Jewish World Review Feb. 6, 2004 /14 Shevat, 5764
Drs. Michael A. Glueck & Robert J. Cihak
Feds Harass Doctors. Who's Next?
In the 1930s, Comrade Joseph Stalin noted that the Soviet population wasn't
growing fast enough to build his Workers' Paradise quickly enough.
So he shot the census takers. The next batch of census takers weren't any
better. But the third generation of census takers reported enough population
growth to keep Stalin happy - and keep their own lives.
This last batch of census takers "got the message." As Solzhenitsyn reported
in a different setting in "The Gulag Archipelago," doctored statistics in
the Soviet Union weren't simply a matter of bureaucratic empire-building;
your life literally depended on keeping the dictator happy.
This historical vignette exhibits a double idiocy. What did Stalin know
about taking a census? And how would shooting the census takers cause
population growth, unless it is presumed that they were incompetent slackers
and wreckers who would do their job only under threat of dire punishment?
Idiotic, of course. But increasingly, this describes the relationship
between America's doctors and America's government. The irony is that the
medical system was working pretty well until the government resorted to its
"shoot the doctors" approach to medicine.
We offer two ongoing examples.
The first pertains to the dangers doctors prescribing pain-controlling
medication face if the feds decide they don't like the prescriptions. Their
attitude is "guilty until proven innocent" whenever a doctor prescribes pain
medication adequate to deal with serious and long-lasting pain.
And some doctors have been, literally, "under the gun" when government
agents break down their office doors to investigate such heinous crimes as
using a form of Vitamin B12 that didn't meet the government's idea of what a
"good vitamin" should be, as happened in the case of Dr. Jonathan Wright in
In March 2003, federal agents stormed the
office of Dr. Jeri Hassman, a
Tucson pain specialist, put her in handcuffs, and took her to jail. It seems
that DEA agents had noticed she was prescribing unusual quantities of
morphine-based drugs and concluded that Dr. Hassman was "prescribing
controlled drugs outside the normal practice of medicine." They charged her
with 362 counts of this crime.
Last week, Dr. Hassman entered a guilty plea to four counts, thus avoiding
the possibility of nearly 30 years in prison. She now faces six months in
jail and five years' probation.
If Dr. Hassman is indeed a criminal - 362 counts is a lot - why did she get
off so easily? Or did the feds just load her down with so many counts that
she couldn't afford to fight? They were also trying to send a message to
doctors: "Beware. This could happen to you if we don't like your
And indeed, scores of doctors have faced these same guns. Some have been
imprisoned. One has committed suicide. Many have lost their medical
licenses, run up ruinous legal bills and gone bankrupt.
The lessons have not been lost on honest doctors, many of whom grow ever
more reluctant to prescribe serious pain medication to those who need it
A second area where the government has been busily threatening to "shoot
first, ask questions later" entails Medicare. By law, doctors may treat
Medicare patients only in accordance with what the government sanctions.
Further, a doctor may not treat any Medicare-eligible patient privately
outside the Medicare system if the doctor accepts a penny of Medicare money.
The result is that more and more doctors are refusing to treat Medicare
patients at all. They're simply fed up with the limits on their ability to
treat patients appropriately, the paperwork, and the constant threat of
legal action, including prison, if they deviate one iota from the 130,000
pages of Medicare law (plus Official Government Regulations, plus contracted
Insurance Carrier Policies) so complex that not even the enforcers
The vast majority of doctors who have "opted out" of the Medicare system,
and those whom I know personally, are very happy with their decision to go
back to the old system of offering competent care at reasonable cost.
So, what does this doctor recommend? Three things.
First, if you're medically "covered" by Medicare or any government program,
be ever more aware that your doctor is working under constant threat of fine
Second, if you're a pain patient, ask your doctor up front about whether or
not you're getting what you need. If you're not, ask what you can do to
And third, if you're a Medicare patient and looking for a doctor whose top
priority is to take care of you instead of pleasing the Medicare
bureaucracy, find a doctor who has opted out.
After all, you wouldn't shoot a census taker just because the numbers didn't
Or would you?
Editor's Note: Robert J. Cihak wrote this week's column.
Michael Arnold Glueck, M.D., is a multiple award winning writer who comments
on medical-legal issues. Robert J. Cihak, M.D., is a Discovery Institute
Senior Fellow and a past president of the Association of American Physicians
and Surgeons. Both JWR contributors are Harvard trained diagnostic radiologists.
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