- Del Meyer, MD - http://delmeyer.net -

Code of Conduct

Being a physician whistle blower in the past has been tantamount to professional suicide which lead to loss of practice, income, bankruptcy, with rejection and humiliation terminating a career–as well as society’s investment of $500,000 to produce that physician. Nonphysician whistle blowers, however, at UC Irvine have found an additional source of income. They are now being paid what is estimated at $500,000 not to talk about what they know of UCI’s Medical Center’s famed fertility clinic where human eggs reportedly were implanted into women without the biological mother’s consent. This “biomedical rape” is now an open investigation and lawsuits have been filed. One doctor remains out of the country. This hush money has been termed “lottos at taxpayer’s expense.”

Academic ethics takes a new twist. In Money magazine’s 1994 college guide, many schools submitted false SAT scores. The schools stated this was a marketing strategy required to obtain students. The New College of University of South Florida was ranked No.1 due to inflation of its SAT scores by lopping off the bottom scoring 6% of students, thereby lifting the average score 40 points. Northeastern University in Boston excludes both international students and remedial students thus eliminating 20% of their freshman class which boosts the school’s SAT average by 50 points. Monmouth University in West Long Branch, New Jersey, was unable to give any rationale for overstating its SAT scores by more than 200 points in their College Handbook.

The mammogram debate takes a new turn. After the arguments concerning whether women in their 40’s should have mammograms (American Cancer Society recommends every other year, the US Preventive Services task Force recommends none) or whether age 50 is soon enough (almost all agreeing that over age 50 they should be done yearly,) our own academia, UCD, came out recommending annual tests for ages 40-49 and fewer after age 50… Now that should confuse the malpractice lawyers, insurance carriers, and HMOs, almost as much as doctors and their patients.

Stanford Medicine reports that their surgical teams use a little knife music. The music in each OR is programmed to each surgeons specifications. The Rockin’ Jock for the Docs were, I believe, in the laparoscopy room, Dr Miller and the Cardiac Cowboys for the 3V CABG, and Mary Chapin Carpenter for the Hip Replacement suite. The music is also programmed for different stages, e.g. there’s “opening music,” “careful dissection music,” “under the microscope music,” and “closing music.” The anesthesiologists have their choice during induction and the nurses have their choice during arousal. Studies on the surgeons reveal that choosing their own musical selections is conducive to fewer involuntary responses, better speed and accuracy, their blood pressure and pulse rates are lower than with background music the experimenter selected. But what about the raison d’etre, the patient under the sterile field? Is it possible to sustain subliminal damage under anesthesia? The author wonders, should somebody do a study?

When the government talks about cutting expenses it’s never clear what the parameters of cutting are. Projected future growth is spoken of in the past tense as if it already is a fait accompli. Recently the Sacramento Media touted the horrors of cutting $270 billion from medicare. Even congressman Matsui speaking to the Sutter staff spoke about this cut but never indicated from what inflated projection. The SF Media spoke of this $270 billion as a savings and explained that the expected 9.9% annual growth of Medicare would be reduced to 7.1%. Although no numbers were given (there possibly aren’t any meaningful ones), if a decrease in growth of 2.8% is a quarter trillion savings, couldn’t we save another quarter trillion and still maintain a medicare growth of 4-5% per year? With the total health care costs in this country approaching a trillion dollars, and we are in a critical cost containment mode, isn’t a 5% annual growth more than adequate for any government program? With our grandchildren’s marginal tax rate projected to be over 80% just to pay entitlements and federal debt interest, wouldn’t a minimal ethical political behavior for our congress be to balance the books and then pay off its debt, just like the rest of us?

The Economist says that the decreases in Medicare and Medicaid do not go far enough. They should be decreased further to be in line with the rest of the economy.

Canada’s medicare is on the sick-list. The Economist also reports that Alberta and Ontario are pushing reforms to reduce their medicare coverage. The Canadian Feds have lumped medicare in with welfare and tertiary education and cut the entire new block…let the vultures fight it out… Is there any federal government that acts responsibly or ethically with taxpayer’s money?

A three year old girl’s response after watching her mother bathe the brand new baby brother just home from the hospital as the diaper was being secured. “We’re real lucky he doesn’t have one of them on his face, aren’t we mommy?” (M. Banks)

The university teaching profession seems to be having problems according to Loren Pope, author of Looking Beyond the Ivy League: Finding the college That’s Right for You (Penguin, 1995). It seems that Ivy League students, many of which are taught by graduate students and may never speak to a professor by graduation, have not learned “how to learn” in the changing work environment. They thought that their degrees insured career success. Surveys show that after 10 years, 75-90% of some graduating classes are working in jobs different from their training, jobs which may not even have existed at the time of their graduation. Some Harvard graduating classes have as high as 25% that have been fired, looking for work, are on welfare, or getting food stamps. A Canadian observer remarked, “The American practice of judging a college by the academic records of the students it accepts is like judging the quality of a hospital by the health of the patients it admits. What happens during the stay is what counts.”