Dear Doctor, Are You a Victim of Your Circumstances?

Are you a victim of your circumstances?

OR would you like to be a victor OVER your circumstances?  This letter is directed specifically to the approximately 150,000 licensed physicians practicing medicine and surgery in California today, as tallied by the Medical Board of California (if you believe it). My goal is twofold, namely, to determine whether you are satisfied with government-run healthcare in this state, and whether you would be interested in fixing the problem. If you are not a victim of your circumstances, please don’t stop reading, because something here might spur your interest.  This letter is intended for you as well.  

My qualifications? I’ve been there and done that. I practiced general surgery in Sacramento between the years 1985 and 2004 after finishing a rigorous training program in general surgery at UC Davis Medical Center in Sacramento, well prepared for what was ahead, I thought. But the environment changed the “business end” of being a surgeon, and it changed for the worse. Doctors did not and still do not learn the basics of how to do business, thus have always been naïve and easy prey for big government and the crony capitalist monopolists, and I suspect many of you agree. Business is not in the least bit emphasized in medical school or residency training! And if you think that Master of Public Health or a Master of Business Administration degree as an adjunct of the Doctor of Medicine degree is anything other than  pure propaganda, please think again, because you are flat out wrong.     

So, you could say that I am an expert regarding the alphabet soup epicenter of “managed care” that developed in Sacramento and metastasized to the rest of the state, and which has ultimately “progressed” into ubiquitous government-run universal healthcare. California has become the laughingstock of America! And I loathe the term healthcare because healthcare is a personal opportunity and responsibility of a doctor and a patient relationship, not a government’s opportunity and responsibility to wreck it for both.  When the government runs anything, that’s when things go south!    

After getting out and moving on, I still can’t get over my desire to help patients heal. It’s in my blood. The number one goal in the remaining life I have is to help salvage your careers and help you heal and make your lives amazing, thus making the lives of the patients you serve amazing. Call it a spiritual blood transfusion, or more aptly exhilarating collegiality. I want you to be successful, and the only way that can happen is when you re-ignite unity among your peers and yourself and develop a warming relationship and trust with your patients. If enough of you decide to do that, there’s no stopping you.

Because of the forces above, there came a time during my career when I was not being paid adequately to keep my surgical business going. Try explaining that to a patient! But early in my career, when physicians weren’t yet getting ripped off by big government thieves and their “crony” capitalist special interest friends like health insurance companies and pharmaceutical companies, and inside trading stock in these companies in Congress, I earned an excellent income and I didn’t spend it. I invested it in income producing real estate, right here in Sacramento.  It worked out, because when being a surgeon wasn’t profitable or ethical anymore, I had an out.  

Being a victim of one’s circumstances means you are experiencing conditions in your practice environment which are causing you to suffer, and those conditions are outside of your ability to control. Here are some more very important questions for you to ponder which will allow you to better understand the “business model” I will be recommending a little later in this letter.  

• On whom do you depend for your income?
• Are you able to be genuinely empathetic and truly care about safety, affordability, compassion, and companionship for your patients, or are you rushed and unsettled about the care you are allowed to provide? 
• If you had it to do over again, would you have sacrificed so much of your life for your present job?
• Do you feel forgotten, resentful and resented, bitter, envious, and lonely?
• Do you believe patients deserve what they are getting in terms of care in your local hospitals and clinics?  After all, that’s what they voted for, right? 
• Is the administration of medicine and surgery in California nonsense or common sense?
• Do you continue to slave along because you can’t afford to retire?
• Why didn’t somebody like me warn you before about what you’ve gotten yourself into?
• Do you ever get the feeling that super specialization and artificial intelligence is limiting your clinical skills and judgment such that the bread and butter medical and surgical needs of the patients you want to take care of are abridged, even dangerously so?

Allow me to briefly but thoroughly explain to you what free enterprise medicine is.  I realize this may not presently be important to you, but if you understand it and sear it into your cerebral cortex even to the point of memory and instinct, you are going to love it.  Note also that free enterprise is the same definition as “capitalism”, which is the opposite of communism.  And please do not confuse capitalism with “crony” capitalism, because one is honest, true, and just, the other is not.   In fact, the crony conditions listed above are the source of your suffering! 

MEDICAL FREE ENTERPRISE is freedom of private business doctors to organize and operate for PROFIT in a COMPETITIVE system without interference by government beyond regulation necessary to PROTECT the public interest and keep the national economy in balance. Those 38 words in that definition tell it all.  

That, my colleagues, is the business model I propose. I have had the opportunity of asking some powerful California politicians that question, and they cannot answer it. I wouldn’t even venture to ask the CEO of health insurance company or a pharmaceutical company that question, because they cannot answer it either. And yet they have taken over the administration of California medicine! Don’t you think they should be able to answer this fundamental question?

