How We Got Here Part 2 - Medical Tower of Babel
How the Centralization of Medical Authority is in large part responsible for the fallout associated with the pandemic response strategy. We are witness to a Tower of Babel moment in Medicine.
Recap of Part 1
In Part 1 we outlined some of the aspects of medical training which has contributed to the formation of the Automaton MD. The contributing factors include:
Incentives which drive people to enter the field
Incentives which drive medical students to decide on a specialty
The Medico-Legal landscape which drives physicians to practice in a particular way
Rise of the Medical Industrial Complex in parallel with centralization of medical authority
Points of Clarification
Before we proceed, I’d like to clarify a few things which may lead the reader to believe that this blog is the raving of a quack.
First, clearly evidence-based medicine has its strengths and benefits when performed judiciously and with clinical relevance. I am not trying to make the case that EBM is a scourge on medicine. Much like you can use a car for transportation, or a hit-and-run.
Second, not all doctors are accurately portrayed by Automaton MD. Actually, the generation of physicians whom I learned from were dominated by well-meaning and critically-thinking custodians of the medical arts. Although the problem of centralized medical authority (CMA) has been brewing for decades, it appears that the negative side-effects of this distributed and unconscious development has either contributed to, or is a direct cause of medical malfeasance we have seen destroy our society over the last 2 years.
What we are seeing in the young generation of doctors are the knock-on effects of years of stripping autonomy from physicians and subverting their decision making to guidelines, algorithms, and one-size-fits-all mandates.
Where Does Medical Authority Lie?
Since we are talking about CMA, it would serve us well to determine where the authority lies. In order of importance…
State Medical Boards
State Medical boards (SMB) provide doctors with the license to practice medicine. They also investigate complaints, discipline physicians who violate practice ethics, and refer them for evaluation and rehabilitation when appropriate.
Notice the word choice - ethics. Not mandates, orders, guidelines, or “expert” opinions. Ethics. The word choice is intentional. SMBs know that each patient is different, with their own set of circumstances, medical histories, personal preferences, beliefs and values. Thus, doctors have two major rulesets they must adhere by to maintain their license:
The Law (duh).
Medical Ethics.
Praciticing medicine is a privilege that is granted by the state. The SMBs establish standards for the profession. The SMB has the duty to determine if a doctor’s conduct warrants maintenance, suspension, or revocation of their license to practice.
Board Certification
In 1933, a collection of 4 medical specialty boards (Dermatology, Obstetrics & Gynecology, Ophthalmology, and Otolaryngology) founded the American Board of Medical Specialties (ABMS). In conjunction with the American Medical Association Council on Medical Education (AMA & CME), specialties were considered for membership into the ABMS by the standards set in “Essentials for Approval of Examinig Boards in Medical Specialties.” Over the following years and decades, almost every medical specialty has joined the ABMS.
Board certification is a process that usually involves some combination of documented experience and examination to demonstrate the mastery of a set of skills or knowledge. Once you are board certified, you must demonstrate “lifelong learning” via Continuing Medical Education (CME) credits to for maintenance of certification. One can obtain CME by publishing, giving lectures, reading journals, and more. Almost all of these methods involve some process by which a doctor pays one of these CMAs to gather enough CME credits to maintence their certification - usually annually.
Key things to know about the ABMS
These are self-appointed organizations
The standards of Certification have not been independently reviewed
More than 80% of practicing doctors in the US have at least one Board Certification
Board Certification is NOT required to practice medicine
While a license is mandatory to practice medicine, board certification is “voluntary.” Voluntary insofar as if you are not board certified, the likelihood of being employed by a hospital decreases, as it can be seen as a liability. Shockingly, the same ABMS ecosystem has also contributed to the “literature” which demonstrates that medical liability increases with lack of board certification.
Coincidence, I’m sure.
Professional Societies & Associations
You may have heard of some of these, like the American Heart Assocation (AHA). Their self-described most important role in medicine is the publication of guidelines on cardiovascular disease and prevention. They also operate public service campaigns…for the good of the population.
From Wikipedia entry on the AHA (emphasis my own)…
The American Heart Association (AHA) is a nonprofit organization in the United States that funds cardiovascular medical research, educates consumers on healthy living, and fosters appropriate cardiac care…
We mentioned in Part 1 that the AHA has several corporate sponsors including but not limited to:
Medical and Life Insurance
Medical Tech and Device Companies
Pharma!
