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From: B. Harris)
Subject: Re: Uninsured patients.
Date: 28 Feb 1999 11:34:32 GMT

>> But they are extremely difficult to find. The public has no basis or
>> choosing a physician. There is virtually no information that is
>> accessible to most of us.
>Not true.  If you are rading this NG, you have the means of finding
>lots of information about any physician that legally practices
>medicine in the U.S

   Really?  Know of a site that provides such data free?  State medical
board sites do, but not all states have them, and there are 50 of them.
And you can get ABA data on Internal medicine and subspecialty board
certification, free.  But that's it, so far as I know.

    The AMA will give you any public data you like, of course, but it
will cost you.  That's how the AMA makes a lot of money.  I have a
feeling that a lot of medical schools and training programs provide
personal personnel data to the AMA in return for a kickback.  Damn if I
know why that's legal.  And the AMA has some means of getting info from
the disciplinary bodies of those many state medical boards which aren't
on the web, also-- although in theory all of it's public knowledge.
Except, they (the states) won't give it to YOU.  They will give it to
the AMA, apparently, which will then SELL it to you.   Not the same

                                       Steve Harris, M.D.

From: B. Harris)
Subject: Re: Doctor-bashing
Date: 2 Mar 1999 02:21:20 GMT

In <> Bettina French <>

>Stan wrote:
>> In article <>, Bettina French <>
>> wrote:
>> >   Where is the animosity toward physicians that's been showing up in this
>> > group coming from? In my experience, physicians are the pnly players
>> > in the system who are on the patient's side.
>> If doctors are on the patients' side, then why has the AMA opposed all
>> all attempts to create a universal healthcare plan in the US?

   The AMA has long gone on record in favor of a plan in which there
would be universal access to healthcare.  Just what form that would
take is the issue.  Do all doctors work for the government, so you get
VA (Veterans Administration) medicine, but on a huge scale?  Or does
the IRS just pay your insurance bill, something like in Canada?  And
suppose you want to pay more for a better package, does the IRS give
you a voucher toward that, in compensation for what you already paid in
taxes?   Or do you have to go completely outside the system and pay
double, as with US public vs private schools (and also the medical
system in Canada).  These are all significant issues.  A voucher system
has always seemed to me to a reasonable meeting ground between Left and
Right (ie, everybody gets basic medical insurance and a basic voucher,
and can then add on or fancier packages, from your medical 401k or
whatever)--- but nobody seems to like it.  They won't even do it with
Medicare. So, we get nothing.

                                      Steve Harris, M.D.

From: B. Harris)
Subject: Re: Doctor-bashing
Date: 10 Mar 1999 12:17:06 GMT

In <7c3kll$jvn$> (Kurt Ullman) writes:

>In article <>, Carey Gregory
><> wrote:
>>Seriously, how does the AMA limit entrance to the profession today? I'm
>>very skeptical that they can or do.
>        By keeping the licensing restrictions in place. This artifically
>increases the barriers to entry and that artifically keeps the price up.
>Same theory as architects, plumbers, lawyers. It is just that the AMA got
>to it first.

   Get a grip, please.  The AMA dates from 1847.   Doctors had been
licenced directly by their own professional societies in England for a
century by that time, and in the US various state institutions (the
City of New York being the first, as I recall) had been licensing
doctors for nearly that long.  But none of it was enforced in the sense
that you could be put in jail for practising without a license.  Mostly
it meant you couldn't use the courts to collect bad debts from your
patients.  The early 19th century had a passion for licensing
everything from barbers to carriage drivers to pedlers.  More lawyers
were licensed by the state than not.

   And it wasn't a smooth transition, or a gradual one.  By the Civil
war it had all gone backwards again, and most people practicing
medicine and law were NOT licensed.  It wasn't until after the Civil
war when the American University system got going that things began to
go forward again.  People were mobile and they wanted assurences when
they saw strangers in strange cities.  But that happened in all
professions.  And instead of the AMA licensing doctors directly, as was
the case in England, early in this century it got the states to let it
set licensing standards for them.  Or the states got it to.
Politicians and voters are lazy, and they'll turn over power to anybody
who seems to have a vision (watch the USDA shortly adopt AAALAC animal
care standards in the next five years for yet another example).  But
the American Bar Association controls standards for law school
accreditation in the same way, and was doing so more effectively than
doctors did for their own profession, from the beginning.
Chiropractors and osteopaths are licensed in all 50 states, and have
have always been licenced right along with physicians.  And naturopaths
now are also licenced in more and more states.  You don't have to get a
physician or else treat yourself, and never have.  But tell me-- what
is the alternative to attornies when you are summoned by the state, if
you don't want a fool for a client?  Right, it doesn't exist.  So don't
come here telling silly stories about how the AMA did it "first".  FYI,
the AMA still hasn't done "it" to this day.

                                      Steve Harris, M.D.

From: B. Harris)
Subject: Re: Doctor-bashing
Date: 10 Mar 1999 12:28:56 GMT

In <7c3klm$jvn$> (Kurt Ullman) writes:

>In article <>, wrote:
>>The AMA doesn't run the MCAT nor the medical schools nor the residency
>>programs nor the state medical boards. In short, the AMA has no power to
>>limit entrance into the medical profession. It didn't have it in the
>>past, nor present, nor will it have it in the future.
>Even you don't believe that. Just try and get a bill passed that would
>cut into the docs ability to decide who gets licensed and why (like any
>attempt to increase the powers of the Clinical Nurse Specialist) and see
>what happens. The lawyers do the same thing from the ABA, etc.

