"If you don't read the background issues first,
you will not understand why the American medical
profession and our healthcare is disintegrating rapidly."

    From the time the first medical schools in the United States started training and teaching medical doctors in this country, three fundamental myths evolved that continue to haunt our profession today.

At that time the predominant belief about the practice of medicine was understood to be a self-supporting profession that functioned as a necessary advancement in healthcare. It meant that the economic principle of supply and demand was what put bread on the table for doctors. It was fair and reasonable.

     Each physician developed his own financial support strategy, how it would be used, and what he could do to improve his circumstances—it was the rudiments of a medical practice business. This was the start of entrepreneurship in the medical profession.

     This professional standard and belief remained in force for more than a century without change. As the industrial revolution made its entrance into our society it completely changed our economic system. Large businesses soon created the platform on which the economy thrived. Pay to play became a ubiquitous trend that most considered to be reasonable
and profitable.

     Physicians were forced to adapt to the principles for business success even though Physician’s knowledge about business education and especially the segment of business having to do with advertising and marketing was grossly inadequate—and persists today.

     Effective Business principles for business success became widely accepted as the world economy changed, except for physicians. They proved essential to the development and advancement of all businesses and our economy.

     I will discuss more about the situation in this document, including how our U.S. government has planned and has been in the process of destroying the medical profession infrastructure for the purpose of gaining full control of our healthcare system over the last 5 or more decades.

The beliefs, standards and traditions in the medical professional system have not changed significantly with the times…

     What was proving valuable economically for physicians over more than a century within the medical education system, advanced truly little in comparison to what is required to manage a medical practice business currently. The belief in the three myths described next and the consequences of those beliefs even today, demonstrate how the medical school education system has become a willing ally of the government control of healthcare.

     And that alliance now includes the purposeful disintegration of private medical practice
as I see it.

     The origin of the first myth took root and continues to hold physicians hostage to the present day. What has happened in the past in medical education was deemed to be enough by the medical education scholars and the hierarchy of medical education to continue the same over the next century.

     They have taken no significant action to make any additional business improvement in medical school education that can provide a remarkable ability for all physicians in clinical medical practice to expand their skills and knowledge far beyond the limitations to their present-day efforts to survive.

     This means that all physicians in clinical medical practice today do not have the business tools to increase their incomes to a level that enables them to reach their ultimate desires and ambitions for the careers, family obligations and lifestyle.

     Who decided that all private physicians should accept and tolerate living a lower middle-class existence while providing outstanding healthcare to their patients during their
career lifetimes?

     This unchanging set of attitudes and beliefs within the medical education system and among the professionals that thrive in the system (physicians and medical educators) have drawn the red line that is not to be crossed. The consequences of that issue have set a trajectory of undisciplined and closed minds that have created the educational weaknesses in the medical profession permitting our government to continue to prey on to gain full control of the total healthcare system. And it is working well.

     The unconscionable result is that an ineffective universal group of medical practitioners and medical school scholars are holding to their dysfunctional belief that business knowledge does not offer any extensive value to fuel their efficiency, productivity, incomes, satisfaction, and ultimate quality of their medical care. What fools they are in not seeing the truth.

     Young physicians practicing today will likely find themselves in disagreement with what follows, but older physicians will quickly recognize where and how the real problems with the medical profession began. They were there and so was I.

     The belief in these first two myths by medical education scholars, physicians in medical practice, and those leaders in our profession who continue to support these beliefs/myths has provided the weaknesses within the medical profession system for our politicians and our government to use to bring our profession to the brink of destruction.

Medical School Education Myth #1

      The worst of the first two myths…“Doctors don’t need a financial, business, marketing, or economic education to practice medicine” was a wonderful and practical concern for physicians before the 20th century began. At that time payment to physicians for their medical services came in many forms (the same as in many business entities) was accepted. Trading goods, gifts in the form of handiwork and even animals were used to pay physicians.

     Because the world economy and culture has changed dramatically, our financial system is now dependent on reliable money management and knowing how to profit in a hundred ways from the use of it. Have you heard, “You can’t do anything without money?”

     Of course, physicians can practice medicine without a business education. Physicians have been doing that for over 200 years. Today, private medical practices are routinely having income difficulties. They can continue earning incomes that are half, or less, than what they could earn with a business education.

     Why would any physician be satisfied with that option? Maybe they were not informed at all during their medical school or earlier education (pre-med) of the incredible value and benefits that an academic business education would and can have on their professional careers.

     Business experts even suggest that most physicians leave an estimated million dollars on the table during their medical careers—and never recognize it. Why? Because lack of business knowledge blinds them. They don't know where to look in their medical practice business.

     What I am concerned about are those thousands of physicians who are in clinical practice today and lose their medical practices for financial reasons. Likely, most physicians are not aware of how many physicians in our nation have had to struggle through that desperate problem. “You made your bed, now live in it” comes from the mouths of the arrogant physicians who by chance picked the high earning specialties at the start.

     Of course, there are unsuitable options available to physicians who lose their private medical practices because they cannot make enough money to pay their bills. They can quit medicine or retire early which many are doing. They can start another non-medical career.

They can join an HMO or other government mandated medical care facility and play directly into the control of our government. Yes—their business needs are all taken care of by the managed care non-physician managers.

     I have not even mentioned about what happens to those physicians not making enough income. Why might you think that about 400 competent physicians choose “suicide” each year as one of the reasons for doing that?

     We all know the mental challenges resulting from divorce, disability, malpractice punishment, loss of medical licenses, medical board members bent on destroying doctors, and the ever-present interference of governmental rules, regulations, requirements, and unfair permanent restrictions.

     The problems with these options are often never considered. For example, physicians are trained to do one thing—the practice of medicine.

     If a physician quits medicine, he or she has not been educated in any other sphere of employment to satisfactorily qualify for another non-medical career. Standing in line at the unemployment office is rather embarrassing for most physicians. Being interviewed for a new job, outside of medicine, will not be supported by their resume that states, no formal
business education.

      Let’s not forget that these financially deficient physicians in private practice frequently can’t afford the necessary educational courses to keep up with their own specialty. They are forced to practice using their older knowledge and training, as their quality of care continually decreases because of that. This is not a rare situation.

     Clearly, large numbers of private physicians today are unable to afford the courses and training necessary to keep them on the cutting edge of their specialty. It got so bad 50+ years ago that the required Continued Medical Education (CME) requirements for renewal of licensure failed to be followed for lack of money to afford the travel, hotel, and
meeting registration.

     CME administrators changed the requirements so that physicians could obtain the CME credits locally without travel to big meetings and pay big money for the courses.

     Even today the CME credits can be obtained by physicians by attending local lectures about medical topics. As an OBG specialist I remember earning those credits by listening to the neurosurgeon talk about brain and neurological problems, a dermatologist talking about skin diseases, and other specialists that were smart and provided medical information that I would expect never to use in my medical practice.

     Is this the best way for me to keep up with OB-GYN knowledge? On the practical side of this issue, most physicians choose to focus on their specialty knowledge, not keep up necessarily with general medical knowledge primarily because they lack the time in a busy practice
to do so.

     As a profession we have all become a “tribe of slaves” for government control. We stand to lose all our expectations for our careers, our ability to reach our ultimate goals, and are forced to live in a professional world of increasing physician attrition, increasing fee restriction, and working increasingly harder and longer in our careers than planned.    

     Wouldn’t you like to know how many physician families cannot afford to send any or all their children to college? At least, being able to send them to the best colleges and universities is a legitimate desire that should be expected by any licensed medical doctor today. But it’s not.

     How about the large numbers of physicians that cannot make enough income to fund their retirement plan? Sure, being schooled in the United States over the last many decades without ever being taught anything significant about money management, economics, business management, marketing, budgeting, and financial matters must have something to do with the financial survival of physicians later-on in their private medical practice careers.

     Some physicians just blow all their money as soon as they make it. If they do that, then they have no income to advance their medical education, or grow their medical practice. Eventually their quality of medical care decreases. The physician's family and medical patients suffer as well. Those things rip these professionals apart, emotionally and physically.

     Anyone with a brain can understand the necessity for a business education that would benefit all physicians. Why has a business education never mattered enough to the medical education scholars to even mention it to medical students, let alone provide it? No wonder there are thousands of physicians in our nation battling money problems as well as our government mandates and restrictions on private medical practice. Add to all that the accrued educational debt that private physicians must manage.

     Wouldn’t you think that the average educational debt of about $160,000 upon leaving medical school would be a good reason to find the proper ways to pay it off the fastest? That monthly debt payment will continue for well over 20 or more years. Such debt forces physicians to relegates some more important financial needs to the bottom drawer.
      

     “Medical school education has not been upgraded enough to enable every physician graduating from medical school today to even begin to meet the business challenges required to effectively profit from their practices over time.”
    

     Wouldn’t you, knowing that medical practice is a legal business you must be capable of managing, believe that these professionals might gain a significant financial advantage, among others, by having the education, knowledge, and the tools of business to improve their
financial status?

     There is no evidence that this business education necessity will ever reach fruition. The absence of a business-essentials education damages everyone in our country. It is undoubtedly a prime cause of poverty in our nation. I believe that is one of the most underappreciated statement that anyone can ever make.

Medical Education Myth #2

     The second myth intertwines with these circumstances…“Doctors must learn so much more about medicine that there is no desire, impetus, or time for medical schools to incorporate a business education into the curriculum.” Such belief sounds horrible to those of us who are embracing the incessant arrival of problems to solve.

     "Physicians that elect private medical practice as their platform for clinical medical practice are concurrently and perhaps unknowingly choosing to maintain total control of their lives, destiny, and their medical careers are never going to experience their full medical
practice potential."

     Additionally, these confident physicians at the same time will be for the most part also making the choice of running their medical practice business without having the specific knowledge and tools (a business education) required for managing a tremendously successful medical practice business, or any business, as a matter of fact.

     Very few medical schools are trying to implement business education today with questionable success. You must hand it to them for trying.

     The few medical schools that are offering a business education for medical students are simply providing or offering an MBA type of business education from their local connected university business school

     The problem with that, I discovered in my research, is that the usual MBA education is far too generalized for doctors to apply successfully to their medical practice businesses. Simply talk to the medical students as I have who have entered medical school with an MBA degree, and you will quickly understand what I mean.

     Physicians need a “focused medical business education,” like can be found with Dan S. Kennedy and his business associates, a world expert in effective entrepreneurial business strategies and knowledge. An MBA will not provide anywhere near that level of knowledge, applicability, and success.

     Be aware that often the business-school teachers learn to teach business by extrapolating knowledge from books on business that medical students would benefit from as well. Most teachers of business courses have never owned or managed a business themselves. The best teachers are those who have had experience in business to back up their lessons. 

     The tragedy is that it may be too late to propose introducing a business education into the medical student curriculum because the current medical students have not been “mentally” prepped to take advantage of a business education, even if it is offered or available. Most students will not opt into the idea that having business education has any benefit or value to them in their medical careers until they have been educated about those benefits. You Know—talked about what it has to offer them.

     To make a point, ask yourself if you know exactly what your monthly financial statement in your practice is telling you line by line and be able to explain the details clearly to anyone else? There is not one physician in10,000 that can do that when asked.

     After about five years in private medical practice, they will learn that lesson anyway, but too late. Now, why would that be? The physicians already with that knowledge by this time are already five years ahead of those who don't, financially as well as in practice growth and current medical knowledge.

