Once you've jumped through all the hoops to become a Board-certified physician (the medical school, the residency, the two-day proctored exam, the oral exam in some specialties), that should be IT.
I'll happily do all the American-Academy-of-Pediatrics-approved Continuing-Medical-Education you want me to do . . . I'll take online open-book tests (a very useful learning tool) every few years without much fuss . . . but being required to sit for another proctored exam when you haven't seen a classroom in nearly 20 years . . . and plodding through all of the juvenile busy work that the Boards have now invented - on the theory that taking doctors away from their patients to play computer games or conduct faux-research somehow improves patient care . . . is TOTALLY FRICKING RIDICULOUS.
In short, the American Board of Medical Specialties (ABMS) is selling a bogus bill of goods to the American public, and they're treating doctors like errant/dishonest children. The very clear message is that physicians who've paid their dues cannot be trusted. We are being turned into the enemy by our own kind.
Given the American Medical Association's (AMA's) track record in "representing" physicians over the years, this kind of thing is certainly not new. But it's damned annoying.
Let us be clear: What the ABMS has done is NOT noble, nor will it save millions of lives - but is instead all and only about generating more money for the individual specialty boards - as well as the peripheral industries that the "Maintenance-of-Board Certification" programs prop up. Many millions of dollars. It's not really about producing better doctors.
If all of the fuss was really about producing better doctors, they'd be working on ways to clean up physician peer review, protect medical whistle-blowers and manufacture/legislate some decent tort reform.
I'm actually planning to write the American Board of Pediatrics (they're based in the very enlightened & progressive burg of Chapel Hill) soon, and seriously ask them when I get credit for the going-on fourteen years of medico-legal CRAP I endured because I followed all the high-minded protocols they now "teach" in their "Part Four Activities", answered a nurse's desperate phone call one night-in-the-middle-of-the-night, and (despite the threats of a trio of clueless hospital/practice executives) came in in to stop malpractice/save a critically-ill newborn baby's life.
A little credit for having the stones to author this blog - and speak a little truth to power - might be in order too.
O dear. I have digressed haven't I? That was last year.
The subject of this 2011 Independence Day's post is the MedPage-Today-hosted blog authored by Dr. Kevin Pho, called "Kevin M.D.".
I actually should have written this post several months ago (back in March) and I didn't. The truth is that I'm pretty burned-out on blogging (it's the reason I took a summer break) - and believe that it is subject to all of the ills now affecting main-stream journalism.
Bloggers selling out to sponsors & corporations (ala HuffPo and AOL) . . . or simply trying to run with whoever is currently politically "cool". . . seems more and more to equate with local newspapers kow-towing to advertisers and/or town cliques. There are "right people" and wrong people, you see. You're either in or you're out. It's worse than high-school.
If blogging ever was "relevant", it's not really now.
The very first things to fly out the door when journalists - or bloggers - sell their souls to the highest bidders are accountability, transparency and the truth. But these things are as necessary as air and water to the health and well-being of a society. Indeed, my hometown of Asheboro, North Carolina can credit most of its "dying" largely to our journalists at the Courier Tribune looking the other way while the-right-people-in-Rotary did very dirty things to good people.
[Speaking of, I am quite frankly AMAZED that Asheboro's Courier Tribune actually published a letter from Thomas Van Camp (a lawyer for Sandhills Mental Health Center) that made mincemeat of Randolph Hospital CEO, Robert Morrison's recent campaign to style Sandhills as the evil-doer in Bob's abject failure (as a non-profit, community hospital CEO) to provide adequate psychiatric care to patients in Randolph County (he was too busy building cancer centers we didn't really need). The Bobber's shameless grand-standing amounts to legal extortion designed to get Sandhills to pay for a psychiatrist that the over-$700,000 man should have hired himself long ago - IF he was so "concerned" about patient care. But this is a subject for another post on another day of what is supposed to be a summer break.]
Where Dr. Kevin Pho, of Kevin M.D. is concerned, as a fellow medical blogger, I've really tried to remain "collegial" (doctors are nothing if not collegial) and do things by the book (we'll get to that).
Blog wars are so tiresome.
(Of course, when you really think about it, doing things by the book is what got me professionally eviscerated in the first place - it's all in the side-bar, folks.)
Alas, collegiality . . . being polite to those fellow professionals who've stomped on me (or sat by deaf, dumb and blind while I was getting stomped) . . . has not ever served me well. So I'm left with calling them as I see them.
