Dear John, I am not for sale. Signed, Dr. Mom

The patient-physician relationship is like no other. One cannot fathom the depth of love for a child until she becomes a mother. One cannot fathom the devotion to a patient until she becomes a physician. I recall my heart fibrillating the day I received an urgent call in the operating room in the midst of a complex ocular trauma case from my three year old daughter’s preschool teacher informing me that no one had picked my baby girl up. My life was at that moment consumed, my being, one with the precious patient that teetered on the edge of blindness and disfigurement. My life was consumed, so much so that I had forgotten that I was a mother, so much so that a precious little girl watched and waited on a curb until trust and smiles morphed into disappointment and tears. But, she was not alone; she stood like a soldier beside a lone little boy, the son of the Chairman of Neurology. I was supposed to have picked him up too.

CEO’s of the likes of Aetna, Blue Cross, “non-profit” hospitals, and drug companies and politicians, the likes of our President, his appointees, and his operatives, callously, if not sinisterly, take advantage of the enigmatic phenomenon that is the patient-physician relationship. This is a despicable, intolerable scenario that will not serve these life-blood-sucking elitists well, particularly in a day when over 50% of medical students are women.

After felonious passage, the unread, paradoxically named “Affordable Care Act” is being rewritten, 28 times thus far, by one man with a pen and a phone, for political expediency, power and money. The CEO-politician relationship is the antithesis of the patient-doctor relationship, the very relationship that the one man’s pen so whimsically and abusively defiles. The former is based on and perpetuated by lies. The latter is based on truth.

As a woman physician/mother devoted to my patients, children, and pursuit of truth, I was aghast when I logged on to the one man and his operatives’ website only to discover that my services are for sale at the stroke of his pen by his Aetna and Blue Cross CEO pals. I was never asked or told that my life-long-cultivated skills, God-given talents, and soul would be peddled on a risky, back-door-undone, discriminatory marketplace. I was tricked.

Dear Johns,

I am not for sale.

You may not use me and my works to discriminate against my fellow American patients, much less for your profit. I will not serve one patient under one set of rules and another patient under a different set of your pen’s usurious rules. You lie to me and my patients. I call you out. You falsely advertise my services. You profess “access to care” for your members using false advertising when you list me as one of your “providers”. You trick patients, who you call members; I will not be tricked by you. By the way, I am a doctor not a provider.

You sell nothing but empty promises without me and my colleagues. You can’t deliver. You are exposed. My colleagues and I will go forward in a new, parallel universe in which we will deliver actual medical care at actually affordable prices. You will be frozen, exposed in the cold of your calculated, Alinskyite lies. The American patient will awaken from your Orwellian-trance and be angry with you.

The Chairman of Neurology was not angry with me. His son, the little boy on the curb, grew up strong, not victimized, able to brush off hard knocks, and pursues success as an up-and-coming artist. The Chairman’s wife was not angry with me. She and her daughter are nurses, gutting it up to treat others in the trenches. Those of us that have shared the rite of passage to become physicians or nurses know, pursue, and defend the unspoken truths.

The little girl on the curb is not angry with me; she grew up strong. She guttses it up, stands for truth, and works to serve others. She, my baby girl, receives her M.D in 3 months. My second daughter survived her waits on the curb in similar courageous fashion and is presently a medical student too, in the footsteps of her grandfather, mother, and big sister.

As for me, doctor mom, I have four amazing daughters. 50% of my women are physicians-in-training in medical school classes composed of 50% women- women who are not victims, women who stand for truth, women who work hard, and women who will not be bought and sold against their will by Dear Johns who peddle false bills of goods because they think we are weak and worthless. I have thousands of precious patients with whom I share sacred patient-physician relationships. As for me, patient mom, I share the sacred inviolable patient-physician relationship with my own physicians and surgeons who rescue me from the ravages of cancer. I fathom the depth of their love. This knowing compels me to fight until the ink runs dry at the tip of Dear John’s phony pen.

Am I angry? Yes. How long will I fight? I will fight until the American patient wins the war on medicine. I will fight until the American woman wins the real war on women-the one that spews from the phony pen of the phony Dear Johns on the left. Fathom that.



Obamacare-Colluders Anonymous: Stop the cycle of addiction to the lifeblood of the American patient

Americans must understand that our federal government has chosen to collude with insurance companies, hospitals and drug companies to take total control of our healthcare system and one sixth of the US economy rather than collaborate with patients and physicians to achieve good healthcare reform that benefits each individual patient. This unholy alliance is facilitated by lobbyists bearing gifts of money and power. Individual patients and physicians are by comparison penniless and powerless. We are nothing more than pawns in a game which we can play no more. This is the ultimate game of life, and the only way not to lose is not to play.