     Even worse, when practicing physicians finally recognize the benefits a business education might have to offer them in managing their own medical practice businesses, they have no backup. Well, they do have an opportunity to hire a medical office business manager for around $40,000 annually. Rarely will you find a physician wealthy enough by then, or incentive enough, to agree to give up their medical practice for two years while earning an
on-campus MBA.

     Would you do that? Would you defer any income for two years while in practice to spend $40,000 to $60,000 to gain an MBA on-campus degree? There is a far better way to accomplish that education found in Dr. Graham's book for about a $500 investment.

     My research reveals that most physicians refuse to take even the shortened and less substantial MBA courses offered, let alone read the business and marketing literature, books, DVDs, videos, and etc. Why not, if that is an important issue for one’s career? But, no one ever told them that.

     The obvious explanation is what is called “confirmation bias.” This wide-spread and totally unconscious brain function automatically responds when we are confronted by something new. We compare our previous knowledge and beliefs to the new situation and circumstances inside our nest of cranial neurons. Our ultimate decision among them normally favors our previous beliefs and what we already know—we cannot trust the unknown.

     The new issues and potential benefits, regardless of the enormous advantages, just are not trustworthy at that moment in time. There is a strategy in marketing that demonstrates this very clearly. You must mail your offer/advertisement/product information a minimum average of 7 to 8 times to a respondent before the prospect will finally open the mail you keep
sending them.

     The same reason exists here—you cannot trust that those pieces of mail have any benefit or value to you, even if there may be great value inside the envelope. Your spouse uses the same tactic to harp at you until you finally do what they want.
    
     Previously knowing and understanding the benefits of something new is key to raising your level of trust to the point that you can trust what is being offered to you.

     Each of these questions demonstrates why exposing the information, advantages, and direct benefits of a business education many times over are required to overcome the previous beliefs medical scholars, professors, and medical students already have.

     Only then does the need and desire build up enough, sink in deep enough, to ignite the minds of those who can perceive the extensive value it truly has and that supports their own ambition and career advancement.

1.  Do medical schools present the advantages of a business (includes marketing) education to first year medical students? 

     NO… it must begin in college premed courses with advisory staff instructions—and it
never happens.

2.  Do medical schools deny that they have any obligation to offer or furnish a business education to medical students? 

     YES… tradition is more important, it seems, than graduating physicians who could reach
their full medical practice potential—as it is now, they can’t.

3.  Are medical schools an essential part of the governmental plans to control the medical profession, therefore healthcare? 

     YES… medical schools create the business weaknesses by not providing a business
education, by not explaining the value of a business education in their medical
careers, and by completely ignoring any topic relating to a business education in
the medical school curriculum.

The government now uses those specific weaknesses to build their medical control
empire while destroying the medical profession.

4.  Is the lack of a business education of medical students a major compromise of every physician’s career, income, continued education, and their expectations for his or her
medical career?
 
     YES… a great part of the frustration in our profession is the fact that the governmental
rules for practice prevent any anticipation of their reaching their maximum potential
for income, skill development, and reaching their expectations about their careers.

Now, let’s get to the heart of the issue.

“Steps in the government plans for total control of the medical profession and healthcare...“

Step #1—Mandating Managed Care Facilities

“Divide and Conquer Strategy”

Planning must begin with the one objective that has the highest probability of succeeding and is easy to do. Because our U.S. Congress makes the laws, it was not hard to pass legislation that would create a major move leading eventually to control of private healthcare in our country.

Take patients away from the private practice physicians (who charge too much for services) and contractually force medical patients into government controlled managed care facilities (ones that guaranteed a reduction of the healthcare costs in our nation compared to private medical physician’s care and proved to be the opposite) was bad enough.

Of greater consequence, it permanently crippled the access to huge numbers of medical patients that independent physicians relied on for their medical practice income survival.

In essence, I call this plan, “Defunding Private Medical Practice.”

     When I started my private medical practice in the early 1970s, the national news media groups were searching to establish their focus and positioning strategies regarding the improvement of our healthcare system. The Democrats were in control of congress at the time and pushed their agenda for solutions to the availability and affordability of healthcare.

     As expected, the government strategies coordinated well with the national labor unions approach to resolving these issues. The perfect time for our congress to reveal their long-awaited plan for government control of healthcare was at hand. Labor unions and large businesses had been spending millions of dollars lobbying congress to do something about pushing their agenda for cheaper healthcare for members.

     The strategy was clever and obvious. Unions have strong voting influence in congress, so it was not difficult to convince our government Democrats to “mandate” a new system
for healthcare.

     Understanding that the means of passing a law to accomplish control of healthcare would never have made its way through congress with a presidential veto at the time, a mandate could accomplish the objective without much turmoil and legalese.

     The mandate served its purpose and enabled congress to control a large portion of healthcare. I suspect that the mandated system that showed up in the late 1970s—known as Managed Care Facilities—had already been on the table for over the prior decade. The legalization of such facilities provided for the management and control of delivery of healthcare under government supervision. It devastated the private practice of medicine across our nation almost immediately. It was the first step in the process of government control
of healthcare.

     The physicians were completely left out of the picture when it came to provide reasonable alternatives to a major change in the healthcare system. Unfortunately, the massive compromises of those alternatives forced on private medical doctors and patients still exist even more so today.

     The government mandate that legalized the process was exactly what the government needed to set the anchor for further intrusion into the control of healthcare. Managed Care Facilities were expected to be much more efficient for providing better healthcare to far more people and could do it cheaper than a conglomerate of private practice doctors working under the “supply and demand” economic format.

     It was a partnership between the unions and the U.S. Congress.

Our government created the mandate and gained control while the allied labor
unions celebrated.

The listing of private practice physician abuses that followed…

      1. The unions around the industries in the USA insured that all union
         members with health problems were required to be treated at the
local Managed Care Facility—not by the private physicians they had
         been seeing for years.
              It resulted in private physicians losing over a half of their loyal
         patients rapidly—the same as I did. Half of the income of private
         doctors was lost almost immediately.

     2. Loyal patients did not have a choice. If they decided to get care from
         their private physician instead, all costs of care had to come out of
         their own pockets. Wealthy patients had no problem with that, but
         very few doctors were serving only wealthy patients. Even loyal
patients had to defect to managed care physicians.
It was a happy change for many physicians locally who were
income hungry as a result of having no business and marketing
knowledge or education back in the 1970s. They left their mediocre
medical practices and immediately joined the mandated medical care
facilities that provided a reasonable salary and benefits. Even better,
no more business struggles or financial worries.

     3. Because of the rapid process of change where patients could get
healthcare, regular private physicians were forced to take what patients
they had still remaining and put up with their financial problems.
Again, this was a perfect time for our government to bite a chunk
out of the private practice physician population. When the incomes of
private doctors dropped to desperate levels, they had several
“unreasonable” choices to select from…

Quit practice—only a few quit, others were not willing to quit the
profession they dearly loved and spent so many years preparing for

Move practice somewhere else—cost to do was more than it was worth

Join the local HMO, etc. as many physicians had to do to get income
rolling again—why wouldn’t they?

Lastly and more importantly, the problem within the medical
profession that had been evident for decades rose to the surface.
Why would income and financial issues be such a problem?
 Businesses fail and start over again. People lose jobs and find
another one. What’s the big deal?... I’ll tell you why.

          Physicians train for one occupation—practicing medicine. When
     they lose their career or medical practice, there is not a broad
     choice of jobs or occupations they are qualified for nor have time
   left or money to use to obtain training for something new.

         The simple secret as to why this is critical to the medical
     profession and not to others outside of medicine, is that most
    employees have jobs in commercial businesses. They gather
     knowledge about business (on-the-job-training) which helps them
     obtain other jobs in businesses elsewhere.

         Experiential learning or on-the-job-training unfortunately is
    what over 95% of physicians have been using to survive financially
    in private medical practice for a century. How is it working for you?

          You may know what I am getting to. Is it too harsh to say that
    physicians are business ignorant—and that is, and always has been,
     a millstone dangling from around their necks? If you are a
     physician, have you ever had that feeling?

         If you do not admit it, then you have not taken the time to
    notice the thousands of physicians that have been disappearing
   from the medical profession annually. There is a particularly good
   reason it is happening and there is a permanent cure.

Planned Exploitation of physicians continues on a different front. Your HMO you joined did "what" to you?

      Understanding the answer to this question is critical to understanding the exploitation of nearly all private physician’s primary vulnerability—the extensive lack of business knowledge required to extricate their financially failing medical practice from complete failure. The problem continues to this day to be given a “pass” by nearly all physicians once they have left the halls of the medical education dynasty.

     For those of us that have for one reason or another participated in the HMO type of medical practice, you have learned how compromising it is to be in the position of “indentured servitude.” A certain percentage of physicians find a home in that “motherly” environment.

     There are, however, many advantages over that of private medical practice. Such things as never having to bother with or learn about the business of medical practice, which is all automatically done for them, is like heaven itself. It lifts a great burden off their shoulders that they otherwise would be required to struggle with in their private medical practices for
years to come.

     This is a perfect panacea for women physicians. Studies have shown that about half of them work as physicians only part time. Now why is that so significant?

     One can easily accept such a part-time role for lady physicians that often take on the extra family obligations associated with raising children. Good for them! But after that comes a flurry of questions that challenge some more universal issues regarding the purpose for and obligations of the medical profession.

     Ask yourself, for example, how much time and effort in the delivery of healthcare in our country is compromised by part-time medical practice when the need for even more full-time practicing physicians is urgent to care for the increasing population of older people today? Male physicians normally are full time physicians and have been replaced by approximately 25% of women physicians in medical school classes who become part-time practitioners.

     It looks like we have been reducing the overall number of available doctors to serve medical patients for years, instead of increasing the number.

     Obviously, the next question arises that will connect the discussion above to another weakness in the medical profession that opens a door for our government to gain even more control over our profession.

     Why is it that American males are drifting away from applying to medical schools and choosing to avoid a medical career? That gap in medical schools is being filled regardless. Are there any new medical schools adding new physicians to fill the gap? Certainly, not enough.  So, the recruiting weaknesses, the absence of males applying for medical schools, medical practice fee restrictions, part-time practices, and the ever-increasing physician burnout have become a critical set of weaknesses that allows our government a golden opportunity to take control.  

Step #2—Governments Intentional Use of Medical Malpractice as Leverage

"Our congressional politicians created another weakness in the medical profession
armor, for a purpose."

     The lack of our government (U.S. Congress) refusal to initiate any significant medical malpractice law reforms since the 1980s tells us that there must be a purpose for that. Nothing terrorizes a medical doctor more than to become a defendant in medical malpractice litigation. A simple medical unexpected and unintended mistake any doctor makes in the care of a patient can result in destruction of their medical career. It happened to myself and many others I personally know.

     Often, it will disrupt or even destroy their family as well. But the public and you, the reader of this, rarely hear about those devastating consequences.

     The plaintiff attorneys and plaintiff medical patients in today's courtrooms in these malpractice cases continue to receive excessive and outrageous monetary verdicts
beyond comprehension.

     So, for what purpose would our politicians continue to ignore any efforts at all to pass legislation that would be far more reasonable—especially the critical segment of the present malpractice law governing runaway verdicts derived from a section of the law named--PAIN AND SUFFERING.

1.  The fact that most of the members of congress are attorneys leads to the conclusion that medical malpractice across our country is a loud and highly publicized source of high income for attorneys practicing in that arena. This cash cow seemingly won’t ever be compromised by attorneys. Ya gotta protect your attorney buddies, right?

