I’ve been in the blogosphere for over three years. I’ve gotten all kinds of advice about my “angle” and my “pitch”.

It’s not an “angle” I’m “pitching”. It’s the sad, sorry truth about a medical and legal oversight system that absolutely, fundamentally does not work.

It’s not about being a “martyr” either. I am PISSED OFF . . . about the despicable way I was treated . . . about the way patients/parents caught-in-the-middle were mislead and lied to . . . about the way my community has been manipulated and played for profit . . . about the care I, myself, received at this hospital . . . about the fact that my Mom still lives in Asheboro, and if she got sick tomorrow the LAST place I’d want her to go is my hometown hospital.

All of that and the fact that my home is my home. I’m not leaving.

It’s time to stop making excuses for the bad guys, stop blaming the victim, STOP RUNNING, stop hiding behind anonymous monikers and FIX what’s wrong. I don’t call that a “whine”. I call it an imperative.

I suppose that (the way today’s media works) it’s regrettable that I’m not a Hollywood hottie with a good agent (like Dennis Quaid who today testified before Congress).

Dr. Johnson has no beef against the subspecialists. Dr. Johnson’s beef is with a “rural” hospital that covered up bad care (indeed, in this case she was the specialist) . . . and retaliated against her for (1)intervening to stop it, (2) and reporting it. That’s not “Econ 101″. It’s dirty pool.

Many, many people want universal healthcare in this country. What happened to me STARTED while I was in government service (remember Walter Reed?). I have accused a “non-profit” (subsidized by public money) of some pretty serious things. NOTHING HAS BEEN DONE – BY THE FEDS OR THE STATE OF NORTH CAROLINA – TO RECTIFY THE SITUATION OR TO HOLD THE HOSPITAL ACCOUNTABLE. The government that is supposed to protect and serve does not care.

Yet we’re supposed to build a solid healthcare system upon that rotten foundation?

Hey, maybe that’s a pitch.

Getting PR for your story is necessary. But your sincere frustrations are read by others as typical doctor whine. Try to change your angle, your pitch to the media.

Press Release: Can you imagine this, Community XZY hospital has voted to replace all doctors with nurse practitioners.

Or hospital XZ patients see nurses in a new role – replacing physician’s to fulfill shortage.

Change your angle and you may get a better response from the media.

Or be a martyr, or just move.

Regarding the anger towards specialists – in honesty their is no anger, just some dare I say mild envy and jealousy. Dr. Johnson is justing that the specialists choose to protect their own economic interests. Heck, if insurance’s ever pay highly for GPs to coordinate a medical home, while NP’s actual see the patients, us PCPs/GP/peds would hire as many NPs as we can. That’s just simple econ 101, nothing personal against any subspecialist.

The newspapers/MSM are not telling these stories – journalism these days (even “citizen journalism”) is ALL about keeping the fat-cats at the Chambers of Commerce (i.e. big fish in small ponds) happy . . . and putting on a pretty face for the next newbie the hospital can sucker. And I’ve had the crap beaten out of me in the Greensboro NC blogosphere (considered by many to be so “progressive”). I’ve lost count of the times I’ve been told to “move on” and get over it . . . and something is wrong with me if I don’t.

I offer fair warning to the brave new warrior in psychiatry, if your voice gets too loud, it can always be silenced with bad-faith peer review (fueled by the snakes climbing on the cadeuses that always live in an administrator’s pocket). Then it’s not just your reputation that is trashed it’s your career. I have seen this happen to a number of people. It’s ugly. It’s effective. It’s about total destruction.

Our medical and legal regulatory systems are a joke – I mean, the sad fact is that Medical Boards EVERYWHERE are slow and sluggish to act on anything except sex, drugs and alcohol. We do not effectively police our own.

In my own situation, I’ve reported perjury/contempt and fraud on the part of two way-overpaid “non-profit” executives to every state and federal agency under the sun. Cut and dried. No question. Not to mention the complete desecration of the “mission” of state and federal programs to bring doctors to rural areas and keep them there. But I’ve got a local DA that is pandering to the mill-town powers-that-be (who are on the board of the hospital that screwed me), a State Bar that is covering the tails of its own – and a gutless North Carolina Attorney general (remember the Nifong debacle?) who still says he has no jurisdiction over what a “non-profit” in North Carolina does.

