Comments on Health Care Organizational Ethics: David Rothman on Medical Professionalism

Hi Eric - As always, it's good to hear from you! ...

2009-07-08T10:06:29.690-04:00

Hi Eric -

As always, it's good to hear from you!

Your comment brings out a problem with the kind of advocacy Rothman is conducting - it is vulnerable to offending the choir and to being ingnored by those to whom it is directed.

The kind of practice you and your teacher did is just the kind of socially responsible activity that Rothman wants to encourage. Rothman would want to use these practices as exemplars of what the profession should foster. He would go on to challenge organized medicine by saying something like - "how can you claim to be an ethically responsible profession when you allow high end specialties to earn as much as they do and allow socially responsible physicians to be driven out of business? Don't ask for more money for our bloated system - redistribute what we're already spending!"

Our payment system is a disgrace!

Best

Jim

Jim--Point one brings out the crank in me. In my ...

2009-07-06T22:38:58.148-04:00

Jim--Point one brings out the crank in me. In my opinion, I served by doing my job. In my last job, a third of the time that I spent in direct patient care was not compensated. Same for my private practice, which I had to close. I was the final common pathway for a lot of poor and sick patients, who required a lot of extra help to cope with the system of care. Furthermore, one of my best teachers had to close his practice for similar reasons. He and his wife worked in their home office. Their family practice was the only doctor's office on their peninsula. They provided clothes for some and food for others. They set bones, did minor surgery, and gave high-quality life-cycle care. Medicare and other third party payors didn't see the "value" of their "service," so they had to leave.--Eric

Hi Dan - Thanks for your fiery comment! I don't ...

2009-07-06T21:32:52.980-04:00

Hi Dan -

Thanks for your fiery comment!

I don't go as far as you do in your critique of/wariness about the APA and NAMI, but critics like you play an important role, holding organizational feet to the critical fire!

If you look under the psychiatric ethics heading in this blog you'll see that I've been rather critical of my own professional organization (the APA). I hope I'm not being too optimistic in saying that I think the criticism - internal to the APA and from the outside - is having an effect. The organization is weaning itself from depending on Pharma support. There's much more awareness of conflict of interest. From public officials like Senator Grassley to private individuals like Dr. Danny Carlat there's been a steady, and healthy, stream of critical attention. It's important to keep that stream flowing!

Keep up your own good work!

Best

Jim

Nearly half of the budget of the APA comes from bi...

2009-06-28T22:15:29.064-04:00

Nearly half of the budget of the APA comes from big pharma, who I believe are promoting unnecessary psychotropic drugs.

Same with NAMI and their budget. Both budget sources are not publically disclosed.

What also is not disclosed is that NAMI, and other perceived non-profit support groups are essentially front groups for their budget sources.

CHADD and NAMI, for example, do disease state screenings upon direction of their pharmaceutical sponsors- arguably for diseases and disorders that do not require pharmacological intervention.

Psychiatrists receive the most cash from the pharmaceutical industry.

The DSM-V is being created right now. The secrecy is allowed with the creation of this very powerful manual, instead of the transparency that is needed to protect the health of the public.

Most who are responsible for the creation of the next DSM have financial incentives from psychotropic big pharma, and coerced directives from the APA, who dictates the creation of the APA.

All toxic forces such as these likely cloud the judgement of those responsible for creating the next DSM,

Dan Abshear