2.  Medical malpractice cases drive very competent physicians out of medical practice, many times even if they win the malpractice litigation. The threat of malpractice suits becomes a driving force for physicians to increase use of excessive lab tests, do surgeries that may be on the borderline of necessity, and avoid accepting patients that seem to have a confrontational behavior—just to avoid risk of a medical malpractice suit.

     During the time that I practiced medicine (1970 to 1994) in California, the statistical fact that medical malpractice suits were filed against one in three practicing physicians in California was a widely quoted issue. In other words, we all understood and tolerated that risk, knowing that we would likely become a defendant in a law suit every three years on average. I equated that risk with the risk of being killed on my tour in the "hot zones" med-evacs in the Vietnam conflict—either way, I felt that my future life-risk was comparable.  
 

3.  The only way a physician can survive in the raging world of increasing medical malpractice cases that often show up unexpectedly is to have more than adequate medical malpractice insurance.  In the past the cost of that insurance had reached levels that most physicians could not afford. Why did the cost rise that high so fast? Because the law permitted juries in California to award unimaginable amounts of money in jury settlements, far beyond reason or legitimate medical care needs for their injuries.

4.  The result is that our government has purposely produced and perpetuates a system of malpractice law, continuing today, that seriously weakens the medical profession vulnerability to such actions. It made it much easier for government to grab control of our profession while practicing under that daily threat day after day.
 

5.  The resolution of this threat lies in one area of the medical malpractice law—"pain and suffering”. It is the one area of the malpractice law that creates misery for physicians and big houses for attorneys.


The run-away verdicts show up commonly in this part of the law. California is one of the rare states in the mid-1970s that was forced to put a cap on the malpractice verdicts. Why? The simple reason was money. When the large medical malpractice insurance carriers run out of money paying off all of the overwhelming plaintiff verdicts from hundreds of malpractice cases, they stopped issuing medical malpractice insurance in California to all physicians.

Suddenly, all physicians in California reached maximum vulnerability to being forced to pay for any and all medical malpractice verdicts against them from out of their own pockets. The alternative for continuing medical practice in California offered very few satisfactory choices such as, start practices in other states, practice without malpractice insurance in spite of the high risk, or use medical arbitration forms with medical patient signed agreements.

Younger physicians today likely have no knowledge about this problem that forced all medical malpractice insurance carriers out of California for about two years—forced physicians to either go “bare” (going without medical malpractice insurance) or use arbitration agreements with their patients. Once the legal cap was put on the malpractice verdicts in California, medical malpractice insurance carriers came back into California with much more affordable rates.

However, during those two years of abstinence, several physician and medical entities quickly created malpractice insurance coverage for physicians in California which enabled physicians to stay in California and continue to practice medicine there.

Many of the states surrounding California saw what was happening to healthcare. About seven of them eventually also created laws to cap jury verdicts to protect their own physicians from leaving. I have found no evidence that the other 43 states ever did the same thing in the past 50 years.

Although the malpractice insurance rates remained at a reasonable level over the last 10 years, the rates are increasing again to intolerable levels, especially for physicians practicing in specialties that carry higher risks for patient care. Very little improvement in medical malpractice law and coverage has been made since then, across our country, and likely won’t happen in the years to come.

Consequently, all practicing physicians across the country continue to be exposed to the extremes of medical malpractice litigation starting from the first day in private medical practice. During their medical training (Internship and Residency), physicians practice under the same malpractice risk.

Step #3—Government hijacking the public and higher education systems...

If students are never told about the essential importance of learning, understanding, and using our financial systems, how would they ever become literate in the use, value, and benefits of them in life, or in any profession or career they may become part of? Physicians in general are just as ignorant about business and money as the rest of the population is. Financial inheritance is one way to escape from that trap. Most of us do not have that advantage.

Preventing all citizens from gaining financial knowledge by means of the public-school education system is a divisive and deliberate means of creating an ignorant population susceptible to a multitude of manipulative consequences. 

The ability of government to control the public education system, kindergarten through high school, college, and graduate school by ignoring any significant economic, financial, money management and business essentials is no secret.  If we had received that essential knowledge, we would be intelligent enough to see through the smoke screens our government and other financial predators present us with daily.

Now you must wonder why over 60% of our physicians admit to having serious frustrations with practicing medicine. The issue is not with our patients.

Burnout is now one of the causes of that frustration and there doesn’t seem to be any satisfactory cure for that yet. It isn't surprising to those who are reading this treatise.

Medical Economics magazine publishes large numbers of articles telling physicians how to earn more income. About 99% of articles tell physicians about how to earn more money by working harder and start doing things that they have already been doing. It should be a wake-up-call to the fact that a doctor's whole education, up through medical school, is a perfect example about what is lacking in their business knowledge. Otherwise, physicians would promptly create a marketing system, become educated in business principles, and would already be doing what all those articles are telling them to do.

Isn't it amazing that all other successful professional businesspeople learn and know all those requirements necessary for persistent financial success, while over 95% of physicians never seem to find out about until they begin to notice that their monthly income has been decreasing over the prior three months? And they have no idea how to reverse the process.
     
I strongly believe after practicing for 40 years (military, HMO, Hospital, private practice experiences) that the far-reaching disappointment and frustration with medical practice can be drilled down to one single cause. If you have an open mind and can put-away your previous biases temporarily, and let your entrepreneurial-mind enable you to crawl out of the box of self-limitations you created for yourself, maybe then you can coax yourself to listen to this invaluable set of ideas…

1.  All money (income) is derived from one kind of business or another. You can’t do anything without money/income. Knowing this fact, isn't it reasonable to understand, at the very least, that we all should learn as much as possible about business principles and marketing strategies? It is not my idea, it's something all business experts abide by and stand for.

2.  For any business to survive and become successful every business owner understands that the established business success principles must be followed. The fact that 95% of small businesses fail within five years of inception happens because the essential principles for business success are not known, therefore never used. Business ignorance (the lack of business tools) is the ultimate cause.

3.  Over 95% of physicians graduate medical school without any formal business education. Knowing that medical practice is a legitimate business entity, what do you believe happens to the 95% of physicians in their medical careers? Business experts will tell you that any physician in a private (clinical) medical practice that is business ignorant (no academic education in business) will, at the very least, leave a huge amount of income on the table during their medical career without ever realizing it. It’s something that should never happen to any physician. I repeat that idea to trigger you to do something about it.

4.  The importance of understanding the above three factors sets the stage for the wide-spread frustration in the medical profession. The key solution to these issues is money/income. Have you asked yourself the questions that point directly to how business knowledge and your income are interrelated?

       “When you are business ignorant, you lack the business and
         marketing tools you need to insure that you can earn all the
         money you need or want, whenever you want, and enable
         you to meet all of your family and personal financial
         obligations without worrying about money issues.”

If this is true, then why is it that physicians are so willing to accept what is handed to them rather than believing the business success facts that all successful business people
know and use?

I believe that the tradition of medical school culture “dictates” (Myth #1 and #2) the reasons. All medical schools are responsible for providing a complete business education. The lack of explaining the value of a business education to medical students in their first year of medical school creates the belief in the student’s mind that learning about business must be
useless to them.

     The barrier is the arrogance created by subtle brainwashing of medical students by the medical school academic community. Have you ever asked a doctor if anyone told them while they were in medical school that it would be a good idea to have a business education?  Rarely if ever. Ask any physician his view and learn the truth.

5.  Having the ability to make or earn unlimited amounts of money, is the undebatable way to eliminate the frustration in the medical profession. If you know or have met a wealthy physician, you know that…

     ---they enjoy their medical careers
     ---have fewer complaints than others
     ---have access to (can afford) all educational upgrades/training
     ---are able to meet every expectation they have had for their careers
     ---can pay for their kids’ education anywhere in the world
     ---have no worries about retirement income
     ---avoid most all the frustrations permeating medical careers today
    

By keeping our population ignorant of all the functional elements composing the world economic systems, leaves all of us vulnerable to the governmental control of everything—especially the medical profession.

If you are now asking yourself, as you should be, why is there a universal absence of money management in our grade schools, high schools, colleges, and even professional/graduate schools, when we know money enables everything.

As I have pointed out above the foundational effects of money on our lives, the ever-critical requirement for our education in all financial circumstances should be overwhelming us. But it isn’t. Our children and adults are being sacrificed on the altar of poverty for a reason. It is our greatest weakness for exploitation. And physicians are a #1 target.

Is it any wonder that physicians are also being sacrificed in the same manner and for the same reason… government control?

Is it any wonder why physicians are so easily affected, even trapped, in their ignorance of the benefits they could derive out of an academic business education?

Even very intelligent professionals can’t fathom the depth of such a disaster when it’s smack in front of their eyes. This is especially true of the medical education scholars/educators who “see no evil” in the medical educational system as it stands today.

Should you be skeptical about these important issues, you might want to dive into a revealing book written by G. Edward Griffin, titled "The Creature from Jekyll Island." It's about a monster known as The Federal Reserve, how it got started. When you are done with it, you will understand why the financial power of our banking system and government financial system has a national debt of over $30 trillion dollars and continues to grow. Also, know why their primary objective for making money and funding the government entitlements is to keep everyone in debt all the time.

(Author's Note) At this point you are likely to know most of the critical issues related to how deeply into the planned government takeover of the healthcare system has already become. From here on you will begin to understand that the destruction of the medical profession as a stand-alone profession involves blatant and persistent personal attacks directed towards physicians themselves. Squeezing the life out of what is left of a worn-down, burned-out, and struggling medical profession is all that's left to attempt to restore.

Step #4—Governmental Legal Requirements forced onto Physicians who are in Private Medical Practice

Remember the Government's Plan: First you must separate medical patients from private doctors as noted above with legal mandates. Then you take advantage of many of the obvious weaknesses that have been created within the public, governmental and professional systems by fortifying them against being changed.
Now that the basic foundations of the medical profession infrastructure and support system have been compromised to a predictable degree, it is time to force the physicians themselves with their own weaknesses into the trap.

The prior 3 steps above were designed to enable our politicians to legally force, bribe, and convince physicians to abandon private medical practice. It’s not a covert plan. It’s out in the open. They can do it because there is no authority other than God above them to prevent it. Perhaps the corona virus will now move the plan into high gear as I expect and now see Biden doing it all unapologetically.

The lie is that they can do for healthcare what physicians have not been able to do. The primary medical administrative organization (AMA-American Medical Association) supporting physicians has been ineffective in the battle against congressional power and takeover.

They never explain publicly what they are doing for us, how they do it, what the focus is on, nor what effect it has had on our medical profession. Perhaps they prefer that all practicing physicians in our nation not know what they do because it's none of our business. If they consider that the publication JAMA reveals it all to us, then I've missed all that information.

     The AMA provides services to physicians that are valuable, but their lobbying sucks.

     I haven't seen any information in the news media about the efforts of the AMA in recent months. Why is that so? Maybe they are hiding for a reason.

     Trying to get a group of doctors to agree on anything is extremely difficult… especially about political maneuvers. Not only are most physicians arrogant to some degree, but also are taught to be independent thinkers. But that has never been enough to protect our profession to any significant degree. Actually, it is a deterrent.

     The possibility of a physician show-down with our government would be like using a Dixie-cup to empty the ocean. A physician's instinctual desire to provide exceptional diagnosis, treatment and follow-up healthcare for every ill or injured person in the world has opened up the greatest vulnerability to survival in medical practice.

     Physicians tolerate a continuous barrage of new and increasing restrictions, laws, mandates, and requirements from our government today. They do it because their passion to cure the ills of society is first in their hearts and minds. That is also the weakness that the government and their allies use to keep physicians in line—and it works every time.

     The medical profession has been weakened that much! And politicians celebrate their accomplishments behind closed doors.