And Kevin Pho, M.D. is a blogging fraud. A sell-out of the first order. An AMA/Obamacare hack masquerading as someone who has an objective, critical eye. He's sewing up holes in that veil he keeps talking about as fast as some of the rest of us can rip them.
Two things happened this past week that made me re-think remaining silent with regards to my opinion of the New Hampshire internist who bills himself as "social media's leading physician voice" . . . a self-endowed "title" that I've always found more than a little presumptuous.
And that's mostly because I've come to understand that all Kevin wants to hear is the sound of his own voice - or those that agree with him/his VIP sponsors (which include the AMA). He wants to be on all the advisory boards and invited to do the Times Op-Eds and/or TV spots . . . he sees himself as the next "Dr. Oz", albeit with more credibility. Blogging is merely a stepping stone . . . and to get up the stones to higher ground, the good Dr. Pho must play the game.
All of that would be just fine with me if he (and MedPage Today) were PLAYING FAIR and letting all the voices of medicine be heard on his blog - and if he were giving the public he says he wants to educate the whole truth - by letting all of his readers speak.
But he's not.
In that sense, Kevin reminds me a lot of Edward-Cone-of-the-Cones-Healthcare-System-Cones . . . one of the Greensboro, N.C.'s progressive "journalists" who invited me to this blogosphere six years ago to tell my story . . . and then (in true Ethan Feinsilver fashion) did everything he could (i.e. by banning and delinking and "Coning") to bury it and discredit/trash/marginalize the Asheboro Pediatrician/home-girl who refused to stand-down and turn a blind eye while a Cone-owned doctor nearly killed a newborn baby girl with his arrogance and clinical ignorance.
Ed and the boys at the N&R sold a bill-of-goods that they did not deliver on. But hey, trust-fund Ed (I know what masters he's served all along) really wishes me well. Besides, Ed didn't have to watch his newborn child nearly die because of the stupidity of a doctor. Likewise, he's never experienced watching someone he's loved and nurtured and raised to be a decent human being endure every manner of professional humiliation (courtesy of a "non-profit" hospital covering its ass) for doing the right thing. His name alone (a name that happens to figure into my story) will likely immunize his offspring from the things other lesser beings have endured. The rest of us can "get over it" and "move on".
Getting back to what prompted this post, first, one of Kevin's readers/regular commenters contacted me out of the blue. We'd corresponded before. Long story very short, she was asking questions from the point-of-view of a patient . . . in this case a patient's parent . . . the very kind of person Kevin says he wants to inform - and help. Her daughter was very badly surgically mauled (I have some experience with that), and she has encountered many roadblocks in terms of extracting any kind of satisfaction or "justice" out of our thoroughly-broken peer review and medical malpractice systems. In what came as no surprise to me (yet befuddled and disillusioned her) this Mama-lioness's biggest problem seems to be the difference between what doctors evaluating her daughter in the wake of the surgical mauling will tell her privately - and what they will say publicly/under Oath.
It's called "the White Wall".
(If you wonder how that works, all you have to do is go to the Housecalls sidebar and read about what
Bob Morrison and Steven Eblin did to me - while some of Asheboro finest and most respected physicians pretended it wasn't happening.)
My commentary at Kevin's . . . back when he did not block my IP address (we'll get to that) . . . often referring to my experience in Asheboro (when appropriate/on-point to his posts), and the realities of physician peer review . . . had intrigued her. She wanted to know more about what really goes on behind that "veil" that the good Dr. Pho brags about about pulling back . . .
. . . but can somehow never can get far enough back to cast sunlight into the darkest places.
We had a good back & forth via e-mail. I was blunt at the time (I've found that most patients actually appreciate bluntness - if it's the truth) . . . advising her that the only profession that circles-the-wagons-and-covers-the-asses-of-its-bad-apples more than medicine is the one symbolically represented by a blind-folded goddess holding her scales.
As anyone who reads this blog knows, I learned long ago - the very hard way - that Lady Justice is no lady . . . she knows exactly who she's bedding . . . she spends most of her time on her back with her skirt up around her neck . . . and she's got no problem with money tipping the scales.
In the practice of law, particularly in North Carolina, "the Two Americas" is very much alive and well (if you have any questions about that, just ask my former Senator, Johnny Reid Edwards - or ex-Governor-turned-convicted-felon, Mike Sleazely).