Some of these professional organizations are more upfront with their sponsors than others, for obvious reasons. Here are a few more for your enjoyment:
These organizations are some of the most well-funded charities in existence. Looking at the Forbes Top Charities of 2020 we see that the AHA is ranked 23 with private donations of $610 million.
That’s not all. Because the Top 50 include…
Rank 4: St. Jude Children’s Research Hospital - $1.8 Billion
Rank 13: Task Force for Global Health - $885 Million
Rank 18: American Cancer Society - $710 Million
Rank 22: Mount Sinai Health System - $617 Million
Rank 28: Mayo Clinic - $527 Million
Rank 31: Dana-Farber Cancer Institute (Harvard) - $451 Million
Rank 35: Shriners Hospitals for Children - $427 Million
Rank 41: Leukemia & Lymphoma Society - $388 Million
Rank 46: Alzheimer’s Association - $349 Million
Rank 49: American Kidney Fund - $321 Million
Finally…the Federal Agencies
The regulatory bodies include…
You don’t need to look very hard in recent times to realize just how badly these federal agencies have failed us. Digging into the details of these corrupt institutions is material for another post. Here, I want to highlight something relevant to our story…
Apart from the FDA, an agency that approves which medications can be marketed and thus prescribed by licensed physicians, there really isn’t much of a role for the dictates of the CDC and NIH to determine how a physician practices medicine. Even the FDA cannot tell licensed physician how to prescribe a drug.
In fact, off-label prescription of medicines is an exceedingly common practice, and is supported by the FDA. At least until recently…
I digress.
In my years of practice, I have never once heard my colleagues say they will do or not do something for a patient just because the FDA, CDC or NIH dictated that it must be the case.
Now, it’s rampant:
“How do you feel about Ivermectin?”
“NIH says we should only use it in clinical trials.”
“Why did you get a booster? FDA only authorized it for elderly and high-risk”
“The CDC said we should just this week!”
“The CDC director over-ruled the FDA Advisory Board though…”
“Yeah but bro, you should see how often I go out. I’m high risk”
“Fauci is a fraud. I would take what he says with a grain of salt.”
“No…I think you are being too harsh on him. He’s the head of the NIAID.”
And, so on…
Central Medical Authority & The Tower of Babel
Tower of Babel
Following the Great Flood, generations of increasingly globalized humans (single language, concerted migration, etc) arrived at Shinar. Here they decide to build a city, and a tower so tall that it would reach Heaven. In response to this, God confounds their speech such that they can no longer understand one another, and scatters them around the world.
Therefore is the name of it called Babel; because the Lord did there confound the language of all the earth
Few people are as famous for their interpretation of Genesis as Dr. Jordan B. Peterson. If you haven’t listened to his Biblical Series, as a previously devout atheist I would highly recommend it.
What is the moral of this story?
One interpretation which Dr. Peterson has noted is the inevitable failure of a hyper-aggregated and hyper-orderly enterprise.
Too big to fail? Or so big it must fail?
As an organization aggregates more and more people, it becomes more powerful - more influential. An attempt to make something so great that it will reach up to Heaven itself, in an effort to replace God. The hyperorganized monolithic state enterprise attempts to bring Utopia to the masses. But, inevitably fails.
Centralized Medical Authority
All that we’ve discussed in Part 1 and 2 culminate into something that is quite hard to see at an instance in time. The changes and causal chain must be observed across years.
So, let’s recap:
Medical students learn guidelines and algorithms
Medical trainees hone their ability to effectively and efficiently manage patients based on these guidelines and algorithms
Licensed physicians’ livelihood now depend on their continued administration of algorithmic medicine, as this is their “bread & butter”
COVID-19 presented a problem that most doctors will not encounter in their careers:
An urgent, unknown, and potentially catastrophic medical entity has entered their field. How do they respond?! How can they deal with this?
They are not trained to effectively and efficiently deal with novel disease entities! They have been groomed to respond X when presented with Y.
COVID-19 was like a bomb that resulted in a knowledge vacuum in the mind of most trainees and physicians. Luckily for them, the CMA was ready with some “guidelines” from day 1! But how?! I thought this was a novel entity? How can there be guidelines already? (More on this in another post).
Most physicians just went with the flow - as the CMAs dictated:
How to assess COVID patients
When to hospitalize COVID patients
What medication to give them
When to intubate them…
When to make them “Do Not Resuscitate”….
Yeah, that one was really weird to witness.
Others, like myself and a few of my colleagues, had a novel thought:
If this is truly novel and we are all approaching this from an even playing field, then the best way to proceed is to keep up with the literature.