We need to examine the weakening factors.

1.  The most urgent issue is the fact that over the last 60 plus years, private medical practice has gradually been disintegrating. Why?

     As the government has successfully tightened the economic and legal restrictions on the practice of medicine, one by one practicing physicians have been keel-hauled by our government. Physicians all have limits to their tolerance for these increasing restrictions and requirements. Over time they just give up. And that has been an essential part of the government takeover plan.

     What they planned is happening. Physicians quit practicing medicine 20 years before they intended. Some restrict their medical practices to avoid potential malpractice threats. Others just get sick and tired of the increasing requirements that forced on them to quit medical practice. Suicide in the medical profession is not rare. Limits placed on physician’s fees today prevent them from keeping up with the current medical knowledge.

2.  The inability of physicians to make enough money to stay in private medical practice (keep their offices open) because of their lack of essential business knowledge, either forces them to find a new job or join an HMO type of managed care facility.

     Physicians stumble along financially in medical practice because they lack the required business tools needed to make money from their medical practice business.

3.  Over 50% of graduating medical students are headed for jobs in the medical managed care industry. Because of their huge educational debt (said to be an average of $165,000 per student) and the financial stress of opening a private medical practice, under present income restrictions on medical practices, they are forced to find a medical job just to survive.

     If a medical student had had a grade school, high school, and college (premed) business education along the way up the education ladder, they likely would have no problem financially handling either choice.

     They certainly would have an essential knowledge about how to overcome those financial barriers. Thus, we are far more willing to overcome our debts, which makes the choice for private medical practice more appetizing. The sober part of their intent involves trying to find a job in a managed care facility which is now overrun with applications, let alone finding an opening in an area of the country they want to live in.

     I’m wondering what their families are thinking about this problem? Our government certainly is not thinking about that issue at all.

4.  Another weakness our profession has—Medical care is centered in the larger cities...
Many physicians choose to practice in rural areas where there are no easily reached larger medical centers to refer patients to.
     These groups of primary care physicians are now having a difficult time financially. Without a business education they do not truly know how to get the most income out of their practices.

     In essence, physicians do not know how to make top levels of money!

     Many leave private practice to join an HMO facility.

     Patients out in the rural areas suffer the consequences of not having a doctor close by or must drive long distances to get medical care. Eventually this scenario will reach a point when there will not be doctors available in rural areas anywhere.

     Any private physician that chooses to care for a Medicare patient is not permitted to charge for their medical services more than what the government law stipulates.

     And that fee is so low that many physicians refuse to treat Medicare patients. Physicians that treat these patients inevitably accept a lower middle class life pattern along with their families.
It is truly a long run for a short slide in terms of what these physicians invested in their years of education and training.

     I honor those who are willing to sacrifice that much for treating Medicare patients. Now, most physicians cannot afford to do this because of the sacrifices their own families must accept
income-wise. Eventually, nearly all married physicians experience some family and
financial problems.

Step #5--Medical Schools implement the
government takeover plans.

     Talk about being in bed with the enemy, medical schools know which side their bread is buttered on. Just take a minute to think about how much money is provided to medical schools by our government using tax-payer money. The government does not earn any money, it just spends the tax money that it collects from all its citizens and businesses.

What would happen if the government ran out of money to support medical schools?
    
Without thinking too deeply, most medical schools would either have to close their doors or establish another source for funds. Consequently, medical schools are deeply indebted to our government. As many colleges and universities across the nation have discovered, raising tuition fees seriously reduces enrollment.

     Raising fees for medical school education will eventually do the same. Might that strategy reduce the number of physicians practicing medicine to intolerable levels? Absolutely.
   
     The obvious conclusion is that the whole medical education system and the medical schools are being held hostage financially by our government. You know, "do as I say," or take a hike. What are you thinking right this minute? Likely, you are wondering who exactly is responsible for what is financially happening to all physicians in private practice today? Maybe you just haven’t heard? 
  
     Some individuals think that physicians are creating their own problems. The thought is, if they are smart enough to get into a medical school, then they are smart enough to know that business and financial knowledge is not going to be taught to them in medical school (rare and feeble exceptions). They don’t need it, right? The medical world says so.

     If no one ever tells them how it would help them financially and explains to them how it will benefit them, then what student would even think about that themselves. Maybe 1 in 10,000 would be reminded of it and then do nothing to make it a reality.

     The same is true for over 95% of physicians that finally, years later, recognize the value of business and financial knowledge and then it is too late. By then, most private medical practice physicians are already standing in financial quicksand with no way to pull themselves out.

     For thousands of physicians the dreams about their many expectations they had originally for their medical career… disappear. Once they find themselves in private medical practice, earning only what they can barely manage to earn on their own, their medical career changes from being a delight to that of being a frustration.

     People wonder why these physicians are so frustrated today? Sailing along making reasonable income starting out has now become something that most physicians won’t talk about.

     Just the thought that any physician has about “financially failing” in their career efforts, after studying and learning all those years and having spent all that money on a single education effort and goal, creates permanent mental and emotional scars that hound them for the rest of their lives. Our memory banks do not let go of them.

Is there anyone today who believes that any medical school in the USA can survive financially without government help?

     Let me give you a current example of how that happens. From the current published edition of my own medical school's magazine, dated Winter 2020, my medical school reports that it ranks consistently among the top medical schools in the nation in research funding from the National Institutes of Health (NIH).

     My school received $493 million in awards across 970 research projects, earning the third highest total among medical schools in the USA.

     Wouldn’t you think that that amount of money given to any medical school would be the result of a well agreed to arrangement with the government on a persistent basis?

     Certainly, it is for a good cause that we all benefit from in one way or another. With a bit of thought, one can understand the deeper implications of such an exchange of money for services. The government requires results from the medical school in terms of improvements in medical research that make a significant difference in healthcare long term. Someone must do the research. Consequently, medical schools provide for and stimulate medical students to choose a career in medical research.

     The medical students that convert to the medical school PhD program during medical school further reduces the number of practicing physicians.

“Our politicians and government have covertly created and enabled a complete medical underground organization and infrastructure that continues to create vast changes in the
medical profession.”

     My futuristic views remind me that the purpose of it is to totally replace, when possible, the medical profession with midlevel providers. And are doing that while publicly assuring everyone that they are doing it for the betterment of all.

     At the same time it reminds me of the many physicians in certain medical specialties that seldom practice clinical medicine. Their efforts are important to support the clinical medical professionals, but seldom medically interact with a live patient themselves.

     There are primary and important supportive specialties for the diagnosis of disease or trauma issues but some are not actually in clinical medical practice directly as some believe. The conflict can alter healthcare statistics as well as government healthcare policies based on those
unreliable statistics.

     It all seems to melt down to such questions as, “Do we need Obstetricians when nurse midwives can do about everything without them.” Would that become an acceptable choice in government healthcare policies should the right circumstances show up, now that the government already controls it.

     After all, nurse practitioners are already managing the care of thousands of medical patients today. To give the midlevel healthcare providers a boost in their egos, not their comparative quality of care, the transition of the meaning for the words “doctor” or “physician” has now become “medical providers,” the same as midlevel medical providers are called. It is essentially downgrading the value of physicians.

How medical schools make it easier for government (politicians) to control the medical profession.

     When medical schools state that they have no time in their medical school curriculums to teach medical students about business and marketing, they are intentionally helping the government takeover of the medical profession.

     Permitting graduates to remain ignorant about business, therefore are subject to financial problems and weaknesses produced in private medical practice. Physicians in private medical practice become perfect targets for being recruited into the government controlled and mandated healthcare system because all other options for them are even more intolerable—like quitting private medical practice

     Medical schools readily admit that they have absolutely no responsibility for educating medical students in business or even providing or offering that education to students. Yet they certainly know the financial consequences of that decision for most physicians.

     Thankfully, a few more decisive schools feel quite differently. My belief about this issue is quite clear. Is there a significant amount of competition for recruiting medical students among the medical schools? You bet!

     My intuition tells me that as soon as these few medical schools are able to provide or offer an academic business education that results in a profound advantage financially and for practice management to their students that those medical schools will become top choices among application candidates across our nation. When that happens, other medical schools will be forced to do the same for their students.

     It will completely change the medical education system for the better by providing the long-awaited advantages that physicians have needed to enable their ability to reach their maximum potential as physicians. And hopefully it will take place fast enough to save private medical practice from disintegration. This one result has been my dream for the last 15 years.

     Until now, medical education has focused on jamming all the medical education they could into the student’s minds, in spite of the fact that much of it probably will never be used. Graduating physicians will advance higher and further in their careers. The priceless advantage they will have, is knowing how to efficiently, effectively, and profitably manage their medical practice business.

     Those other physicians, uneducated in business principles and tools, spend a lifetime in their careers pretending to know how to run their medical practice businesses. Their arrogance about this is not surprising. That arrogance is powered by the “two myths” discussed above.

     The real tragedy is that every single physician graduating from medical school today (about 19,000 annually) are destined to work incessantly long hours and overtime in their private
medical practices.

     For their 30 or more years in medical practice, they will earn less than 60% of the income they could have earned by adhering to successful business principles (that they are never taught or may have accumulated themselves).

     This tragedy hopefully will cease to exist in the medical profession.

     The real benefits would be experienced by physicians who have an academic business education under their belts by the time they graduate from medical school. Every physician will have the business skills, tools, and passion to use these during their medical careers to accumulate the income necessary to...

****Afford to access to all new medical training to advance their
knowledge and skills anywhere or anytime they choose

****Avoid the common traumatic experiences associated with
loss of their medical practices for financial reasons—think
unfulfilled expectations.

****Never worry about retirement income again

****Meet all financial obligations to their families and themselves forever

****Contentment in practice that, like a machine, revs up and
slows down production depending on the desires of the
physician--not government restrictions

****Bypass Government restrictions, especially on income, that
will not interfere with desired practice income because o
the business tools that enable it

****With maximized income, the practice frustration, disappointment,
and burnout have no reason to exist

****Overtime work and patient care extending beyond the
9 to 5 hours will not be needed—called working smart, not hard.  

Remember; These benefits, unfortunately, are not available to most private practice physicians today.

Personal note: My best friend in my medical school class, in spite of my discussing these issues with him, continues to believe that I'm nuts and that he, in his Internal Medicine private practice of 40 years, could ever have done any better financially in his medical practice than he already has. Like so many physicians across our nation over the last century, they have become victims of their own arrogance, "they don't know what they don't know, and they don’t care."

“The cause of man’s problem is lack of knowledge.
It does not stem from a shortage of information,
but rather from rejection of information.”
Hosea 4:6

Step #6—Physicians are covertly forced into indentured servitude where they can be controlled.

     “If you can create a situation where patients are no longer available in enough numbers to private medical doctors, where patients are given no choices about where they get their medical care, where the educational debt accumulated for physicians requires 20 years to pay off, and where medical practice legal mandates and restrictions increase annually for private practice physicians—you have a perfect plan for the control of and destruction of the medical profession.“

"The government plan for ultimate control and destruction of
the medical profession is going far better than expected."

     What seems to be the last resort for practicing physicians today leads to a significant reduction in quality and effectiveness of medical care, as us older physicians know. I'm talking about the open and pleasurable personal interaction between the medical patient and the medical doctor. Does physician rapport lead to improved medical care? I know so.

     Now that our government control of healthcare has reached its highest level to date, our government must next eradicate the remaining elements of private practice of medicine where physicians are still able to control their own careers. The job of accomplishing that, however, has reached an impasse that has been and remains as difficult as trying to pass a camel through the eye of a needle.

