Liberty and The Medical Mindset

Via Cranky via Tam, a pointer to this from The Happy Hospitalist:

Kill Off The Cardiologists And Save America At The Same Time

How you ask?  Erect A Federal Smoking Ban.
...
It's amazing how we spent over two trillion dollars last year, the vast majority of which was spent on conditions directly attributed to smoking.  Heart disease.  Stroke.  Emphysema.  Cancer. It's all directly correlated to smoking...  We spend billions of dollars a year on medications trying to counteract the results of these preventable disease processes.
...
...If Obama really wants to make a dent in the health care expenditures, he should, by executive decision, in the interest of National Security, sign a federal decree banning smoking in all public places.  Talk about leadership.  He would save America, I believe, with that one act.  Decreased health expenditures, increased productivity, fewer sick days, no more smoke breaks.

Needless to say, the links from C&T have resulted in HH getting a beating from the libertarian side of the ’sphere.  In their posts, both Cranky and Tam address the issues of nanny-state-ism, the proper sphere of government, and personal liberty, but it seems those involved are shouting past each other.  I believe I know the reason why.

There are doctors on both sides of my family.  In addition to my father and grandfather, two of my uncles and a pair of cousins are/were M.D.s., D.D.S.s, or the like.  (I also have lawyers on both sides of the family; perhaps I should be considered doubly cursed!)  And after growing up surrounded by physicians (but not being one), I think I can write fairly about them.

Most doctors are tremendously dedicated.  The ones who aren’t don’t make it through med school and internship– or, if they do, find some non-practicing niche to occupy themselves (medical administration, perhaps, or employment at one of the drug companies).  The ones left– who actually see and treat patients– are saints, giving up their evenings, weekends, and Christmases to help frightened, cranky, uncooperative, and, frequently, ungrateful people.

But sainthood is only a step or two away from godhood, and there’s the rub.  After traversing the obstacle course of medical education, doctors feel, with some justification, that they are special; that the M.D. they’ve been granted also means “smarter than the average bear.”  And the whole medical environment encourages this.  In hospitals and clinics, the man (or woman) with the degree is boss.  Their orders are law, their opinions are solicited, their concernes are addressed, their whims catered to.  The deferential treatment given star specialists is comparable to that received by four-star generals, corporate CEOs, or members of Congress.

The only fly in the ointment is those damn patients.  Every time, it seems, it’s the same old scenario: Someone comes to you with a problem.  You diagnose it, and prescribe a course of treatment to cure (or at least alleviate) it.  The patient says, “yes, doctor,” and then proceeds to do as he damn well pleases.

Your hard living, Twinkie eating, cigarette smoking, drive-instead-of-walk lifestyle dug your own grave.

Medications prescribed but not taken, courses of treatment begun but left unfinished, lifestyle changes that never change... what’s a doctor to do?  It’d all be so much easier if we could make ’em do the right thing.  They’d live longer and be grateful, and doctors wouldn’t be frustrated.

So the doctor, accustomed to deference, accustomed to saying “let it be,” and having it be, thinks:  What’s more natural than to pass a law.  That’ll fix it.

And should someone object, the doctor will be amazed.  Isn’t he the expert, the one dedicated to taking care of people, the one who has the correct solution (and only the best interests of others at heart)?  Where is the understanding?  Why all the ingratitude?

Except...

Except people will still be people.  But now they’ll be lawbreakers, too.


(Note:  I added the 3^rd para from the end on 090107 08:20, because on rereading it didn’t seem sufficiently clear what my point was.  Demonstrating one problem with instant-posting: Insufficient time for the ideas to gel completely. - o.g.)

Posted by: Old Grouch in Rants at 17:09:30 GMT | No Comments | Add Comment
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