Death by Compliance and Complacence

Growing up in the United States of America was a blessing. As a little girl, I was told that unlike anywhere else and in any other time in the history of the world, “You can be whatever you want to be and do whatever you want to do.” So, I believed, worked hard, made good choices, and became a physician and surgeon at a time when medicine was transforming from a historically male profession. My parents were both first generation to go to college. My father, who overcame poverty to become a chairman of neurosurgery, had only two women in his medical school class. My mother defied her mother, who said she was wasting time and resources, and went to college and became an RN; my mom regrets not going on to medical school to this day. I would not make that mistake when opportunity knocked for girls as never before. The unspoken part of the message that little girls internalized was “you must prove women are truly worthy of this newly bestowed privilege.” To prove that we were worthy, we did many things that have come back to bite us. We were too trusting, too compliant, and too self-sacrificing. We did not question authority, we did whatever authority said, and we did what they asked and more for them at our expense, with a smile and a hug of gratitude for letting us do so- the female equivalent of “Thank you, sir, may I have another”.

We eagerly joined our male counterparts and shared a rite of passage known only to the rare few of us that have endured medical school, internship and residency in a day when “Men (and some of us women) were men, and giants walked the halls.” There are no words for this. We endured. We survived. We were damn good. This came at a cost. The high cost of becoming a physician is physical, intellectual, spiritual, psychological and monetary. This cannot be shared vicariously, it must be lived. We convince ourselves it is worth it when our patients shed tears of joy when they can see again, when babies are born, and when transplanted organs free lives from machines. We question ourselves when patients lash out at us at times of greatest suffering and when our babies lash out at us for not being there for them. We live the choices we make, and a life in medicine brings the highest of highs and the lowest of lows. We work until we drop, compartmentalize our lives, and try to get the most out of the ever-shrinking compartment where we are enjoying the fruits of our labors away from work.

Physicians, women and men alike, are now taken for granted-our services, our lives, granted as a right to people of an entitled society as part of the “free” healthcare package promised by an over-bloated federal government of naïve, egotistical central planners seeking to establish a false-medical Utopia. This manipulative lot demonizes us, degrades us, blames us, shames us, pushes us to our limits, coerces us, extorts us, threatens us, and lies to us. With our heads under water, peddling our bicycles as fast as we can, through our trusting complicity, self-sacrifice, and fatigue-blind faith-borne complacency, we have facilitated the destruction of our profession and sabotaged our blessings of liberty. We were told by government “Come back when you’re not willing to take what we give you”. We didn’t. We were complacent, trusting…scammed. By not questioning this authority, we have done whatever they said, and we did it asking for more at our expense, our smiles fading, too tired, too humiliated, to hug.

Worst of all, we now fear for our patients, our families, and our livelihoods. The central planners shoved a law on us that sic’s IRS agents and bounty hunters on us, reduces us to data gatherers, and threatens to fine and even imprison us for data-collecting errors. October 1, 2014, physicians who do not spend exorbitant amounts of money to implement the insane, WHO-derived ICD-10 billing/coding system will no longer be able to bill for services- we won’t be allowed to even play the game anymore. Operatives of the central planners infiltrated the AMA, our societies and our medical schools. The ACA empowers them to control our education, how we treat our patients, how we are perceived, and how we are paid. They stifle innovation, tax technology and fundamentally transform physicians from men and women of the mind to mindless drones. Our medical students, of which 50% are now women-including two of my daughters, continue to “prove we are worthy of the privilege”; ironically, the privilege has transformed to groveling for crumbs to serve government and fearing retaliation for questioning the ethics of this mission. Many of us continue to do whatever the overlords command, ironically hastening our demise.

Our desire to please, trust, and comply combined with our complacence, fatigue, and fear has resulted in complicity. We are functioning as unwitting facilitators of fundamental transformation, and if we do not change our behavior, we are to blame for the demise of American medicine and the Constitution of the United States of America. This will be tough, but we are just the women and men to do this. The time has come for physicians to stand tall like those giants who walked the halls not so long ago and proclaim “No thank you, sir, I will not have another. I have had enough. I have nothing left to prove. I am worthy. I am strong. I am an American. I stand on my Constitution. You, sir, are out of order. You, sir, work for me.”