     There has always been a certain group or percentage of physicians who love to practice medicine and interact with patients as friends, rather than as suffering folks that simply need a quick prescription and reassurance while the doctor is going out the exam room door. Those of you whose healthcare is dependent on the managed care industry physicians know exactly what I am describing here.

     Most patients that maintain a friendly and social relationship with their physicians derive considerably more benefit from their medical office visit health-wise than HMO physicians. The disheartening aspect of it is that those managed care physicians know this deficiency better than anyone else but are working in a tightly controlled healthcare environment and workplace which has rules for patient care that they choose to tolerate.

     To work under the primary objective of increasing the profits of the managed care hierarchy, demands rules and a whip—obey or leave.

     Stiff medical practice guidelines and requirements are necessary and essential to mass productivity, persistent rise in income for the facility, and military like requirements of that facility. It will always be about money and control in the forefront of our government's
primary intentions.

“For managed care facilities, hospitals, and other contracted healthcare employment environments, the ultimate goal is to require physicians and other accessory medical personnel to produce enough income from seeing and treating enough patients to pay all salaries, business expenses, and administrative costs for the medical business that runs the money machine.”

     The same is true in lesser degrees for a private medical office, the physician(s) and employees.

     There is a significant difference, however, in the numbers of employees that are required to do the supportive and maintenance tasks of a private medical physician's office than is required for a managed care facility in costs, time, and training. Larger size requires many more employees, materials, legal services, and oversight personnel, to name a few. And you all already
know this. Right?

Of critical importance is to recognize how our politicians and our government “work” the healthcare systems to their greatest advantage. One must ask themselves how the politicians managed to work the healthcare system so successfully…

How did so many American physicians end up on governmental salaries and indentured to others who control their medical careers?

     Have you noticed that today, compared to 50 years ago, when you meet most any physician in their medical office or in hospitals or in HMO’s that over half of them are foreign doctors with an "origin" accent? Does that make you wonder where this increasing trend is headed?

Well, the steps in the sequence start with a quick review…

A. Pass a law/mandate approving a managed care system. That happened because of demands by unions/industry for cheaper healthcare for their members. The mandate (for example) requires that all labor union members across the USA in contracted healthcare be treated by HMO or managed care physicians. That forces all medical patients covered on the contract to dump their private doctors and move to Health Maintenance Organizations for their medical care.

B. Restrict private practice physician access to patients results in…

     Private medical doctors are left unable to rebuild their practices. That is caused by the vacancy of patients that were forced to leave their private doctor. Of course, the HMOs, to look unbiased and not outrageously competitive to the private physicians, offered a compromise. This
was the deal...

     Patients that are contracted with healthcare at HMOs, under “uncommon or unusual” circumstances, are permitted to see their private medical doctors. That may seem to be very reasonable option, until you read the fine print.

     First the plan “steals” the private patients, followed by requirements in a contract that essentially blackmails private physicians, already suffering financially from the reduction of their practice patients, into signing a contract. Some income is better than no income for private practice physicians left without options. Read what that really looks like next…

C. Contracts can be a punishing and restrictive tool.

Private medical doctors must sign contracts with the HMOs to care for HMO medical patients. These contracts require the local private medical physicians to agree to see and treat those medical patients, only if they agree to a 30 to 40% discount in their fees. The fee structure is almost the same amount charged for Medicare patient visits. It is the same fee range that results in medical practice financial failure. And that is another means of forcing private physicians, who need to rebuild their practices from the left-over scant community of patients, to comply.

D. Reducing private patient availability = financial deprivation
    
Medical doctors learned early-on that they could never survive financially in their private medical practices, even if they were able to see 60 or more HMO patients or Medicare patients a day in their offices. Seeing sixty or so patients each day equates to reduced quality of medical care and more superficial care. The average time that a physician sees patients in their office each day is about 8 or less hours a day depending on the specialty and medical problems.

If you divide 480 minutes by 60 patients, it means there are only 8 minutes allotted to each patient in the exam room with the doctor. Remember that part of that 8 minutes is to learn about the patient’s medical problem and more time at the end for writing prescriptions or instructing a patient. The rest is used for a quick physical exam by the physician. That 8 minutes is fine for a sore throat, but what about the need for a pelvic exam and disrobing for that?

Talk-about pressure day after day that the physician must live with.

These are similar issues that medical patients are forced to put up with, at the same time. Neither the doctor nor patient are satisfied with that set-up.

Managed Care physicians have an obligation to see such a volume of patients daily that they usually only have time to diagnose and treat one patient problem per visit. My patient visits at the Kaiser Clinic were limited to 15 minutes maximum.

     Let me give you a common example of how that works....

     After waiting a month or two to get an appointment with the private practice physician, most patients have more than one health question, medical issue, or health advice need, and all are handled on that same visit. Spending the time with patients to do that, knowing that it is the best care, is why private medical doctors are not willing to, or are able to, see sixty patients a day and go home believing they have practiced good medicine. Many private physicians stay overtime or see scheduled patients in evenings or on weekends for financial reasons.

Managed care physicians do not have to do that because they are paid for their work time and not for the number of patients they treat. This may have changed since I worked in that healthcare environment, but I doubt it.

Increased healthcare competition is an undermining tool.

The healthcare competition between the HMOs and private medical doctors continue to be profound and destructive to private medical practices. It means that private physicians have to work much harder and longer in their careers for incomes that are far less than HMO physicians—so why are private physicians willing to do that?

E. Educational debt is the primary driver of physicians into managed care practices today. It's part of our government's plan.

     The costs of education are rising annually. It is another reason there is a constant migration of graduating medical doctors to HMOs and other managed care facilities. With a total educational debt averaging around $160,000, the day a medical student graduates from medical school, who can afford to start a private medical practice after internship. Yes, only the wealthy ones
(family money).

In the last few decades, the escape route from debt and private practice expense has led to other problems such as…

F. Physicians are only trained for one career—medical practice.
 
     When any physician becomes separated from their career in the private practice of medicine, regardless of the reasons, he or she is faced with an unanticipated challenge that usually has intolerable consequences. Jobs for physicians outside their medical careers commonly lead to significant downward changes in their families, lifestyle, income, and ambition.

     To the contrary, business professionals out of work have no hard problems finding appropriate employment. They are knowledgeable and trained in business foundations which are a requirement to be hired for almost any worthwhile good paying job.

      Most careers are built on increasing business knowledge and skills. I can think or only three professional careers where business knowledge is essential, but is totally lacking: physicians, dentists, and lawyers.

      What may happen to physicians expecting to practice in an HMO eventually may be associated with disturbing consequences. The available opening may be in an area of this country where they refuse to reside. Beggars cannot be choosey. That position opening may be somewhere that would compromise their long hoped for way of life—consider boats and surfing in the middle of Vermont. Not having access to college towns where your wife/spouse even kids could increase their education level, might sway one's decisions.

      Ultimately, you may decide to remain un-married and put up with what you are offered. It may not be a good or suitable ending for any physician that prefers to retain control over their personal lives and careers.

      There is one positive factor. They may choose private medical practice after all. Statistics show that about 15% of physicians move somewhere else each year so those spots need to be filled—if you can find them.

      Joining a private medical practice group might be the right move for those physicians.

Step #7—By our government creating a barrage of increasing restrictions and mandates required for private medical practice physicians to abide by, it ensures that private medical practice will become impossible to tolerate and many more will quit medical practice than ever before, or avoid the medical
profession completely.

     “If the politicians can create an environment that will not only make the private practice of medicine so stressful for physicians, that medical school recruitment will eventually have to be drawn totally from foreigners who now compose nearly one-third of med school classes today.

     Such a situation may result in fewer college eligible American students applying to medical schools once they understand that a physician’s life of indentured servitude is not what they are looking for.

     Physicians, who do as they are told, practice as they are told, happen to be exactly what our politicians and government want for its medical providers. When the politicians succeed in accomplishing that, I would expect that it will likely require a new national holiday
on our calendars.”

The most important question is... What are the factors today that continue to fuel our government’s plan and ignite our politician’s irrational passion for elimination of
private medical practice?

     When private medical practice is eliminated, our government will have total control of healthcare and will have no further need for medical school recruitment.  Med students will be assigned, and medical careers will be manipulated extensively for-profit reasons.

From this list of destructive factors below, that continue to erode the private practice of medicine, anyone can understand why so many American students are no longer applying to medical schools.

1. Medical Malpractice reform is dead.

2. All physicians are frustrated/angered to some degree about
    medical practice restrictions, whether employed or in private practice.

3. There is no end in view to the increasing restrictions on the practice
    of medicine by our politicians/government.

4. Nearly all medical schools refuse to offer or provide a business
    education for med students.

5. Private medical practice has no politically powerful/influential allies.

6. Physicians accept what is handed to them like wimps.

7. Medical professionals lack respect from patients, even their peers.

8. Government control is increasingly replacing medical doctors
    with less educated healthcare midlevel providers.

9. Medical Boards are increasingly biased and punitive.
    Members are appointed by politicians.

10. Neither college premeds nor first year medical students are
      informed of the advantages of a business education and its
      monetary value to a medical practice career.

11. Medical students are left to believe that their high expectations for
      their clinical medical practice careers are attainable. That daydream
will continue to perpetuate if private physicians are unable
      to earn enough income to turn it into a reality.

12. Surveys reveal that over 70% of physicians are frustrated in practice.

      

Step #8—The substantial factors that are evidence of the disintegration of private medical practice and the medical profession.

     These facts and admonitions are not only proof of the pending demise of the medical profession, but also serve to illuminate the fact that nothing of importance is being done to alleviate the increasing barriers which will ultimately lead to destruction of the medical profession. If anything is being done, the efforts are hidden in the closets that line the halls of
medical pundits.

The facts that can easily be recognized. So, let’s talk about a few of those...

1. Burnout

     This descriptive word has become the key word for articles, publications, discussions, and personal planning throughout the medical profession arena and most of the supportive tributaries surrounding the profession.

     The problem is not what is being debated, but what never reaches the eyes and ears of most medical patients and the public.

     At present, the public commonly is unaware of how serious of a problem this is for themselves and even for the physicians.

     The public rarely pays attention to what happens to all those “rich” doctors. The public is ignorant of the numbers of physicians that are quitting medical practice annually in our nation. It is never in the news.

     Physicians rarely go public with the issues they have and how they feel about them, even to their friends. Divorce rate is a bit higher than average in this profession population.

     Suicides among physicians (about 400 physicians per year) are kept quiet. Incidentally, that number is about the same amount as one medical school (all four years of classes) annually wiped out. Stress is a great perpetuator of that tragedy.

     How about the stress of medical malpractice suits that have the capacity to completely wipe out a physician’s finances, family, reputation, and career? There is no way to predict when or if that will happen during any physician’s practice. Nearly all those malpractice suits result from unintended treatment results, so physicians must live with that possibility daily in their careers.

     Do you think that any error, complication, or outcome is an intended injury process by any physician, knowing that all hell will come down on his or her head promptly? All physicians believe that the power of the elected attorneys in our government will never permit any helpful revisions in the malpractice law as it is today. That means runaway jury verdicts of multiple millions of dollars with no cap placed on the “Pain and Suffering” segment of the verdict will
continue forever.

     How would you like to be in a profession where the personal biases held by lawyers working in congress enables them to prevent such verdicts from destroying the professional lives and careers of medical doctors—and they purposely do nothing? It is more than bias, it's lack of integrity.

     Only God can correct the problem, apparently.   

     Is it any wonder that physicians are suffering from burnout?

