency despite a completely normal EKG.

    Had I not been an ornery bitch I'd have ended up paying for the nuclear stress test they ordered for me on top of the several thousand bucks I was charged for staying over night with a monitor on me.

    My heart was 100% fine--all this cardiac nonsense was because I have the word "diabetes" on my chart and because my lung--which is in my chest, hurt--after 24 hours of coughing--which the ER doctor interpreted as "chest pain--Heart attack???.

    If I'd had that stress test with the false positives I might well have ended up with unnecessary surgery.

  • Jenny

    7/25/2008 2:11:00 PM |

    From a different Jenny  (Jennytoo):  You are getting to the essence of the problem, and it's not just cardiology that is rife with what is at bottom malpractice.  There is little incentive for the profession as a whole to know anything about or promote prevention, and many incentives from hospitals, drug and insurance companies to stick with the status quo or to change it in their corporate favor.  The formulaic, conventional statements purporting to be guidelines for prevention that are put out by various interest groups and in such publications as hospital-sponsored newsletters ("eat a 'balanced diet', avoid stress, etc.")  are useless sops to the concept of prevention.  It is, and I fear is going to remain, up to motivated individuals, both physicians and patients, to reshape the system, and it's going to be a long frustrating struggle.  It's my personal conviction that if just 4 things were promoted to the public, and people actually practiced them, we could change the health profiles of the majority of people in this country for the better within two years or less.  They are (1) education on and promotion of a true low-carbohydrate, whole foods, diet, (2) measurement and supplementation of Vitamin D3 (3)supplementation with DHA/EPA (found in Fish Oils) and (4)measurement and supplementation of  intracellular Magnesium.   I am not a health professional, and others may want to add to this list, but I don't think any strong case can be made against any of the items.  The wonderful and hopeful thing is that each of us can implement them ON OUR OWN, and thereby take charge of our own well-being.  (The Life Extension Foundation is one organization which provides access to lab tests you can request on your own.)  If you have a physician who is willing and capable of being your partner, you are richly blessed, and that is the ideal we all should hope for.   But in the more likely event that you do not have such a physician, and if your physician demonstrates little potential for becoming one, think about firing the one you have and finding another.  Sometimes we are forced by circumstances, particularly urgent ones, to deal with physicians who are not ideal, but the main impetus for change will come from us, the patients, and the expectations we communicate to our individual doctors.  In the meantime, we can be self-reliant in our own prevention practices.  Learn from Dr. Davis and Jenny Ruhl and the Dr.'s Eades and the Vitamin D Council (and many others), and put what you learn into practice for your own benefit, and when in health-care settings, be friendly and accommodating when you can and ornery when accommodating doesn't work.  Your health is your own, and shouldn't be at the mercy of any other whose interests are competing.

  • Dr. William Davis

    7/25/2008 4:41:00 PM |

    Eloquently said!

  • Mike Dodge

    7/28/2008 10:38:00 PM |

    I haven't visited the medical community in over 5 years. I think that I am healthier for that.

    In the past, I had lots of expensive tests done that resulted in nothing of significance being done, but lots of money spent. Doctors can easily scare people into having lots of tests done. Who wants to drop dead? If I break a bone, I will, most likely, go to a physician. I see no need to get the recommended no-symptom tests done as they are just looking for the needle in the haystack but finding lots of pitchforks.