 

Kristin S. Held, MD

 

Advertisements

Physicians’ duty to stand for patients means “implement and comply” is not an option

November 15, 2013

2013 Physicians’ Workgroup Meeting, Washington, DC

Thank you, Congressman Sessions and my esteemed physician colleagues for the opportunity to convene, seeking solutions as the Affordable Care Act is resulting in millions of Americans losing their healthcare plans, in spite of the repeated promise this would not happen. Three years ago I stood before a similar group to report on my assigned section of the ACA, as a member of The Physicians’ Council for Responsible Reform. I literally spent weeks reading, trying to understand, and summarizing less than 100 pages. I knew immediately that the ACA was the manifesto for the promised fundamental transformation of the United States of America. The ACA is the usurpation of the Constitution of the United States incarnate. Since that time, the espoused “Law of the Land” has proven to be the biggest fraud and annihilation of liberty ever perpetrated on a free people.

Having shared a rite of passage traversed only by physicians, most of us in this group share an unspoken, unbreakable bond, understood by rare few. We seek to honor our tradition, serve the sick, and advance the field of medicine. We do this in truth and for good. We have sworn to uphold the Hippocratic Oath. We honor the sacred patient-doctor relationship. The ACA is destructive to these ends. Accordingly, we, our once great nation’s physicians, must abolish this law of absolute despotism, oppression, and human suffering, to institute new law, in accordance with our Constitution, for the good of the people, to secure our blessings of liberty, and with a firm reliance on the protection of divine Providence.

My colleague and friend, Dr. Jane Hughes, and I formed AmericanDoctors4Truth, to provide a voice of truth for America’s physicians, who have been silenced and stonewalled, demonized and denigrated. We offered a viable plan for patient-centered, free-market driven true healthcare reform and participated in formulating a similar template with many of you at the Dallas Healthcare Policy Forum in 2012. The proponents of the flailing ACA proclaim that there are no alternatives; this is just another of their proven lies. While Dr. Hughes focused on what we must do and our plan, I will focus on what we must not do and their law. America’s physicians must not serve as the pawns, unwitting accomplices, or drone-like henchmen entrenching the law by proceeding with implementation. We must not comply; we must not implement. If we do, we are to blame for the destruction of American medicine, the United States Constitution, and the greatest society of free people in the history of the world.

The ACA uses outright coercion and extortion to manipulate physician and patient behavior. Already, physicians have been targeted by the IRS, imprisoned, fined, audited, and subjected to loss of licensure, profession, and livelihood. My personal friend, orthopedic surgeon Dr. Dave Janda and a personal role model, neurosurgeon Dr. Ben Carson, were both viciously targeted by IRS this summer after speaking out against the ACA. Many of the Executive Branch’s measures to control physicians border on and will, no doubt, cross the line of impeachable offence if not stopped. Amendment XIII Section 1 of the Constitution of the United States states; “Neither slavery nor involuntary servitude, except as a punishment for crime whereof the party shall have been duly convicted, shall exist within the United States, or any place subject to their jurisdiction. Section 2. Congress shall have the power to enforce this article by appropriate legislation.” Before I list just a few of the measures of the ACA with which I will not comply or implement, I ask Members of Congress to contemplate the need for appropriate legislation to protect physicians, like me, living under the constraints of the ACA. Are physicians like me subject to involuntary servitude as a punishment for the crime of “refusal to comply and implement the ACA”?