2. Loss of medical practice for financial reasons

     Yes, it is the lack of business knowledge and the tools that would enable any physician to prevent financial problems. These business principles alert any person in a business of any type about pending financial failure and allows the prevention of and recovery from potential
financial disasters.

     Medical practice is a real business. Doesn’t it seem sensible that anyone that wants to succeed in business needs to know how to run the business efficiently and profitably. Because approximately 98% of physicians graduate from medical school business ignorant, how is it possible that they could ever earn enough money to stay in their medical business? When they recognize they are failing and finally see that their income is dropping rapidly, they have no knowledge about how to reverse the process.

     Of course, no one talks about the fact that medical schools refuse to even offer a business education, with rare exceptions. Why? Do they believe that physicians should not succeed? Do they believe that physicians will succeed anyway to some degree regardless of what every top business expert says to the contrary and which also runs contrary to every business principle taught in business schools today? Or is this a matter of tradition—for a century or more physicians have not received a business education and got along reasonably well.

     Someone forgot to tell the medical schools that we live in a different world today where physicians require far more than a medical knowledge to survive or even to reach their own maximum level of service to their medical treatment of their patients.

There is a formidable aspect of this financial arena that rises above the possibility that these financial problems can be attributed to tradition of the medical school scholars that they hold with iron fists never to be let go. Medical schools sense it. Medical students sense it. Medical school educators sense it. Although people or even the medical school educators may imagine that tampering with tradition is not an option because it violates divine order somehow. Do they fear what God might do to them if they violate human created tradition?

Who can deny that God's rules and commands must always trump human customs and traditions? Perhaps this iron-fisted medical school tradition of "physicians not needing a business education" has something to do with the hundreds of medical school scholars over the last century who developed the traditional belief as the result of their own lack of an in-depth appreciation of, and knowledge about, what a thorough business education truly adds to the value and benefits physicians derive from that extra knowledge.

Common sense does rile our minds now and then. One can easily fall into a belief, perpetuate it indefinitely, because of one's irrational fixation on incomplete knowledge that they are never are able to update to match the changes happening in our world around us. The best example of this is the Patty Hearst Syndrome/story.

We are talking here about survival issues. It is that serious.

     Beyond all this is the obvious fact that all medical schools have been promoting the business ignorance of physicians. This weakness that is inherent in medical education and career success is the perfect weakness that allows the congress and politicians to open-handedly continue the destruction of the medical profession, especially private medical practice.

     The fact is that the leadership in the medical profession is still living in the last century of thinking. They are arrogant enough to avoid doing anything to make the issue go away. And that is what breaks my heart. Essentially all physicians today deny that they have been taken advantage of by their medical schools. It is "herd" thinking.

     They simply take what is offered to them. Physicians have lost the instinct to care enough about themselves and their careers to take control of what happens to them during their medical careers. Even when the truth is told to them, they deny it. Isn't that something Christ said in the Bible? Is business ignorance a disease that they can never recover from?   

     It is astounding how much any physician can earn, can improve their skills and knowledge, can provide far more updated medical care, and can treat their family obligations at their leisure, when they have a business education and use it effectively in their medical practice.

3. Arrogance and confidence play a primary part in reaching one’s maximum potential as a medical professional—but are also vulnerable weaknesses that can be manipulated.

    Standing up for yourself, your beliefs, your expectations, and the lifestyle physicians deserve is paramount to overcoming barriers.

     I admit that this was part of my own problem in my medical career. It's the reason that I was forced to quit each of the three healthcare platforms (military-HMO-hospitalist) that I practiced with and where I had no control of my own career. In all three, my situation for practicing medicine was dictated to me.

In all three, membership/association/job retention “dictates” significantly prevented my ability to advance my skills. That is a fact. In all three, I was seriously restricted from applying/using the more advanced skills, talents, procedures that I had earlier trained for and had extensive practice experience using and applying in my medical practice.

     Physicians, called hospitalists (when a physician practices within a hospital and under a contract with a hospital) are often the victims of such abuse. That was my frustrating experience with a hospital in Michigan.

     Radiologists demanded that I quit doing OBG ultrasounds because they were losing money by my lack of referral of my patients to their department for all OBG ultrasounds. I never charged for the ultrasounds because the technology was used only to document or rule out medical problems that my that my physical exams might miss in my patients.

The ultrasound machine was mine that I trained for and used for over 6 years in my practice in California before becoming an employee at the hospital. I was given no choice. No one came to discuss it with me beforehand. It became a stop, or leave issue bluntly handed to me
one day unexpectedly.  

     The practice level of the staff physicians at that hospital, at least for the OB-Gyn physicians, were about eight years behind in skills and knowledge compared to the Ob-Gyn physicians I practiced with in California.

     These are a few of the undesirable characteristics embedded in all medical practice systems other than private medical practice. The purpose of those dictates is to control each individual physician’s activities regarding not only how they practice, but also what they allow
physicians to practice.

     Think of it as being a means to maximize the profits, money saving strategies, and production efficiencies necessary for the financial survival of the ruling/controlling entity—certainly not for the financial benefits of the physicians they employ.

     The freedom to practice medicine as doctors choose; the eternal fixation every physician “dreams of” is today becoming exactly that—a dream only. You will not ever hear about these restrictions mentioned above in the public realm. They are kept quiet in the profession. This is just the tip of the iceberg.

     If you want to know what has been destroying the medical profession over the last five or more decades, read about some of these situations below...

4. The consequences of the political/government plan of "rounding-up” the medical profession physicians…

     When cowboys round-up the cattle, they can control the cattle activities, their productivity, and their assets. Such a well-known plan works every time, even with humans.

     For years now the government has been involved in strategies that seem logical, voluntary, and agreeable. By very cleverly squashing the physicians in private practice to the point of extreme frustration and anger, they are left with one sensible alternative. They go find a job that permits them to remain in medical practice and continue their career. GO-HMO!

     If that is not “rounding them up,” what is? The government gets a "pass" on doing that because the process paints a picture of it being a voluntary choice by physicians. It's quite the opposite.  Now carry that idea up another step. Strange as it may seem to the public, physicians are now called “healthcare providers.” You know, the same label that also is given for nurses, midlevel providers, and other non-professional medical care people.

     The intolerable and emotional part of this issue for physicians is being “downgraded.”

     No longer are the value of, status of, and reputation of physicians recognizable—except perhaps that they are all designated rich. They have become part of the herd. Of course, any respect, trust, reliance, and appreciation are also downgraded along with their value, at least that is our government thinking.

     You see it daily in the news media. And you sense it when you’re being treated by physicians. So, after all those years of education to become a physician, you are called a "healthcare provider" on a level with all the non-professionals.  Do you refer to the president as President Biden, or Joe Biden? You can bet that this downgrading is a segment of the government plan—"tear their arrogance out by the roots.”

5. What happened to all the American college juniors and seniors who used to apply for and fill up all medical school classes?

     Why is it that college men have lost their passion for considering a medical career? Do they know something that the medical educators do not?

     It is no big deal today because medical school classes are quickly filled up with women and foreigners for the most part. Shall we give the medical schools a “pass” on that? Somebody is missing the ball here. Something is very wrong.

     Does it matter if you cannot quite understand what your physician has been saying to you in a foreign dialect?

     Does it matter if half of the women physicians practice part time?

Could it be important that male physicians practice full time? Could that mean there are ultimately less physicians practicing full time and are seeing increased numbers of patients because they must?

      If there are more medical schools being constructed and producing many more doctors, then the numbers would even out. But that is not the case.

      Forcing physicians into the herd of doctors where all these physicians can be controlled, results in consequences for patients as well.

6. The destructive force of uncapped medical malpractice verdicts… 

     Uncapped verdicts mean there are no legal limitations to the extent of acceptable financial punishment for violations of the laws. Physicians are not suggesting that medical malpractice be legally eliminated, just not be left completely open to the outrageous whims of a jury.

     There are several segments of a malpractice verdict that juries make decisions about. Over the years the single segment of the verdicts that have been permitted to gradually take on a life of its own is named "pain and suffering." The emotions that arise throughout a medical malpractice trial are purposely ignited by prosecutors to influence the jurors.

     Prosecutors know that if they can suggest, demonstrate, or prove that a physician has viciously violated the malpractice laws causing harm to a medical patient, the passion of that violation(s) usually draws a higher monetary verdict for the plaintiff. And the harder the jury needs to punish the physician.

There are several problems with such a process...

a. The medical malpractice laws of each state are quite different from other states. This permits plaintiff attorney’s leeway in what they show to the jury and what they purposely withhold
from the juries.

b. The medical malpractice laws on the books were written in such general terms that the courts must interpret what the law is saying, are “violations” of medical practice in each case.To list the thousands of violations that should be considered in each case is impossible, so each violation is a matter of interpretation as to whether it is a significant violation and then how bad a violation it is relative to the implied damage done to the medical patient.

c. The worst of the problems is what the jury thinks is deserving of punishment and how extensive they should make the punishment. Jurors must be educated by the attorneys well enough to make reasonable decisions about punishment.

d. There are no legal or other restrictions in each state that limits or maximizes verdicts of juries for pain and suffering unless a "cap" has been placed on verdicts being considered. Of the several states that have placed caps on “pain and suffering,” juries are held to reasonable limits, especially concerning the amount of money allowed in verdicts.

e. Run-away verdicts in medical malpractice cases have often been in the range of 7 to 10 million dollars, or more. Those verdicts, when approved, are a certain death sentence to any physician's career because they are impossible to recover from.

     The United States Congress could easily and completely resolve this practice destroying element but refuse to do so. The primary reason seems to be to protect their "cash cow" for attorneys that manage medical malpractice cases against physicians across the country.

     Receiving an attorney fee of 25-35% or so of a $7,000,000 jury verdict certainly sucks hundreds of attorneys into the medical malpractice litigation business specialty. After fifteen years consulting with malpractice attorneys on their medical malpractice cases (both plaintiff and defendant) during my private practice years, I know what I am talking about.

     California seems to be the best example of such consequences. In the 1970s run-away jury verdicts reached the point that all medical malpractice insurance companies quit providing malpractice insurance to medical doctors in California. I was in private medical practice in California at the time.

     The malpractice insurance premiums became so high that physicians were not able to afford insurance, so physicians were forced either to practice without any malpractice coverage or move to another state where premiums were much cheaper.

     I chose a third option. Using arbitration agreements with patients worked for me, at least up until the physician groups created their own malpractice insurance companies that nearly all doctors signed into over time. As problematic as it seems to be, during the two years or so that malpractice insurers remained outside of California, I had all my patients sign an arbitration agreement.

During that time period, I had only one patient that ever refused to sign the document. She had been a loyal patient of mine and a friend. And she was a nurse that lived under very strict beliefs about commitments.

     After a couple years California passed a new law capping the jury verdicts. Then medical practice went back to normal as the malpractice insurers returned to California with reasonable premiums.

     At the time, about 7 other states passed "capping" laws later, leaving the rest of the state medical malpractice laws unchanged.

     Such medical malpractice cases that occur in Managed Care practices can sidestep trial options because they have the necessary funds to mediate the case (out-of-court) directly with the injured medical patient. Cash settlements work miracles. It keeps the cost of litigation down and results in a reasonable amount of money being paid to the plaintiff. There's always a glitch one finds
to be unacceptable...

As part ot the mediation process at Kaiser Permanente and other managed care groups, it requires that the physician(s) defendants involved let the attorneys handle everything. Physicians do not have to agree to be at fault for the problem in the claim, whether they thought they violated the standard of care or not.. But there is a good side to this process...

