Who is your physician working for?

Dr. Weeks’  Comment:   The fundamental conflict of interest in American medicine today is that “your” doctor is working “on” you but “for” the insurance company.  Read on to better understand how this is not a semantic issue…


This cartoon was published in 1992 but seems oddly appropriate for today’s debate on health care reform.

Doonsbury cartoon

Funny eh?

Now (after you have had a good chuckle) please consider this cartoon to be a dire warning about the government further insinuating itself between doctor and patient.

We at the Weeks Clinic for Corrective Medicine and Psychiatry www.weeksmd.com are grateful to be free – still, for the time being at least – to care for our patients. Here is our statement to our potential patients:

“…Finally, we think that it is very important to clarify in advance that we do not bill or accept payment from any third parties like insurance companies or Medicare/Medicaid. Why is this important? Well, we think that the only way you can be assured that your doctor is working exclusively for you and has your best interest at heart is quite simply to be the one to pay for the care you receive. We have seen such compromise in patients’ care when third party payers insinuate themselves and their profit motive between the patients and the doctor that we decided a decade ago to work exclusively for our patients. Ask yourself this question: “Who pays my doctor?” The answer to that question is the person your doctor is actually working for.”

Otherwise stated, since we at the Weeks Clinic are non-participating providers (meaning we do not contract with any 3rd party – insurance or government), we are paid exclusively by our patients. What does that mean? (Please understand this before it is too late!) It means that we, as doctors, work exclusively for our patients and that therefore, we are accountable exclusively to our patients! I say this because I strongly encourage you to create a similar relationship with a doctor before it is too late.

Recently at a conference I attended, I was shocked to be among a group of doctors being taught about our responsibility to “society” to ration care and utilize resources “responsibly”. I had to pinch myself to see if it was a nightmare. I looked around the room and had to pinch myself again because I was the only one who seemed to think this discussion had nothing to do with the practice of medicine. I am a competitive person – my childhood was full of football, ice hockey, lacrosse and later ski racing and ski jumping. I like to set goals and accomplish them. I love the advice: “Duc, sequere aut ex via discede vale, lacerta!” (“Lead, follow or get out of the way!” …with a heartfelt thanks to FDM!)

And today, I remain highly competitive as a doctor because I love to get excellent results for my patients. I love the challenge of practicing above the standard of care (although it frequently results in scrutiny from the administrative state medical board) and I love achieving better results than are expected. Towards that end, as a doctor, my commitment is not to ration care in a way that is good for society, but to clarify for my patients what I think is best for them and then to work hard to provide it, if they are in agreement. The beauty of Corrective Medicine is that this approach to health care is more effective and cost-effective than what is practiced today (check this out  for the most recent example of wasteful government in cahoots with BigPharma). Quite simply: if Corrective Medicine were the standard of care, we would not need to ration health care resources.

I would not want to practice medicine, an ancient and honorable profession (only recently disgraced over the past 60 years by we doctors allowing other interests than the welfare of our patients to take top priority see what doctors serving the state accomplished in Nazi Germany and see this post on my blog for only the most recently exposed egregious behavior , if it meant that I would be working for anyone other than my patient. Caring for patients is what we doctors swore to attend to, not the “welfare of the state”. That is what the Hippocratic Oath calls forth from a doctor – not to serve the state, but to serve the patient and specifically, not to share private medical records. (For a better vow, read the oath of perhaps the greatest of physicians, Paracelsus whose dying words are inspiring: “I pleased no one save my patients.”).

So, before we close, please consider for a moment “your” cardiologist and “your pediatrician” and “your” primary care doctor. Now wonder with me “Whose?” Pause and consider this all important question: “Who pays these doctors for their service?”

Doctors of political economy suggest that we might follow the “money trail” to understand why things happen in the world and the answer to the question of who pays “your” doctor’s bill is the answer to the question of who the doctor is really “caring” for. “Your” doctor might be working on you but he or she is working for other interests.

Now, because you have honored me by reading this far, I will let you in on a little known, surprising professional secret. It has to do with burnout among my medical peers. It speaks to why doctors are dropping out, taking administrative job, retiring early, working for drug companies or government agencies. The truth is that “your” doctors miss being able to care for you. They wish they didn’t have to appease insurance companies by downplaying (to your face!) what is really best for you in order to not upset the gravy train. Doctors HATE the idea of rationing health care. They want YOU to get best care available be it the real drug that works best for you because they hate to kowtow to the insurance company by having to talk you into the generic drug or the version which is on formulary. They want to see you in the office today and would be happy to fit you in. They want to help you get the operation you need even if it would rub some bureaucrats the wrong way and paint them in a pushy light. You know what else? (This may surprise you!) They miss the thrilling and gratifying freedom to tell you: “No charge, Mrs. Wilson. It is my pleasure.” Did you know it is illegal and insurance fraud to not charge a patient who is contracted with an insurance company or Medicare/Medicaid? It is considered “unfair marketing and competition”. What have we come to in America that doctors are such servants of third parties that they can’t give away free care to widows, orphans and those in need?

Interested in a solution to our current challenges in delivering high quality health care?
Corrective Health care, in the context of a fee for service medical system is the only workable reform (for more intelligent arguments on this topic see www.aapsonline.org and review medical articles at www.lewrockwell.com) See also www.correctivehealth.org.

Your next step?
Re-establish a private and trustworthy relationship with a courageous doctor who will agree to buck the tide and commit to work exclusively for you.

Otherwise, if the option becomes to serve the state at the expense of caring for patients, the best and the brightest of American doctors will retire, renew their interest in poetry, music and other creative endeavors and leave your “care” to bureaucrats, as this Doonesbury cartoon warns.

BSW  3-10-03

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