Monday, September 27, 2021
Saturday, September 25, 2021
Since the HIV epidemic, liberal planing introduced two changes. 1. Liberals passed legislation forbidding routine testing for HIV and tightened the rules insuring patient’s medical confidentiality to the point of stiffening both continuity of care and medical education. 2. An overgrown medical bureaucracy introduced rules based medical care based on guidelines with disciplinary measures against physicians not following those guidelines.
If nothing else, the CoV2 pandemic exposed these failures. Firstly, the inertia of Public Health in reacting to the pandemic lead to a faster and broader spread of the disease. Rules based guidelines became obsolete by the time they are published. Contact tracing and quarantine was overwhelmed. Secondly, guidelines denied the use of treatments not supported by as yet incomplete double blind studies.
Universal rules forgo regional variability and the magic of multiple trial and error, an end of the scientific method. Medical bureaucracy insisted on a negative interpretation of the relevance and validity of many published clinical trials, not completed and interpreted by themselves. These acronymous agencies, CDC, FDA, NIH, HHS and a plethora of others placed greater value on population wide studies, statistics and completion of years long studies. The inertia of time alone rendered their judgments irrelevant. This egregious denial of care from government entities resulted in many unnecessary deaths and continues to do so today.
Traditionally, the consideration of multiple clinical trials and clinical judgment was the prerogative of individual clinicians viewing multiple variables. Any clinical physician knows that treatment is highly individual and enhanced by the presence of a trusted physician, and that most clinical studies contain a bias of one sort or another: independent variables, clinical bias, incompetence, statistical or just plain inertia. Then enters political bias. Hospital employers even licensing agencies got into the act threatening consequences for any deviation from their negative guidelines.
The generations long history of treating Influenza included off label drugs with antiviral efficacy and support with multiple strategies including optimal treatment of underlying conditions and support of the immunize system. The same could apply to COVID19. With a death rate over 20% for patients over 70, physicians needed to be free to treat early and try options.
In the heat of the pandemic, with rigid guidelines, other serious conditions were neglected. Guidelines, algorithms and artificial intelligence fell far short of adequate management of the multiple problems and fast changing threats.
Friday, September 3, 2021
Friday, July 16, 2021
Saturday, May 15, 2021
The American version of authoritarian medicine features additional elements of greed and politics, along with massive bureaucracy. Starting with the theory of "Evidence based Medicine," medical science became the purview of the growing medical bureaucracy, then hospital administrators, corporate medicine, politicians and big pharmacology. The burdens today's physicians face, match or exceed the burdens of various religious dictates during the Dark Ages. No longer medical science and patient care, doctors now practice with political correctness, censorship and manipulated evidence. Today, I read that the AMA has come out in support of Critical Racial Theory. Politics and greed have no business in medical practice and patient care. Patient care, patient satisfaction, current science, treatment outcome, the physicians judgment and local medical societies should be the only authority in medical practice. Authoritarian-guidelines negate the scientific method and inductive reasoning. Evidence is good. guidelines can help, but bureaucratic regulation or administrative regulation cannot. Now the AMA wants to replace merit based medical school admission standards with social standards. Such a move favors corporate medicine and social medicine producing young obedient feldshers who will not question the authoritarian mandates or the political and economic motives -- over clinical judgment, medical science and patient care. We desperately need to reaffirm the Aesculapian mandates of Western medicine and resist the Marxist authoritarianism, greed and politicalization of medicine.