It’s ludicrous. He absolutely has jurisdiction – by virtue of my service to the state. And if he maintains that he doesn’t the power, then he/the state should be doing something to get it. In order to fix anything, hospital exectutives and their lawyers MUST to the same moral/ethical standards as doctors. They are not. “Non-profit” hospitals can do whatever they want to whomever they want – right and wrong are irrelevant. They hide behind the “good of the many” when it’s really about the good of the few and well-connected.

You hear all the time that JCAHO can shut hospitals down – for the very kind of things that I reported and that were done to me. It’s a load of hooey. Everytime those clowns show up for another dog & pony show I have to roll my eyes. Tell me, when’s the last time you saw JCAHO shut anybody down for anything? It’s all wink and nod.

Our “advocacy” organizations sold us out long ago. What use have I got for their expensive “advocacy” if they cannot do something/anything for the individual (which they all say they can’t).

I needed a union. The AMA ain’t it.

In my younger days I thought might would stand up for right, but I was tragically mistaken and I have paid for it with ten years of my life – thirteen if you count the time I spent in my “rural” hometown trying to build a life and a practice I could be proud of.

I practiced and spoke and advocated fearlessly . . . and I wound up spending years paralyzed in fear – of loosing everything . . . looking over my shoulders for the next legal dirty trick . . . constantly on the road . . . barely able to make ends meet. I have only recently gotten back on a bit of an even keel – emotionally and financially.

To this day I cannot wrap my head around what happened to me. On WHAT planet does it make sense that a doctor would be fired for saving a baby’s life? And on WHAT planet is it okay for the guilty parties (executives and doctors) to skip merrily on with their lives?

Our planet.

There’s much that needs to be fixed. I’m not a newbie anymore and I am jaded/cynical beyond my years. But I still believe it can be done. It IS going to take cahoones – and more people speaking out and signing their names.

It MUST start with the new generation hearing more about what has happend to those who came and fought-the-good-fight before – i.e. medical schools and residency programs taking real steps to educate their charges about the real world. I MUST start with MSM doing something to shine light on these stories and what is really going on in medicine – especially “rural medicine”.

It ain’t pretty.

The last piece that “60 Minutes” did on the National Health Service Corps (in which I served), was a total pile of white-washed fluff. They only want to tell the success stories.

My story is about a total failure of the system to work.

I’m telling the medical blogosphere and the MSM, if you’re gonna pull back the veil and “fix” medicine, then pull back the ^%$#@* veil. Shake out the fluff and get to the dust mites.

I partially agree with the med student poster about baby boomers getting their minds on things and doing it… but i think its going to take a collective set of cojones for them to do it. I mean, they’ve been standing in this steaming pile of a mess for a while, watching it decline, their generation watched it and some helped it happen and made some nice money off of it… I dont know if they can change it, but I wont discount the possibility. I think by the time medicine finally hits ‘bottom’ they’ll be retiring and will have a foot out the door. I think change is up to us, the new grads. This generation of people in their 20′s think differently and have a completely different relationship to ‘the rules’ and authority- some of which I agree with, and some of which I don’t.

Bottom line: Docs have to realize that they can stand up and practice medicine fearlessly.

Some people might want to pack up and thats their prerogative, but MORE MD’s MUST KNOW that they have the option to stand up for whats right, and that there’s power in numbers.

I suppose it’s “blaming the victim” but nothing will get done unless the doc leaves. Cut your losses.

And rural underserved areas are the worst for this sort of thing. They’re monopolies, and the only way you can make a living there is to get governmental dispensation to charge more than a doctor just hanging out a shingle. Then pretend you’re Mother Teresa because your clinic is treating the poor and no one else will.

1) Telling an unhappy primary care doctor to pack up and move is akin to blaming the victim. In many cases, years have been spent building a practice and roots have been laid down.

2) As far as displeasure with local specialists, we should respond with our referral patterns. Just don’t use them. I tell my patients not to go to Dr. So-and-so, saying, “he does not treat other doctors well, and if he doesn’t treat doctors well, I have no reason to believe he treats patients well.”

It’s not just primary care. The profession is in deep trouble and has been excluded from a lot of important decision-making.

Comment at http://executivephysician.blogspot.com/2008/05/accountability.html

Good luck!