A very bad national healthcare law has now been spun and woven within and throughout a very bad national tax policy, strangulating and choking the life out of the American patient and American medicine. Patients and doctors must stand and say “No more!” First, we must understand the disease, so we can fight it.

There are two components to a medical bill. One component is the bill for the hospital or outpatient facility services/supplies; let’s call this the hospital bill. The second component is the bill for the physicians’/surgeons’ services; let’s call this the doctor’s bill. We must make a very clear distinction between the “Bill” and what is actually paid and by whom. When Americans talk about our staggering medical bills, we are predominantly referring to the hospital bill, which is nothing more than a usurious, manipulative tool.

The hospital bill is staggering. It is enormously, artificially, and intentionally inflated to produce phantom losses resulting in tax-exemption for the hospitals and scaring patients to death, into believing they cannot survive without expensive, comprehensive health insurance. Dr. Keith Smith of The Surgery Center of Oklahoma gives a good explanation of how this is achieved and contrasts his model for excellent care at a fraction of the cost .

Here is my real life example: the hospital “bills” $12,000.00 for a minor procedure on a woman with a gynecologic condition. The woman gasps at the bill when she open the envelope, and then concludes “Thank goodness I have health insurance; everyone needs health insurance.” In reality, the intentionally hard-to-decipher bill cloaks the billing game/tax scam. While the hospital shows the patient the $12,000.00 bill, the hospital has actually agreed to accept far less from the insurance company; this is called an allowable, which in this case was $5000.00. By billing $12K but accepting $5K from the insurance company, the hospital recognizes a $7K phantom loss, which it reports on its tax return, thus maintaining a “non-profit”, tax-exempt status. The individual patient, now with a huge $5000.00 deductible because of Obamacare, must write a check to the hospital for the entire $5000.00, on top of her monthly $250.00 premiums ($3000.00 annually). The patient has come out of pocket $8000.00 with Obamacare style insurance. In stark contrast, if the patient was uninsured, she could have negotiated a direct fee with the hospital for $1200.00.

So, follow the money. The hospital got $5000.00 from the patient plus a $7000.00 tax write-off in return for less than $1200.00 of services/supplies. The insurance company got $3000.00 in premiums from the patient and paid $0 to the hospital, while the patient paid all of the $5000.00 allowable because of the high Obamacare-induced deductible. The patient ended up paying $8000.00 ($5000.00 deductible plus $3000.00 in premiums) for the privilege of paying more than if she had no insurance (the $5000.00 insured negotiated allowable v. the $1200.00 uninsured cash price) and gets no tax benefit for her health care expenses. Understand this: the individual spent $8000.00 with no tax break because she was mandated to buy Obamacare, and she would only have had to spend $1200.00 if she was uninsured. If business gets a tax break, most certainly should the individual as well, but with Obamacare the individual patient is in essence penalized. $6800 of this woman’s livelihood was essentially laundered to sustain a Government-Lobbyist-Insurance Company-Hospital-Drug Company Collusion Scam. The government, insurance company and hospital profit and get tax breaks- from our health, our bodies, and our lives- by manipulating us and scaring us. This is just wrong.

Now, what about the doctor’s bill? The surgeon’s insurance company allowable was $600.00. For a relative pittance, the doctor assumes all the risk and must practice under oppressive, punitive, coercive, innovation-stifling, mind-numbing, ever-changing-at-the-whim-of-a-politician government control. This $600.00 must then be spent toward overhead (taxes, employees, rent, supplies, malpractice, continuing education, computers…) into which it doesn’t make a dent. Doctors don’t get tax breaks either. Doctors love their patients. We are all patients. Americans are generous, compassionate, and self-sacrificing. Physicians and surgeons are willing to accept ridiculous agreements to retain our patients, who in reality have now been bought by government from insurance companies in collusion with hospitals. Hospitals, insurance companies, and government now own the doctors too. Doctors and patients must refuse to play this deadly game anymore. Stop and look at who actually paid what to whom, not just what the hospital “bills”. Expose the truth.

Americans are smart. When everyone understands what is going on, we can call out these gamers, get rid of their fixed game, and implement true patient-centered healthcare reform at dramatically lower cost with increased choice and access to good doctors and state-of the-art care for all. In the meantime, we are complicit enablers. They cannot do this without us. You can’t get your appendix out or broken hip fixed without a surgeon. Doctors and patients, together we must acknowledge the problem and stop enabling. Only tough-love can stop this cycle of addiction of the colluders to the power and money sucked from the lifeblood of the generous, compassionate, self-sacrificing, scammed, and scared-but very smart- American patient. We need our own version of AA and a twelve step plan for the recovery of American medicine.