What I have learned is that a Constitutional Democracy or more specifically a Constitutional Republic is a free enterprise system, where majority rule is a fine aspect of the operation of that economic system, but that government must have safeguards built into it to protect the individuals and the minorities it governs.  Those safeguards are called rights. And those rights are analogous to self-governance. We, the doctor and the patient can handle it, hands down!

For example, I have the right to exercise my free speech, as I am doing right now.   Look down the list of the Bill of Rights and you will see what I mean. But let’s look specifically at the first amendment and consider the following. Would you say that since doctors know best about the diagnosis and treatment of patients based on their challenging, exciting, and tense experience of doing so over and over again, and patients go to their doctors for that expertise and are willing to pay for the service, that our Constitution and the First Amendment give doctors and patients the right to COMMERCE without government interference? And do you not believe that if doctors and patients are allowed to “do their thing” that they will trust each other and perform their parts of the deal (the doctor makes the diagnosis and renders treatment, and the patient pays the doctor for the service rendered)? If you disagree, let me know. I would love to debate that point with you!    

Now bounce back to the amazing definition of medical free enterprise. The amount of interference permissible of the government is only that which protects the public interest, not harms the public interest. Doctors and patients alike have become victims of intrusive, unsafe and even tyrannical abusive big government.  My diagnosis is aggressive domestic abuse!  

And here is where the tricky change in capitalism to crony capitalism occurs.  The thieves of the big government start to say that we need more than minimal interference in our commerce to protect the public and that’s when things go south. It’s called regulations and restrictions, and fines, and taxes.  These costs do only one thing. They rip off the doctor’s paycheck, and they make it harder for the doctors to accommodate the diagnostic and therapeutic needs of the patient, thus isolating the tight bond of the doctor and patient. So, by the time the big government gobbles up the businesses of the doctors, there is no one with the incentive to go on. It is hopeless and exceedingly unsafe for both doctors and patients. In political economic terms, this is called “universal government-run healthcare” or Marxism, or communism. Communism has never worked out well, and it never will.

And yet another job of our government in the definition of medical free enterprise is keeping the national economy in balance. Our national debt at the present time is nearly 40 trillion dollars. So, we ask the question, where is the money?  You must ask the question, are we the doctors and we the patients getting ripped off by our government officials and the crony special interests? The answer is yes.  Our overstuffed parasitic government and its cronies are literally sucking the life blood out of doctors and their patients, like a big fat tick in a dog’s fur.  

It is an outright fallacy to be told that you need a third party to help you operate your small business affairs. Please understand what I just said. In fact, small businesses comprise about 80% of the California economy, and that is a fact. Part of that small business system needs to be private doctor-patient arrangements, each one with 501(c)(3) tax exempt status, just like our churches.  After all, the Chief of the Medical Staff is the Chief of our Nation and the World.  We are a nation under God, and our currency states….” In God We Trust,” for both the doctor and the patient!  We already have an establishment clause for the doctor-patient relationship built into our Constitution in the First Amendment! 

My California medical license remains active in what’s called “voluntary service status” which means that I have the privilege of consulting with you my colleagues as long as I do not charge money for my services and as long as I do not violate the standard of care of the medical profession here in California. It is delightful to be able to talk with you about these matters and to write about them. In fact, the editor at California Globe, a powerful online publisher of political California news allows me to be a guest author. That is a privilege!

One of the requirements to be a voluntary service physician is to keep up with CME.  The surgical CME of today is littered with DEI. And DEI instructs physicians to stay away from patients.  Thus, there cannot be a substantive “one on one” in person evaluation for the benefit of both the doctor and the patient, the examination of the patient, and a discussion of the disease which sets the stage for treatment, which is called an informed consent. This is all by tyrannical design, and it is evil, evil, evil!  

I stumbled across a statement made by Hippocrates himself the other day.   Maybe you’ve heard it, maybe not.  He said…” It is more important to know what sort of person has a disease than to know what sort of disease a person has.” The administrators of healthcare today, which includes the DEI educators of medical students and residents in training programs, has dehumanized both the doctor and the patient. They speak a lot about AI, and that AI is here to stay!

My response is hogwash! Humanness, not “robotness” or humanism, is the magic of the friendship between a doctor and a patient. Trust and faith in another human being for something as important as a disease, any disease from a sore throat to a ruptured abdominal aortic aneurysm, is a big deal for a caring physician and a caring patient! And both are relieved and will work very hard for the well-being of their partner once they set up the arrangement. 

In summary, the “three pillar” foundation or platform of a successful medical profession in the USA is completely dependent on medical free enterprise, limited Constitutional government, and fiscal responsibility. These are the keys that open the door to amazingly affordable, satisfying, and safe medical help, for both the doctor and the patient! And to protect that foundation, we must add it to the curriculum of our educational system in this country. We must be sure to teach our students across the board to advance to professional jobs based on merit, not on envy and bias. 

Please let me know what you think, especially if you disagree with me. It would be wonderful to begin a dialogue about this extremely important need of the people of California and the nation.