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Confessions of a Medical Heretic (Part Two)

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Duty to Warn

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 By Gary G. Kohls, MD

 

Last week I wrote about some of the ethical concerns that I have had with the modern medical profession. Over my 40 years of practicing medicine I have experienced increasing frustration with its direction, mainly because the business of medicine has been increasingly distorting the ethics I was taught in medical school. The profession has become increasingly difficult to recognize over the 40 year span.

Like many other physicians who have tried to take the Hippocratic Oath seriously (“first do no harm”), I also tried to resist the increasing corporate influences that eventually made the once-honorable practice of medicine into a crass profit-making industry. I makes me sad to report that outside forces have gradually made us physicians into computer bound high class technicians that are largely prescribers/providers of Big Pharma’s often toxic and always unaffordable drugs. In the current profit-above-all-else era, it is not even remotely possible for us physicians to be the compassionate healers of the long-gone era that I knew.

Way too often, the money-making Big Business of medicine is being controlled by institutional shareholders  (who demand increasing dividends or increasing shareholder value) whose CEOs are often amoral Masters of Business Administration graduates who are equally at home leading Wall Street banks, tobacco companies, weapons manufacturers or brothels – or big clinics or hospitals. In this era the term “business ethics” (just like “military justice”) is an oxymoron.

So last week, when my column deadline approached and I discovered that I had written twice as many words as my editor allowed (a theoretical 1600 word limit per week), I had to quit writing and figure out how to cut the column in half. (I also realized that the title could be – and should be – the title of a book-length treatise, but that notion will have to wait for some future time. For now, what follows approximates the last half of last week’s unbridged column.

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Confessions of a Medical Heretic – (Part One)

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Duty to Warn

new-logo25kohlsGary G. Kohls, MD

 

 

The readers of my weekly Duty to Warn columns know that I often write about some of the concerns that I have regarding the once honorable medical profession that, for 40 years, I called my own.

Actually, my major concerns haven’t been solely about physicians, but about the for-profit systems that have arisen since I was a medical student. Most of the med school friends that I knew seemed to be serious about their desire to do good in the world. I sincerely believed that most of us took seriously the Hippocratic Oath (“first do no harm”) that we all swore to adhere to when we got our medical degrees.

I was naively grateful to Eli Lilly when that drug company gave us reflex hammers, stethoscopes and a doctor’s bag during our second-year clinical rotations. I still have them and, although the rubbery parts are getting pretty brittle now, the chrome plating is still shiny.

The reputation of Lilly since the 1960s, however, has been increasingly grimy on its ethical inside but somehow still somewhat shiny on the outside – when it comes to corporate profits.

Ever since 1989, there have been thousands of lawsuits (originating in every state of the union) that have been brought against Lilly just from its block buster (so-called “antidepressant” drug Prozac. Prozac received FDA approval for marketing in 1987 and it didn’t take long for surprised and alarmed psychiatrists all over the world to start seeing dramatic increases in suicide attempts and suicidal thinking among the patients that they had naively recommended taking the new, heavily advertised drug.  One set of Prozac class action suits settled for $1.5 billion.

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