In her latest e-mail, the blogging-Mama-bear said she'd been thinking about me and wanted to know what I was up to. I told her that I was working on exactly what I said I was working on when I took my break back in May . . . constructing a legal case against the toothless state and Federal"oversight" agencies that coldly let this former public servant swing while Randolph Hospital worked its dark magic on her life and career.
But I also have a job, I'm doing massive amounts of overtime this summer, and lately the stork has been crapping on my head (that's okay, it's job security). So it's a slow go.
Bottom line: The N.C. Medical Board, the Joint Commission for the Accreditation of Hospital Organizations, the N.C. and U.S. Departments of Social Services, and even the Internal Revenue Service (now charged with the oversight of healthcare courtesy of Obamacare) were utterly toothless when it came to actually doing the right thing by a doctor who put a patient's life before her own career and happiness. They were NOWHERE TO BE FOUND.
And if all of these hallowed agencies could not do right by the aforementioned Pediatrician-in-public-service, what in God's Holy Name makes anyone think they're going to do right by patients? GET REAL! You have to wonder what the politicians who dreamed this mish-mash up were smoking.
Instead of responsible, ethical oversight, what Dr. Mary Johnson got was a conspiracy of dunces - getting endlessly bounced from jurisdiction to jurisdiction with no one cooperating or communicating with anyone else.
Plainly and simply (much like the American Board of Medical Specialities peddling their maintenance-
of-certification schemes), these organizations are selling a bad bill of goods to the public. It's WAY past the time their collective feet were held to the fire.
Especially in the wake of the cyber-stalking business last year, I cannot think of a better case than
mine. The state and Federal governments have watched me get professionally pummeled, insulted, and ridiculed (for telling the truth) for years. They have not cared - not intervened EVEN ONCE to stop Randolph Hospital (or anyone else) from doing it.
The case itself is not really hard to make. It's simple malignant, deliberate, never-ending/on-going negligence on the part of ALL of these "oversight" & "patient-safety" agencies. They require duties of physicians that they IN NO WAY protect or defend.
But, as I recently told my good friend, Sir-Buzz-Armfield-of-the-Asheboro-Armfields-who-gave-one-million-dollars-to-Randolph-Hospital's-Cancer-Center, over the years I've discovered that there as many legal opinions as there are lawyers.
And the biggest problem I currently face is finding an attorney in North Carolina who, apart from a real sense of ethics and the spirit/intent of the law, has a spine and some guts. For whoever takes this case is going to have to cast some very negative aspersions on his own profession.
As I have done on mine.
There's no veil to pull back on this blog. I burned it long ago.
We'll get back to my comrade-in-blogging in a few paragraphs. The other thing that prompted me to write this post was a recent conversation I had with an out-of-state Pediatrician (who happens to be black) looking for a position in North Carolina. She's done a fair amount of Locum Tenens work (the way I've made my living since the giant screw) and has looked in several states and commented how positions in other neighboring states seemed far more "stable" (i.e. physicians tended to take a job and stay there) as opposed to North Carolina. She opined that North Carolina is a "revolving door" (once-upon-a-time I got SLAPP-sued over pointing this out in a complaint sent to USDHHS, so I always LOVE it when a colleague makes the same observation). She was surprised by this ebb and flow of (mostly) young physicians in and out of positions throughout North Carolina - as the state boasts four medical schools and a number of nationally-prominent medical institutions. She thought the state would be a haven of medical stability - but exactly the opposite is true.
I told her that North Carolina's medical schools and giant medical institutions (most of them sucking eagerly - in some fashion - at the public teat) were EXACTLY the problem . . .. as our medical schools, (despite all of their enlightened, progressive hype & rivel about diversity and cultural enlightenment) are perhaps some of the last standing bastions of white male supremacy (aka: good-ole-boyedness) in our society. Having four medical schools in North Carolina actually means that there is an endless supply of newbie physicians to sucker into the scut work in places no one wants to work - and they are very easily taken for granted and abused. Women, blacks, other minorities and especially foreign-medical-grads are merely cogs in a giant wheel of profit . . . run by way-overpaid people with MBA's (as opposed to M.D.'s) . . . skimming their own money off the top and on the backs of the labor of others.
Despite the massive fiscal and human investment made in their training, these young doctors are oftentimes treated horribly . . . in a state that has embraced "right-to-work" philosophy with such gusto that employed physicians, despite their unique duties and responsibilities, are oftentimes be treated no better, if not worse, than lowliest employee at one of the local mills in one of our dying towns.
