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Who, exactly, is your doctor?

People used to know who their doctor was. His name and phone number were on the wall or the refrigerator next to the telephone. He was there for you and could manage most of your problems.

When I was about 13, my mom took me to our pediatrician for belly pain. He was on his way out the door, but he stopped to take care of me. He diagnosed appendicitis based on history and physical examination. He called his favorite surgeon (“Billy,” a Tucson legend), who came from the golf course to meet me in the emergency room. Within hours, my red-hot appendix was in a jar. My parents paid the hospital bill ($150—10 days’ pay for a construction laborer) as I was discharged a few days later.

Today, the patient with abdominal pain could wait for hours to see the ER provider—possibly a nurse practitioner or physician assistant who had never seen a case of acute appendicitis. She’ll probably get a CT scan, after another wait. Eventually, Dr. On-call may take her to the operating room, hopefully before the appendix ruptures. And the bill will be beyond the means of ordinary people.

I used to be able to direct-admit patients from my office and send them with a set of orders to the hospital admitting office. For years, this has been impossible. The hospital is decidedly unfriendly to independent doctors. There’s now a gatekeeper in the emergency room, and most patients are under the control of a hospitalist.

This hospital, still Catholic at least in name, is now owned by a huge national conglomerate. Recently, it thwarted all efforts to keep it from dehydrating a patient to death despite lack of an advance directive or permission from next of kin. The patient’s mother disputed the diagnosis of brain death. The gastroenterologist of her choice was willing and able to place a feeding tube, needed in order to transfer the patient to a skilled nursing facility, but the hospital would not permit it. An outside physician whom the mother had called on was removed from the patient’s room by security, when she was merely praying with the mother. The mother could not get a phone call returned from an attending physician. Who was the doctor? Apparently, the hospital system.

Recently, a physician called me about her mother, who was seemingly a captive in a world-renowned hospital. She was concerned about her mother’s nutritional status and falling oxygen level. She could not speak to the attending physician. “They play musical doctors.”

Largely driven by government policy, the System is increasingly in control. A new level of intrusion is being proposed in California in a bill (SB 276) that would outlaw all medical exemptions for vaccines, unless a public health officer approves each one, based on the very narrow list of contraindications accepted by the Centers for Disease Control and Prevention (CDC).

Doctors traditionally swore an oath not to harm patients, and are liable if they do. But government officials are immune from liability, even if they overrule a physician’s judgment that a particular patient faces an unacceptable risk of harm from a vaccine.

If you disagree with your private doctor, you can fire him or simply decline to follow his advice. But what if the government is your doctor?

In Arizona, law enforcement officers in tactical gear broke down the door to a home where children were sleeping, entered with guns drawn, and took three little children away from their parents. The stated reason: the mother had decided not to follow a doctor’s advice to take her two-year-old to the emergency room for a fever, because the fever broke and the child got much better soon after leaving the office. The main concern seemed to be that the child was not vaccinated.

Americans need to defend their right to have an independent physician, to choose their physician and type of care, and to give or withhold informed consent to medical treatments. Otherwise, their “doctor” will be a protocol in a system staffed by interchangeable automatons. Treatments will be inaccessible or required, tailored to meet the needs and beliefs of the system.

If the government is the ultimate authority on your “health care,” remember that its tools for checking whether a child has a life-threatening disease such as meningitis include battering rams and assault rifles.

Jane M. Orient, M.D. obtained her undergraduate degrees in chemistry and mathematics from the University of Arizona in Tucson, and her M.D. from Columbia University College of Physicians and Surgeons in 1974. Her views and opinions, if expressed, are her own and do not necessarily reflect the opinions of GCN.  Her column can often be found here at www.pennypressnv.com. Her column has been reprinted in full, with permission.

Published in Health

While a Detroit-area doctor has been charged with performing genital mutilation on two young, Minnesota girls, the parents, who misled their children into believing they were taking a “girls’ trip,” have yet to be charged with child abuse as of this writing.

Female circumcision is most commonly done in Africa, Asia and the Middle East. Egyptian politician Elhamy Agina supported the practice because Egypt’s men were “sexually weak” and could not meet the sexual demands of Egyptian women. So punish the women, right?

Many instances of female genital mutilation go unreported, but instances have tripled since 1990 according to this report by the Government Accountability Office. This is the first federal case of its kind under the federal statute passed in 1997. Female genital mutilation is governed by Title 18, Part I, Chapter 7, Subsection 116 of the United States code, but only focuses on the doctor performing the unnecessary surgery. The entire law follows:

(a) Except as provided in subsection (b), whoever knowingly circumcises, excises, or infibulates the whole or any part of the labia majora or labia minora or clitoris of another person who has not attained the age of 18 years shall be fined under this title or imprisoned not more than 5 years, or both.

(b) A surgical operation is not a violation of this section if the operation is—

  1. necessary to the health of the person on whom it is performed, and is performed by a person licensed in the place of its performance as a medical practitioner; or
  2. performed on a person in labor or who has just given birth and is performed for medical purposes connected with that labor or birth by a person licensed in the place it is performed as a medical practitioner, midwife, or person in training to become such a practitioner or midwife.

(c) In applying subsection (b)(1), no account shall be taken of the effect on the person on whom the operation is to be performed of any belief on the part of that person, or any other person, that the operation is required as a matter of custom or ritual.

(d) Whoever knowingly transports from the United States and its territories a person in foreign commerce for the purpose of conduct with regard to that person that would be a violation of subsection (a) if the conduct occurred within the United States, or attempts to do so, shall be fined under this title or imprisoned not more than 5 years, or both.

The parents will be subject to state child abuse laws, but no charges have come from the State of Minnesota as of this writing. The penalty for causing “substantial bodily harm” to a child is five years in prison and/or a $10,000 fine. Does that penalty fit the crime? Dr. Dalia Wachs doesn’t think so.

“Are you kidding me? I mean, that should be a lot longer,” she said, adding later that “if you psychologically traumatize someone at that age, especially a child … these girls might not ever have an interest in sex.”

Wachs thinks if some of the more than half million American women were to enroll in a study to determine the psychological effects of female circumcision, it would be helpful in determining a punishment that fits the crime, because “there are no health benefits” from the surgery.

The federal law should be altered to provide harsher penalties to parents forcing this procedure upon their children. Imagine if your parents did this to you at age seven and then you had to continue living with them for another decade or so, knowing they had forever altered your ability to enjoy sex and quite possibly your ability to have children of your own, according to the World Health Organization. Everyone has the right to attempt to be better parents than their own parents, unless, of course, you have parents like these.

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Published in News & Information