When a medical malpractice case goes to trial, the outcome is reported to the state Medical Board, and often spreads to other state Medical Boards. If the physician applies for licensure to practice in another state, the results of the every malpractice case is considered by the licensure committee in their decision about granting a medical license.

When a medical malpractice case is settled through mediation, the results are not reported to the Medical Boards. And remains independent of Medical Boards normally. Thus there are far less strikes against a physician should they face the state Medical Board for some other infraction.

Private practice physicians rarely have the funds to fight for fairness in their litigation that spring from errors or complications their patients claim to suffer from. Malpractice insurance premiums paid by physicians are increasing again in 2021. Malpractice insurance carriers had to do something to stem the increasing cost problem--they modified their tactics for managing claims as
noted above.

     What happened to physicians was again an attack on their weakness. When physicians are facing severe restrictions on their incomes (government plan is working), there is no way to pay high court costs and attorney fees. Bankruptcy is not the best answer but often is the only choice for physicians. Bankruptcy if approved, wipes the slate clean for physicians and can resume their medical practice. It's a permanent strike against the physician's credit score that disappears
about 7 years later.

     The modification that the malpractice insurance carriers gave physicians, essentially removed any ability of the physician to make decisions regarding the management of the claim against them. Previously, physicians were given a say about management of their legal cases.

Now a physician has two choices...(more detailed info than above)

1. Agree to hire private malpractice defense attorneys to handle the claim process and pay for it all out of their own pockets, which in most cases is not affordable. This is especially true when the actual malpractice incident is deemed to be obviously a matter of incompetence or neglect of the physician(s) involved. Under these circumstances a trial is the only reasonable method for the doctor’s attorneys to keep the eventual jury award to a minimum and to be more affordable for the insurance carrier to cover the costs. This choice is a gamble at best.

2. Permit the malpractice insurance carrier to decide the method for and financial settlement figures necessary to settle medical malpractice claims outside the court. In such cases it enables the insurance attorneys to negotiate directly with the plaintiff attorneys on behalf of plaintiff patients to settle the claims outside the courtroom for an amount of money sufficient to avoid trial costs.

    The advantage for the physician(s) is that he or she avoids having to admit that they are responsible for the malpractice incident. This effectively prevents the legal records from showing this incident as a malpractice claim against that physician(s).

         Why is that important? Every medical malpractice verdict recorded against a physician has profoundly serious consequences for any physician. Some
of these are…

         ****Malpractice records are not only filed with the State Medical Board where the physician is licensed, but also are filed with the State Medical Boards where the physician has a medical license. So, if a physician moves to another state to practice the records follow that doctor.

         ****State Medical Boards have legal leeway to punish physicians in any manner they choose with very few limitations. Personal Biases of Board members are well known inside the medical profession. State Medical Board members are appointed by state governments and usually include individuals not in the medical profession as well as medical doctors.

         ****The reputation of the physician is compromised in many ways, even by each hospital medical executive committees of doctors. They can restrict a physician’s hospital privileges, surgical privileges, among others. Such actions result in compromises of the physician's reputation among his or her peers, but also throughout the local community.

The local community finds out about this problem rather quickly, which results is patients leaving the physicians medical practice or potential patients from joining the practice. Local doctors stop referring patients to this doctor. Often their practice incomes diminish a
significant degree.

     I am elaborating here on the weaknesses of private medical practice that the government uses to undermine the medical profession and force all physicians into their controlled environment.

     Would you choose to become a physician if you knew all these factors beforehand--factors that are stacked against you and are relentlessly increasing?

     If you read newspapers, listen to news, or watch the trends of important issues being discussed daily today, you may now be aware of the pending and predictable increase in litigation burning up the airwaves and fogging up the court system. The Covid-19 pandemic has ruined many businesses and lives.

     Most people likely never consider what is happening to private physicians during this pandemic. Yes, they were forced to close their practice businesses the same as other businesses. Physicians earn no income during those months, lose employees, lose patients, go into debt. Because they make money only when they care for patients, it takes years to build up their patient load
and incomes. 

     Members of congress are now proposing passing a law that protects the government employees and elected officials from lawsuits related to the pandemic management. Our congress is now facing potential litigation against them and may well create a law to prevent it.

     Physicians have been waiting for years to have laws passed to protect them as well and for
the same reason.

     For example, if the government politicians put a cap on malpractice jury verdicts in states without them, it would open a new world of medical practice interests, especially in the specialties that attract the most severe malpractice claims—ones that physicians have avoided specializing in for decades.  But do not worry! Patients can still be treated by those thousands of outside doctors that seem to have no fear about those issues.

Step #9—Ultimate Benefits Our Government Seeks from the Destruction of the Medical Profession.

     Our American Constitution was a marvelous creation of new and unique governing principles required to establish a nation founded on life, liberty, and the pursuit of happiness. A government of the people, by the people, and for the people and by the leadership of those endowed with the dominant qualities necessary for creating a blueprint for our nation.

Our deep-thinking forefathers, who had personally witnessed and studied why all previous national governments in history had eventually failed, recognized what was lacking.

     The Constitution was not perfect, but was the best collection of laws, considering the world circumstances. The added amendments to the Constitution corrected many of the factors that they had not considered significant at that time. It still is not perfect and may never be a perfect guideline or blueprint.

     Today, we are in the middle of a political battle in Congress as well as in our society. This conflict has been slowly building up over the last 200 years and has reached its exploding point.

     For those who read, understand, and believe in Bible prophesies, the structure of life is filled with expected challenges and we learn to adapt.

     For others, it is a matter of accumulation of power because that’s where wealth, comfort, satisfaction, and control are dominant. Politics is the ultimate means for accomplishing that, it seems. Now that we agree that the Constitution is fallible, we can see how the controlling factors can go so wrong, out of balance, and even reach a point when it becomes permanently irreconcilable. We are there now.     

     So far, our elected politicians have taken full control of our financial system, railroads, mail system, school systems, and other elements of our society. Control provides power. Power provides dominance. Dominance provides subservience. Subservience delegates authority. Authority provides omnipotence. And that’s when all hell breaks loose!!

     Now it is the Medical Profession on the block—a system to be divided up into controllable segments dominated by medical employers. But first, the power and control by our government must forever ensure that the medical profession, as well as other segments of healthcare that have already been impounded, cannot ever again regain its complete independence from
government control.

     The politicians understand they cannot totally control the Healthcare Industry unless they destroy the systemic foundation, doctor-patient integrity, and freedom to practice medicine as a physician pleases. This then allows for the rapid reduction in quality and availability of medical care for all medical patients.

What other reasons would politicians have to be in control of all aspects of healthcare?   

   You well know what they are. The rationale is always the same. Greed,fear, and envy all fuel the process. As you also know, the United States Government has only one legitimate source of income/money—by taxing citizens and businesses. Other advantages the politicians have, however, are far more lucrative. These are not available to the public.

Slippery Financial Benefits:

1. Election to one term in the national Congress provides a lifelong funded retirement plan—at least it used to.

2. Anytime Congress needs money to do their bailouts, they call up the FED who then prints up the currency and hands it over to Congress with the promise that it will be paid back—a never ending source of income that is never paid back. Sure, it dilutes the value of dollar bills already in circulation—called inflation.

3. Bringing all physicians into and under government control removes all means that physicians have to control their own careers and lives. Politicians can dictate their salaries and how they practice medicine. Physician unions do not exist and when they tried that, it didn’t work. They cannot strike for fear of ridicule. Physicians can only quit medical practice or find a job elsewhere, to get out from under such rigid and perpetual control. Stretching the point further, one might imagine physicians rioting, looting, and protesting viciously to get changes. It seems to be working well today.

4. All members of congress know about the elite money-making opportunities before the public finds out. They get into stocks, businesses, and investments when it is cheap, and they earn millions of dollars. Favors beget favors. Being re-elected to Congress enables an ongoing expansion of wealth far beyond imagination because of their private and government interactions with the wealthy, the industrial leaders, influencers and the lobbyists that rely on securing legislative benefits using favors and enticing verbiage. Once you have a “cash cow,” you will do anything to keep it.

POWER DERIVED BY PLACEMENT:

1. Once you are elected to a political position, whether local, state, or national, you have more power to control things than you will rarely have as a common citizen.

2. Affluence, influence, leadership, and personal connections continue to follow these individuals, even if they remain in their re-elected position or not. The longer they remain in their position the more power they accumulate which opens them to higher levels of responsibility and position and money opportunities.

     These elements of strategy not only permit them to retain their position but also makes it far more difficult for anyone to remove them or replace them. Yes, incumbents usually are re-elected. There are more formidable opportunities—like serving one year in congress and being nominated for vice-president and get it, even if one is completely incompetent for filling
the requirements.

TRICKS FOR CONTROL OF HEALTHCARE:

     The control of healthcare was easy for our government. The Democratic Congress intentionally passed the healthcare law “Obama Care” knowing that the Republicans could do nothing to prevent it. Once it is a law, it is almost impossible to repeal it. Most members of the congress had no time to read the law before it was passed—that is why it was rushed through congress so fast.

     The boost that the Democrats got from passing that healthcare law without Republican consent compounded the advantages mentioned in the two issues discussed above. The Democratic leaders have stayed in power since then, even with a strong Republican (Trump) president.

     In 2021 the Democratic Party controls of the Senate, the House and the Presidential office under Biden. As a result of the 2020 election, we now have a renegade government promoting not only a socialist society, but also socialized medicine.

     When you are in control of healthcare using all the legal available tricks of the trade, you essentially control the medical profession. Many of those strategies have led to the acquirement of allies to remain in control—packing the congress and the Supreme Court, with attorneys and radical left members of congress.

     Even more detrimental, are the alliances made with the medical schools. These supportive initiatives offered by government to medical schools have resulted in preventing reform of medical education in any way that would improve the lives and careers of medical doctors.

     The government being in control of healthcare as they are today enables congress to prevent any changes in the healthcare law that run contrary to their plan for increased control in the years to come.

     Every physician practicing medicine today has a clear view of what is in store for them in the future. It is not a happy one for sure. Most physicians have already thought about what they might do next. 

     Now, the Democratic controlled large cities have abandoned law and order at a time when healthcare is disintegrating in availability and quality.

Step #10—There is a limit to the tolerance physicians have for increasing governmental restrictions and mandates.

    If increasing burnout of physicians, increasing physician attrition, widespread medical practice frustration among our physicians, and the increasing disaffiliation of physicians from their professional status of being addressed as “physicians or doctors” (being lumped into the “professional medical providers” category) doesn’t speak the truth about a severe unresolved problem among the ranks, then patient dissatisfaction will continue to increase exponentially.

     The reality is that you can push people to their trigger point where justification for their present environment is intolerable. The expectation is that changes will happen. But when? The nature of a physician is to “do no harm.” But that is not the belief of those who make judgments about physicians when medical problems occur.

     Don’t you see how tolerance fits exactly into the government’s plan to destroy private medical practice? By making the private physicians angry enough to quit medical practice, they more likely will choose to join the managed care system that the government controls.

What is the core issue hounding physicians?

     Some believe that long hours of attending to medical practice issues and patients care is the source. Others think it gets down to government restrictions increasingly being forced on to practicing doctors and the anger resulting. Many suggest that the shift away from doctor-patient rapport, that is induced by the necessity for physicians to see more medical patients’ daily, increases stress to a breaking point. Intolerance fuels the plan.

     What I have researched and now passionately believe is the core problem for all physicians who practice medicine will probably astound you. I say that because the public and patients over the last century have been led to believe that all doctors are wealthy—they aren’t.