Meanwhile, the increasingly-entitled American public still thinks that all doctors are "rich", so we deserve and/or can handle whatever pummeling comes our way. Everybody "knows" Pediatricians perform tonsillectomies for the money.
This brings me back to Dr. Kevin Pho . . . one of the fortunate in our profession who has apparently been allowed to live his dream, and seems to have never had a bad professional day in his life. Like my local blogging nemesis Edward Cone, from his carefully constructed online perch amongst the "right people" and organizations of medicine, Kevin appears to me to have no real ability to comprehend the darker underbelly of medicine . . . or some of its uglier secrets. And he most certainly has no empathy or real compassion for colleagues who've walked through - and been badly burned by - fires started by someone else.
Indeed, lately Kevin has done nothing lately but HACK for the American Medical Association (at best, it "represents" about 20% of practicing physicians in the United States) and its support of Obamacare.
Several months ago, I could take no more. Dr. Pho had put up yet another post that advocated young physicians going into public service (it's very Kennedyesque and Peace Corpsish, dontchaknow) - specifically the National Health Service Corps . . . the very Federal program that allowed Randolph Hospital to do what it did to me without batting an eyelash.
The boys and girls in Bethesda could barely come out of the rain - much less enforce the terms of their own site agreements.
"Obamacare", of course, threw even more money at the program - without fixing ANY of the massive black holes physicians-in-public-service can fall through (so much for "reform").
It's glorified indentured servitude. Make no mistake that if you sign on for this ride (usually on the road to nowhere), and you need help, NO ONE IN WASHINGTON IS GOING TO HAVE YOUR BACK.
I sent Kevin a personal e-mail that minced no words about endorsing these programs - and his wholesale failure to educate "newbies" about the dangers of public service. It equates to deliberately leading lambs to slaughter in order to get a "seat at the table" in Washington (never mind that the AMA's table equates to the kids table in the back of the room). Pure self-service. It's despicable - especially when you have doctors on your blog who have served in these programs who are telling very ugly stories . . .
. . . ugly stories President Obama and his administration did not want anyone to hear BEFORE "reform" was Rahmed through Congress.
Almost immediately, I discovered that my IP address was blocked at Kevin's and I could not post comments. I tried to post as a "guest" from other computers - yet nothing got through.
In essence, this physician's voice had been effectively silenced by an influential medical blogger who bills himself as "social media's leading physician voice" and whose blog is regularly read by national reporters trolling for medical stories.
Mine is a story that SCREAMS to be told to the largely kept-in-the-dark masses - particularly for the sake of younger doctors trying to sort out how to pay back those God-awful school loans.
Par for this course. It made me angry, but as I said before, blog-wars are tiresome and rarely worth the effort put into them. I basically wrote Kevin off as a loser and a loss - much in the way I've written off John Robinson and Edward Cone and everyone who has ever tried to pass themselves off as a "journalist" at Asheboro's Courier Tribune.
I stopped checking Kevin's blog every day. And I discovered that I wasn't really missing anything. I could live without vanilla medical commentary.
I did send Kevin another e-mail asking for an explanation and got nothing but radio silence. For a short while, I let it go. I tried to "move on" and "get over it".
But as Kevin continued to drool over the AMA and its "representation" of physicians (his main argument seeming to be, "what else have we got?"), I did eventually write MedPage Today's Editors, and ask for an explanation for my banishment.
I made the point that I sign my name and take responsibility for all of my comments - something that many of Kevin's favorite anons do not do.
I also pointed out that prior to blocking my comments altogether, one of Pho’s tactics was to (1) heavily edit my comments, or (2) let me comment a few times . . . get a conversation or exchange going . . . and then drop/edit/block responses I made to other commenters who were addressing - or (sometimes) outright attacking me - essentially letting their statement or attack stand as "the last word". You could say it's a very "transparent" way to steer your thread towards making someone look bad.
Editing comments without permission - then publishing them - particularly the comments of people who sign their names and own what they say - is one of my pet peeves. You essentially take that person's voice and make it your own. It's the worst kind of deception and fraud . . . a wholesale rape of that person's right to free unencumbered speech - to be heard as they are.
Marrianne Mattera, Managing Editor of MedPage Today, initially reported back that MedPage today would be reviewing Dr. Pho's policies with regards to comment moderation. Later on, as I remained banned - and persisted, she became more prickly, stating that Kevin had the right to "moderate" his blog as he saw fit - and had no real obligation to explain what he was doing or why.
