Regarding “
Cardiologist faces possible sanctions”:
I'm very much afraid that this debacle is but the representative tip of the iceberg and a tragic reflection of the systemic pressures in our non-system of medicine and its frantic need to increase revenue even at the expense of running roughshod over ethics and integrity.
More procedures—more stents and open-heart surgery—equal more income. Are we really blind to the corrupting pressure this brings to bear on otherwise great people? It has been said that only when we have evolved from fee-for-service to “outcomes=incomes” will the very human impulses that lead some to this sort of abuse be potentially controllable. Perhaps that's correct, but it certainly should be cause for deep reflection. Even if this physician is guilty as charged and has his license removed, and the hospital involved adequately addresses the systemic failure-to-discover-in-time what was happening—and the physicians who knew or suspected face their own failures to act, the haunting question remains: How do you compensate on a human—and non-monetary—basis the victims for their pain and suffering and further complications, including unnecessary death? How do you make right the wrong of painfully impacted lives of patients and those who love them, especially if what they went through was solely to generate income?
In my view, a major contributor to such problems in Western medicine—and especially the U.S.—is the viewpoint that medicine is a business with the profit motive as paramount. All the sincere language about service and ethics and healing we could ever generate becomes subordinate to a need to generate profit, and thus the old parable—Biblical in origin—that one cannot serve two masters is called to mind. Is medicine a profession of healing, or a business? I am eternally troubled that we're wrong when we try to believe that it can be both.
John Nance
Seattle