   On the contrary.  The lawyers do it, but doctors have not been able
to.  There are nurse anaesthetists putting people to sleep out there.
There are midwives delivering babies.   Maybe not as many as you'd
like, but they do exist, and they even licensed.  If you don't want to
see a doctor you can see a licensed chiropracter, Christian scientist,
Osteopath, and even (in many states) Naturopath.  Or you local Navajo
singer, if that's your thing.  Naturopaths and nurse anaesthetists and
nurse practitioners have access to morphine, as well.  And
chiropractors have their X-ray machines and licenses to opperate THEM.
Not bad for the oppressed.

   Now-- who is it other than an attorney in good standing with the ABA
cab you can have represent you before the bar, when you have to go
there?  Sure, you can reprent yourself.  You can cut out your own
appendix, too.  But it's the land between that and the full orthodox
way, that tells the tale.

    Well?  You really can't argue that doctors have a better monopoly
than anyone else (try flying a jet for hire without a bunch of papers
from the FAA).  About all you can do is argue that they (doctors)
*should* have a nastier monopoly given their personalities, and surely
*wanted* one, and don't have one for lack of *trying* .....

    But that's pretty lame.

                                        Steve Harris, M.D.

From: (Steve Harris
Subject: Re: 100 Years of Medical Robbery
Date: 13 Jun 2004 14:56:04 -0700
Message-ID: <>

Orac <> wrote in message

> In article <40cc3774$0$70109$>,
>  "Howard McCollister" <> wrote:
> > "Paul Antonik Wakfer" <> wrote in message
> >
> > >
> > >
> > > Excerpt:
> > >
> > > "The American Medical Association (AMA) was founded in 1847 around two
> > > propositions: one, all doctors should have a "suitable education" and
> > > two, a "uniform elevated standard of requirements for the degree of M.D.
> > > should be adopted by all medical schools in the U.S." [1] In the days of
> > > its founding AMA was much more open--at its conferences and in its
> > > publications--about its real goal: building a government-enforced
> > > monopoly for the purpose of dramatically increasing physician incomes.
> > > It eventually succeeded, becoming the most formidable labor union on the
> > > face of the earth."
> > >
> >
> > I swear, ignorance about the American Medical Association abounds. I suppose
> > it makes for a good focal point for peoples' frustrations with the health
> > care system in the US. Never mind that statements such as Paul Wakfer's
> > represent total ignorance of how the system actually works.
> >
> > The AMA isn't a labor union at all, it's as a lobbying organization. Of
> > course, their mission in that regard is hampered by  the fact that only
> > about 35% of physicians are even members of that silly organization. Even
> > so, conspiracy theorists love to tee off on the AMA even though the majority
> > of US physicians have nothing to do with it. Like most physicians, I
> > consider the AMA harmful to the interests of most US physicians as well as
> > to the US health care system in general. Not to mention that they have done
> > a piss-poor job of keeping my income even level, let alone increase it.
> Indeed. I belonged to the AMA's medical student organization back when I
> was a medical student. However, I soon became disgusted with the
> organization (the Sunbeam fiasco and its utter ineffectiveness on issues
> to improve patient care and of interest to physicians). I have not been
> a member since. Lots of people who dislike conventional medicine (for
> whatever reason) often use the AMA as a convenient whipping boy, when it
> really doesn't have all that much power. Hell, if the AMA had as much
> power as people like Paul seem to think it does, you'd think that, in my
> state at least, it would have been able to do something about the
> outrageous malpractice insurance premiums and the state laws stacked in
> favor of the plaintiffs that are forcing so many obstetricians and other
> specialists that deal with high risk cases to leave the state. If the
> AMA had as much power to protect physicians at the expense of the public
> as people like Paul think, physician reimbursement adjusted for
> inflation wouldn't be flat or decreasing, as it has been for over a
> decade now.


Yes, Paul Wakfer is here quoting a moron. What he calls "the most
effective labor union on the face of the Earth" has so far not been
able to effect collective bargaining on behalf of its profession, in a
country where most members of this profession now work for third
parties. Anyone BUT a moron would sense a contradiction there between
assertion and fact. US doctors can only *dream* of an AMA with as much
political and workforce clout as the Teamsters Union, the AFL-CIO
(including the AFT), the AWA, and so on. US doctors not only do not
have the "most effective union on the face of the earth", we actually
have no union at all.

There's also an undercurrent in this piece to the effect that doctors
have some kind of "government monopoly" because we're licensed by the
state, like electrical contractors and airline pilots and the people
who inspect elevators. In the libertarian world of Mr. Wakfer, perhaps
nobody would have licenses. In that world, anybody would be able to
buy things like radioisotopes, no questions asked. So what if you
don't know one end of a geiger counter from the other?

However, there are many other libertarian scenarios where licensure is
perhaps the best way of coming to grips with the other problem that
the incompetent person is really not a lot different from a child,
when it comes to his danger to his fellow man. So how do we tell the
incompetant adult from the incompentant adult? Who can we sell
dynamite to, radioisotopes to, allow to fly jets and do brain surgery?
Libertarians would probably say "caveat emptor" when it comes to brain
surgeons, but the potential customers of brain surgeons might not be
in a greatest position to exercise market judgement, you know?  And as
for the unlicensed people with jets, dynamite, and radioisotopes,
they're flying overhead and living next door. There's a lot of caviat
there, but we're missing the emptor entirely. So it's a problem.

Paul, perhaps your problem is you think that a licence to practice
medicine is hereditary?  Sorry, but they aren't. I'm the first person
in my family to have one. I wasn't born with it. It's actually pretty
much like the Ph.D. held by the moron who wrote the article you quote.
If he can get one, anybody can.


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