Don't become a doctor #17 - a checkered past

When I talk about the history of the United States, I use the word "we". We had a tragic history of slavery and institutional racism. We oppressed and slaughtered the indigenous people of this land. We fought difficult and deadly wars in Europe and Asia. But I wasn't a part of that, and neither were my parents who were immigrants to this country. I could not be more innocent to the checkered past of this country. But I was born here, and am an American, with all the positives and negatives that entails.

This is the part of being a doctor that people do not like to talk about. Being a doctor does not come with a clean white coat. It comes with a painful history. To take credit for all the amazing things done by physicians, we must also own all the terrible things we have done, and still do, and there are so many.

In the name of research, we have done things like the Tuskegee syphilis experiment, where we withheld treatment from participants for almost 30 years after penicillin was discovered to be effective. So egregious was this study that the government has forced any and all human research to be required to meet safety and practice standards, because we couldn't be trusted. And right they were, because we have also experimented on people in other countries, children, prisoners, and many other groups disadvantaged or with diminished ability to consent.

We have behaved like autocrats over the medical system, consistently devaluing and diminishing the roles and responsibilities of not only allied health professionals, but even the patient, to the point where we actually had to declare that a patient has the right to consent to treatment. Because we have, on so many occasions, fought this very point.

We have practiced our trade under the influence of business and industry, accepting benefits, gifts, and perks from all sorts of entities to influence the appropriate care of patients. There are no free lunches, but forget lunch. It was only 10 years ago that pharmaceutical reps could get a doctor vacations, trips, and outright money.

And still, we cheat patients, insurers, and Medicare out of money, to the point where President Obama's administration has stopped literal billions of dollars worth of fraud to Medicare. It's so bad, CMS has made a YouTube video about it.

So if you're coming into the profession of medicine, know that the ethical standard has now been set high, extremely high, because any less is not acceptable. And because we have done such a miserable job in the past of meeting any standard. If you're not willing to own the dark past of medicine and the failings of our peers, then you have no business enjoying the privileges of medicine.