In no specific order, an aspect with which I will not comply is ICD-10. Physicians who do not spend exorbitant amounts of money and resources to implement this WHO-based, convoluted billing/coding system will not be able to bill for services as of 10/1/2014 contributing to physician shortages and leading to loss of livelihood for physicians. Last week alone, three of my patients who are physicians informed me they are leaving the practice of medicine. One will make hats, and the other two, husband and wife OB/Gyns, are contemplating what they will do next. I assured them they will succeed in whatever they pursue, because they are among the best and brightest-a group no longer inclined to practice medicine nor seek to enter the profession. An estimated 50% of practicing physicians are over 50, and a majority of this group may leave medicine altogether. More than 50% of medical students are now women; the assault on the profession of medicine is the true “war on women”. My father, who calls medicine the noblest profession, overcame poverty to become a pioneering neurosurgeon. Accordingly, I became a physician and my two oldest daughters are medical students. Sadly, at a time when we need the best and brightest to enter medicine and are in desperate need of good doctors, my youngest two liberty- loving daughters informed me they will not become doctors under the ACA-saying, what their grandfather espoused has changed, and they would never work as hard as they witness their older sisters and mother work to be so regulated, controlled and oppressed. I confess-I am saddened but relieved. My solace for my older girls is in the knowing of the great personal satisfaction derived from a life in medicine and that at least they will be able to take care of their own family and friends as American medicine and the American patient dies. As a cancer patient, I fear I will lose my own physicians and surgeons- already, two in their 50’s have cut back to part time to pursue alternate careers.

I will not implement Meaningful Use Electronic Health Records. Pay-offs to physicians to comply will end this year; penalties will begin in 2015. The coercion/ extortion game of selective reward and punishment to manipulate a people is contradictory to our founding principles. The Government has proven inept with implementation of their very own Healthcare.gov website. EHR has been implemented, untested, on false pretense, and has already resulted in loss of life and medical injury, which I have personally incurred. Confidentiality, integrity, privacy and dignity are disregarded by government fiat.

The unprecedented powers of the Secretary of HHS to write law, alter law, and allocate money at whim for political expediency or personal gain makes it impossible to know the law, much less implement and comply. The Secretary has unlimited power to award millions and soon billions of dollars in grants in the name of “outreach, enrollment, and education”, and the waste of this money on politically motivated navigators, educators, and IRS agents is proof of its misapplication. Further, the Secretary’s ability to award grants to medical schools and training programs gives her control over curriculum, faculty and student composition, numbers and salaries, and therefore, the future of medicine in the US. Three days ago, I was on Medscape to get my CME ethics credit, and commented “Medscape is proving to be the propaganda arm of the ACA and its single payer advocates. Implement and comply is all that is ever presented here. Patient, doctor, Hippocratic Oath, choice, cost savings-not so much.” The very next day, I learned that Sebilius recently awarded Medscape $4.8M to “educate physicians”. How ironic that our ethics credits can now be earned through watching paid government propaganda.

The expansion of the National Health Services Corp in Sec 5209 and Sec 5210 granting the unilateral power of the Surgeon General and Secretary of HHS to subject American doctors and healthcare workers to involuntary deployment foreign or domestic, to places deemed in need or crisis by the Secretary, for loan repayment, and her ability to grant waivers in this regard is intolerable. Billions of dollars are allocated here. The government must be relieved of its duty as the usurious sole loan shark in the student loan business, and the HHS Secretary and Surgeon General must be relieved of duty as commanders of a global army, called up in the name of responding to crisis and meeting needs, at the whim of one unelected ideologue. That at the Secretary’s discretion, certain people are selectively exempted from aspects of the law, while others are forced to violate their personally held beliefs and religion to comply with the law or be punished, is antithetical to our Constitution and Declaration of Independence- with such heresy, we cannot comply.

The ACA-sanctioned government agencies of appointed bureaucrats put politics and money before the wellbeing of the people. Their terms and recommendations are not to be followed. The IPAB, USPSTF, PQRI, The Council and other agencies and task forces of cronies, non-experts, and ideologues, the likes of Don Berwick and Ezekiel Emanuel, place physicians in an untenable, unethical position with which we must not comply. Unauthorized data collection and manipulation and allocation of medical resources by bureaucrats are the antitheses of what has made American medicine, via the sacred patient-doctor relationship, great. Bad recommendations made by the USPSTF stand unless it is politically expedient for the HHS Secretary to unilaterally alter the law, as exemplified by the politically motivated handling of the 2009 USPSTF recommendations for mammograms for women v. the handling of the recommendations for PSA testing for men.

The usurious taxation of the American people via the ACA is oppressive and stifling to innovation, technology, and prosperity. 18 new tax hikes of $836B by 2022, including tax hikes on capital gains, increased Medicare taxes, and taxes on medical devices are unbearable. The rules prohibiting physicians and drug company reps from discussing pharmaceuticals is absurd and stifling to great minds. We now lag years behind in the ability to utilize many of the best medical advances available in the rest of the world.