Read, read, read. Practice, practice, practice.
This is where the pathes diverged.
Option #1: Daddy knows best, just listen to him.
Option #2: Nobody knows WTF is going on, but let’s figure it out together.
Centralized Medical Authority as God
Physicians are members of a practice or hospital.
The physician, practice and hospital are constituents of institutions.
All of the above are supporters and adherents to practice standards, professional organizations, and the medical industrial complex more broadly.
With the usurpation of our federal regulatory bodies by corrupt Corporatists, we have attained peak Babel. Doctors now defer any issue that is COVID-related to the dictates of the Holy COVID Church. If they don’t?
Let’s ask the College of Physicians and Surgeons of Ontario (CPSO)
One Canadian responds:
Winston Smith is not alone. The CPSO received extensive backlash from the doctors of Ontario. They did not budge.
How about the Federation of State Medical Boards?
There has been a monolithic deference to all things COVID-related:
How does one prevent infection or severe disease? Ask the Holy COVID Church.
Are there effective alternatives? Ask the Holy COVID Church.
Is my child safe at school? Holy COVID Church.
Can I have FUCKING DINNER WITH MY FAMILY?! Holy Covid Church…
It’s very dangerous…because a lot of what you are seeing as attacks on me, quite frankly are attacks on science.
-Saint Anthony Fauci
In parallel to this consolidation of power, so too is there a consolidation of chaotic elements of its ecosystem. Inevitably, the monolith must fragment. Unfortunately for us, the fragments cannot communicate as they are incomprehensible to one another.
Does this sound familiar?
It should. On the one side you have the pro-CMA statists who insist that Saint Fauci & Friends know best. Despite repeated instances of flip-flopping, back-tracking, goalpost moving, and being proven wrong. Not to mention their ungodly alliance with Big Pharma, Big Tech, and Globalists.
On the other side? Doctors, nurses, and scientists who are willing to lose their practice, family, friends, admitting privileges, their jobs, and their licenses to take down the monster that is the Holy COVID Church. Before it mutates into something far worse.
Future is looking bright…if we fight for it.
Thankfully, the people have had enough. Across the world there are protests and riots which the legacy media are not covering.
Doctors are banding together to get their patients the medication they need. There are grassroots organizations aimed at uncovering and making sense of the Vaccines being pushed by the Holy COVID Church.
Lawyers are banding together across the globe to take the core actors of this monstrosity to court, including but not limited to allegations of crimes against humanity.
Economically oriented revolutionaries are working overtime to bring the decentralization of money and the hyperbitcoinization of the world to the masses.
We need only pause and pay attention.
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There's yet another CMA, at least in my case: my insurance company. I'm in a Medicare Advantage program at 76. It costs me nothing, other than co-pays, and it's an HMO. I have a Primary Care Physician (PCP) at a large corporate practice. My policy mandates two exams per year, the usual stuff with labs. I like my PCP, but I've created a lot of stress for her, as I have a high (per AHA) cholesterol, but refuse statins. In 1983 my numbers were considered good, but now they are "Get your affairs in order" bad, per my doctor. I've done a LOT of research, and my doctor admits that I know more about nutrition than she does. My health is better now than at any time in the past. As my PCP has told me, she doesn't work for me, but for the insurance company. That same company also happens to be part-owner of the corporate practice. Since I have no prescriptions, and no conditions that require monitoring, I only go in when I must in order to maintain insurance coverage. She gets a lot of flack from the insurance company, which makes no sense to me. I cost them nothing beyond what they pay for my annual visits, and that amount is more than likely less than what it costs to see me. It's become clear to me that the Health Industrial Complex regards me in much the same way as a cattle rancher regards a cow. The goal is not to make or keep me healthy, but to generate income for the practice. In his book "Longevity" Dr. Peter Attia says that we need to move from the current Medicine 2.0 (Medicine 1.0 being leeches and potions) to Medicine 3.0, which addresses causes rather than simply treating symptoms. I'm on board with that, and happy to be managing my health myself for the most part.
Excellent summation of where we are. It's very similar process here in Australia. Both in terms of training and practice. I have seen how Standards, Best Practice Guidelines and Clinical Pathways have eroded individual discretion and shackled clinicians into authority mandated practice.
Introduction of mandatory Expiry Dates and Single Use everything has led to a steady income stream for Industry at the cost of gross clinical waste and expense with little, or no, patient benefit.
I hope you can return to clinical practice and help to change culture ....