Later on, Executive Editor, Peggy Peck, also made some easy-to-take-as-disparaging remarks about the number of readers of my little-blog-that-could vs. the number of readers of heavily-sponsored Kevin's. My forum was my blog, and Kevin could do as he liked - even as he told the world that every voice mattered. The message was very clearly sent that my physician's voice was not nearly as important as the butt-kissing blogging internist who seems intent on buryng his head in the sand when it comes to what some of his colleagues have endured on the front lines of medicine - and in the service of their country.
This response to a physician/fellow-blogger who signs her name is interesting in that my aforementioned "Mama-bear" friend reported to me that Kevin had once banned her too.
She immediately complained to MedPage today.
She told them that Kevin was being deceptive.
"Patients only think they have a voice (at Kevin's). There is a place online that shows the worth of his site, and the profit from more clicks. Ad revenue requires neutrality."
(Or at least the appearance thereof. It's the same trick the journalists pull. And no one is buying.)
She was very quickly unbanned.
She tells me that I'm not the only physician/commenter who is fed up with Kevin's tactics as a blog-owner-billing-himself-as-the-voice-of-his-peeps. She's heard from others who cannot seem to get past the smug little wizard's curtain (as have I). I'm not the only physician whose voice and commentary have taken a back seat to Dr. Pho's agenda-of-the-moment - and his desire to move on to bigger/better things.
My biggest frustration with Kevin Pho is that he positioned himself as some kind of big media "player" during the shameful Congressional fiasco that eventually turned into what is now called "Obamacare". Now, one would think that "social media's leading physician voice" . . . someone who KNEW what a fellow-blogging-physician had been through in public service . . . might have said something at one of those kiddie tables he and the AMA were sitting at in Washington . . . might have encouraged someone in Congress to contact Dr. Mary Johnson, formerly a Pediatrician in the National Health Service Corps, and talk to her before throwing more good money after bad . . . maybe even let her testify before the Committees that throw the money.
He might have encouraged the bureaucrats in Washington to clean up their act.
In the interest of justice, he might have also asked a national journalist/media outlet to look seriously at investigating and reporting my story.
But he didn't.
Because it was all about Kevin and how high he could go.
So call me independent and less-than-collegial, but I am calling BULLSHIT on Kevin M.D., Marrianne Mattera and Peggy Peck and MedPage Today. I'm availing myself of my forum, and the Internet is FOREVER.
Dr. Kevin Pho is not pulling back any veils. He's part of the problem now. Smoke and mirrors and pure self-promotion.
And in my humble opinion (as someone he clearly regards as a "nobody"), it ain't what blogging is supposed to be about.
In closing, where blogging is concerned, I feel like those one of those Angry Red Birds who die hammering their heads against walls built by evil pigs. But at least I'll die trying . . .
. . . and clean . . . as opposed covered in filth.
Author's Note: I'm going to pretend I'm Kevin now. Comments on this post are closed. As stated
early-on, I'm officially on a blogging break , and doing boatloads of Pediatric overtime in real-world rural North Carolina, so I don't have the time to moderate. That and at this point in the great scheme of things, I really don't care what anyone who might defend Kevin Pho's tactics thinks.
Because if they defend his tactics . . . in 2011 America . . . they're just wrong.
7/5 Evening Update: I forwarded this blog post to Marianne Mattera and Peggy Peck of MedPage Today.
This was Ms. Peck's response (it's in blue because it's soooooo progressive):
I believe this matter has been addressed, digested, and it is now closed. I see that you continue as an active blogger and I applaud your enthusiasm.
Very "John Robinson". This was my response:
Ms. Peck both you and Kevin Pho are as phony as it gets. It’s crystal clear that FREE SPEECH and journalistic neutrality/integrity mean nothing to MedPage Today.
Forgive me if I cannot applaud presenting yourselves to be
something you are not. You are LYING to the public you-all claim to want to
educate.
Digest that.
And/so, there you have it. While proclaiming to lead the way in representing the opinions and experiences of physicians online, MedPage Today and Kevin M.D. are shutting people out of the dialogue - a dialogue that Kevin edits or shapes by exclusion to suit his purposes.
It's despicable. And if I am enthusiastic about anything, it's about exposing liars and frauds in medicine.
It's despicable. And if I am enthusiastic about anything, it's about exposing liars and frauds in medicine.