The perpetuated, proven lie that the ACA guarantees we can keep our healthcare plans and our doctors if we like them, when in fact millions more are losing coverage than gaining coverage at 50:1, is basis enough for complete repeal of the law.

Time precludes a complete delineation of grievances and aspects of the law with which physicians must not comply. At one point, I thought that I could comply with half of page 38; I now know that even that would be unconscionable. I implore Congress to relentlessly fight for complete, unabashed repeal of this Un-American, Unconstitutional law in the tradition of correcting mistakes-the likes of Dred Scott v. Sanford (endorsing slavery), Plessy v. Ferguson (affirmation of segregation), Korematsu v. United States (upholding the internment of Americans) and Amendment XVIII (prohibition).

Physicians have succumbed to fear; we are fatigued and fed up. In my fight against this law for my patients and liberty, I have encountered evil as never before. I have been attacked by ideological ACA proponents who call me Josef Mengele, want me “snuffed out”, want to come to my daughters’ baby showers after they are raped, call me vile names I will not repeat, and fabricate lies about me for speaking truth, praying, and merely acknowledging God, the sanctity of life and the Constitution. Never in my wildest dreams did I fathom an America like this. Yet here I stand, public enemy number one, still fighting to secure our blessing of liberty. V. Lenin said “Medicine is the keystone of the arch of socialism.” It is our duty as physicians to do everything within our power to keep our profession from becoming the foothold of socialism in the United States of America. Surrender is not an option.

I close with a passage from Samuel Adams: “The sum of all is, if we would most truly enjoy the gift of Heaven, let us become a virtuous people; then shall we both deserve and enjoy it. While, on the other hand, if we are universally vicious and debauched in our manners, though the form of our Constitution carries the face of the most exalted freedom, we shall in reality be the most abject slaves.

 

Kristin Story Held, MD

Response to Medscape interview

I wonder if Dr.Mostashari has practiced actual hands on medicine with real patients a day in his life. His background-Masters in Population Science from Harvard and MPH from Yale perfectly coincides with the ideology of the “Team” he refers to as the best part of his experience. He thinks Sebilius is “amazing”, really? The discussion of the “politicization of medicine” should be retitled the “Tyrannization of medicine”. Dr.Matashari’s references to “Incredible urgency” and “Move Forward” are straight out of Alinsky’s playbook. When he tells physicians to “Profit from meaningful use” and policy “tools” like ACO’s (he calls an investment vehicle with 1-sided risk), he is essentially telling us to sell our souls and patients’ lives out to the government for cash. A 3 years profit, take the “tools” (translation cash)…so fellow physicians, after the 3 years of succumbing to the coercion and cash ($37Billion) of government elites, what then? I literally feel ill after watching this. Our profession has been defiled, and we are to blame. God help us. I do think Dr.Topol did a good job exposing our HIT Czar’s agenda and ideology. Excellent questions exposing Matashari as an insider, Obama operative. Office of National Coordinator, The Institute, Meaningful Use, Plan B, ACO’s Evidence-based- yes, this HIT Czar has bought into Big Government medicine. He has completely ignored the vast majority of America’s physicians and patients in his arrogance that he and his progressive colleagues know what’s best for us. I can’t wait to see how much he will now make with his new job for some HIT company-no doubt $Millions, as have most who sell us out, then leave Sebilius’s service to cash in. Medscape-where we can go to see how to implement and comply with the fundamental transformation (AKA destruction) of American medicine. Never do I see anything about alternative options for those of us that dissent and refuse to spend the rest of our lives as government drones. We did take the Hippocratic Oath-is that worth anything anymore?

I wrote this back on Sept 7 in response to a Medscape interview.I discovered last week Sebilius granted Medscape $4.8M to “educate physicians” about the ACA. Interviewees like HHS darling former HIT czar Dr. Matashari get upwards of $161,000 for a 4 minute video according to recent reports. I also read Dr. Matashari got a plumb job as a fellow at the Brookings Institute. Oh, to be one of the central planner,ruling elites…