     One cannot do anything in life without money, no matter who it is. All money originates from “some kind of business.” Work done produces income. Businesses, therefore, are essential for our economy and our paychecks. Even managing a medical practice is a business. The basic income of a medical doctor is determined by treating patients—no patients, no income. If a medical doctor does not manage the business well, income is poor.

     The problem for medical doctors is that with no exposure to how to manage a business profitably, leaves all doctors (about 98% of them) ignorant about how to make their business profitable. So where do they get the essential business knowledge? Rarely will a doctor take a couple years off from practice to get an MBA (master’s in business administration).

     College pre-med students are never told they need a business education, unfortunately. Medical schools do not offer such education or rarely provide it. Ultimately, new physicians are left to struggle with their own in private practice or hire a medical manager as an employee.

     In these situations, most new physicians jump into a cafeteria style business education. They get advice from other practicing doctors or their office personnel or read business books online and off. Discovering where to look and what to read for starting medical practice is difficult. Very few books are written specifically for doctors to follow successfully.

     I have yet to find such a book written for physicians to follow that explains to them how to do what it says. Such books always tell them what to do, but not how to do the improvements that are recommended. They are written by authors who are not knowledgeable about business strategies and processes.

     Marketing is essential to business success. Marketing is left out of the few books written for physicians for the same reasons.

     So here we have approximately 19,000 new business ignorant physicians each year graduating from medical schools that are left to fend for themselves---their careers, lives, and income. If that is not a tragedy in itself, what is? Would you send a soldier into combat without a rifle? Would you send a physician out in the world to create a small medical practice business with to
business knowledge?

     As you can deduct from this information, physicians are predestined to have financial problems, hence income problems, and even more detrimental factors to contend with which result from business ignorance.

“The core issue in physician’s practices and careers is lack of medical practice income, due to business ignorance.”

     This is the essential weakness throughout the medical profession that the government uses in their plan to control the medical profession itself, separate from healthcare control. Each requires a different strategy to work well.

     Take a physician that has never learned the principles of creating a profitable business, stumbling around over the years wondering why they aren’t making the amount of money to keep their practice in business, to build a retirement fund, to meet all their family obligations, and to send their kids to college. 

     And then pile on the increasing fee and medical practice restrictions by our government further restricting their incomes. Is it any wonder that physicians quit medical practice early and have been doing that for the last 5 decades in increasing numbers?    

     You need to know here what the public and most patients are not aware of. It is not in the news anywhere. But the facts are undeniable. The facts are more obvious when you look at a list of consequences that result from doctors living a lower middle-class lifestyle in a frugal manner with poor income.

Consequences that lead private practice physicians to burnout

1. Lack of a reasonable income means that many physicians are unable to afford the cost of current knowledge, training, and courses to keep them on the cutting edge of practice. This makes the critical decision about where to practice important.

2. Within the first 3-5 years of medical practice the new physician has the belief that the level of income he or she already earns are expected to slowly increase. As medical practice competition moves in and numbers of patients are diluted, often the practice income levels start to drop. Rural practices are likely to result in far less income, which becomes an reason to locate their practice close to or in the suburbs of cities. Patients in rural areas are disadvantaged for healthcare throughout our nation.

3. Physicians who practice in cities or nearby face increased competition from other physicians, especially in the same specialty. There are frequently new physicians in the same specialty starting practices close enough to significantly reduce the income of established physicians. It is not something they plan for, it just happens on the day the established physicians becomes
aware of it.

4. New physicians without an academic business knowledge commonly set up practice without having given due diligence to the geography, where patients earn their income from and whether that source is likely to be stable and reliable in the future—so patients can pay their bills. The density of physicians of the same specialty in the area is especially important. Research has documented when any physician that starts practice in an area where the population density of the same specialty doctors is over one doctor per 10,000 people, their practice income and growth will be compromised indefinitely. 

5. The issue of income for physicians is leveraged on many more factors than just setting up a medical practice where they would love to live. A formal business education would give physicians the business tools, such as marketing, to survive. Launching a medical practice without those tools and knowledge results in compromising their income for the duration of their medical careers. Studies have proven that under these conditions physicians during their medical careers leave at least a million dollars on the table that they never recognized was available.

     Our government knows about that and uses this weakness to take control of the medical profession. Wouldn’t you think that medical schools across this nation would know this fact? I believe they do. Why do medical schools deny any obligation to offer or provide a business education to all medical students?

     In my view it would be a cheap and honorable means for medical schools to ensure that their graduates are fully capable of using business knowledge to efficiently set up and run their practices. One might assume that such an effort would reflect-back favorably on the medical school’s value and would increase demand among applicants.

     These business tools absolutely enable a physician to earn as much money as they desire, whenever they desire. About 98% of doctors today do not know that. If they do, they ignore it completely and justify themselves by their arrogant beliefs.

     The far-reaching importance of these things cannot be overestimated. I believe with a passion that the adjustments that could be implemented into the medical education system would provide the means for all physicians to earn the incomes they want or need. Such action would provide physicians the income to magnify their expectations that they have always had for their medical practice careers and, does not do so today.  

     Logic and common sense do not exist within the medical hierarchy regarding the importance of a business education, it seems. Physicians today are not smarter, more diligent, or better physicians than those of a century ago. The rapid advancement of medical technology and research today creates the illusion that we have far better doctors today. It is not the case.

     The restrictions placed on healthcare and the medical profession by our government seriously interfere with the ability of every physician to reach their maximal potential, pursuit of their natural talents that remain dormant, and their freedom to practice medicine as their please. A good example today is the outrageous expansion of government power over the profession in the Covid-19 Pandemic.

     Dictatorial practice requirements for physicians to follow, dictated by our government medical authorities have become obvious—like forbidding doctors to treat covid-19 patients with a safe medication that doctors know helps patients recover--Ivermectin.

The future of healthcare and medical practice in our nation is disintegrating rapidly. Why?

Let me tell you how I know...

     I can see where our nation’s healthcare is going in the future. Already physicians are relegated to an inferior position in our society by substitution of them by mid-level healthcare providers and technological assistants. It’s not that these healthcare providers do perform excellent healthcare functions, but the fact that they have evolved to a level of healthcare where they are trusted and respected on a level with physicians, but have far less medical education.

     Initially, these providers were legally kept under the supervision of physicians for good reasons. In a short span of time it has become obvious that most of them were being “allowed” to treat the minor medical healthcare problems without supervision and oversight.

     Because the supervision by doctors was too time consuming and interfered with the physician’s time involved in the care of their own patients, supervision became ineffective. Now these midlevel providers commonly practice independently without supervision.  Many work independently, even while they are supposedly actually providing their medical care of patients while working directly under an assigned and higher-level supervisor.

     While consulting on medical malpractice cases, one case stood out. While the physician was out of the medical office, but on call, a patient called the office and spoke with the office manager. Her breathing was exceedingly difficult after discharge from the hospital after having a major abdominal surgical procedure.

     The office manager’s advice was simple. The patient was told that she was just having a minor asthma/allergy condition which the patient had a history of and should come into the office tomorrow to be evaluated. She figured that such a minor symptom was not worthy for a call to the doctor. The patient had a pulmonary embolism (clot in the lungs) and died in the emergency
room that night.

     The one fact that the office manager never knew about was that after major surgery the symptoms the patient had matched the diagnosis for a fatal pulmonary embolus. Any doctor would have known that risk immediately if she had not taken on the responsibility for care personally and called the doctor instead.              

     This points out that sooner or later healthcare providers that are not physicians themselves will make healthcare mistakes that physicians wouldn't if consulted.

If you don’t trust the physicians, can you trust the quality of healthcare?

     In the news today was a mention about healthcare problems in the United Kingdom. It described the healthcare problems that were related to Socialism effects on healthcare. To provide healthcare to the Covid-19 patients appropriately, the diagnostic and treatment of cancer patients had to be put on hold because of budget restrictions.

     In a free capitalistic system like we have, that issue would never happen—unless the left-wing Democrats get their wish for conversion of our system to socialism.

     Our healthcare system, however, does have a severe pending catastrophic problem.

     The quality of healthcare by my standards, among others, is decreasing rapidly. There are a few examples that demonstrate that clearly.

     Medical Boards (State government appointed individuals that punish doctors for medical practice violations) are now dictating to physicians what they can do and cannot do in healthcare. The Boards have unrestricted powers and make up their own rules along the way and have gone beyond the established activities and standards set by law. Unfortunately, the medical practice laws are different in each state.

     Dictating to medical doctors in their own state what they are allowed and not allowed to do—meaning deciding the standards of medical practice—goes far beyond their official limits.

     I read a newspaper article recently insisting that the “residency training slots” normally available to, and filled by, American doctors were being handed to out-of-country medical school graduates. Could it be that we don’t have enough American applicants of our own to
fill those slots?

     A bit of deep thinking and research here will tell you that it’s true. Did you know that today almost half of medical school classes are allotted to foreign students? The other half is filled with American women. For the last century medical school classes were almost entirely filled with American males. What’s happening?

      This rough statistic folds out into what you are seeing daily in our nation when you are in hospitals or doctor’s offices today. There certainly is a need for greater numbers of physicians in our country to care for the increasing population as well as the older aged population that evolved from post-World War II babies.

     Do our 174 accredited medical schools produce enough doctors? No--but there are a large number of unaccredited medical schools in our country that provide physicians of
questionable competence.

Studies show that there are a decreasing number of practicing medical doctors. One cause for that is the increasing attrition of American doctors that are fed up with what’s happening to them as the result of governmental restrictions and mandates. Another part of that is the fact that about half or women physicians practice only part time.

     You may still be wondering why American males are no longer applying to medical schools? Most likely they have discovered the truth. The truth is that college males have learned that they can gain a far more profitable future in professions other than in the medical profession.

The political and educational bear trap...

1. Physicians in private medical practice make far less money but have the freedom to practice as they want.

2. Physicians that are employed earn far more money but are constantly restricted in what they are allowed to do in practice.

3. Thousands of physicians (stats are hidden) over at least the last 3-4 decades have lost their private medical practices for financial reasons. This is caused by their business ignorance—remember 98% of them. They don’t know how to manage a business profitably and don’t have the business tools and knowledge to use to get themselves out of their perpetual financial quicksand.

This single factor ignites the core cause of the disintegration of the medical profession—Deficiency of income over their medical careers.

4. The destructive consequences of not being able (prevented from) to make enough income--for the above reasons are…

a. Physicians in private medical practice never make enough money to satisfy their original
medical school expectations for their medical career.

b. Physicians have never in their medial education been told or advised by any premed or
medical school academic of the outstanding advantages that a business education adds
to their medical careers—especially their incomes. They learn about that later as their
practice financially fails underneath them when it’s too late to do anything to save their
practice. They are coerced into becoming indentured employees.

c. When our government intentionally creates  laws and mandates—like fee restrictions,
increasing competition for patients from Managed Care Facilities, and enforcement of
electronic records mandates among other things—the process of earning enough money
for survival is almost impossible.

Comments...

The government plan for destruction of healthcare and the medical profession continues
towards victory.

If there is another way to save the medical profession—let’s hear it.

     Business experts across our nation all understand and agree that the present infrastructure of the medical education system needs a massive overhaul regarding the business side of
medical practice.

     Brilliant minds acknowledge the major deficiency that physicians are suffering through. I’ve been told by one of the most brilliant business educators, offering me friendly advice, that I should not waste my time trying to change a system that has been embedded deep enough that it
can’t be changed.
 
      Maybe he was right. For the last 18 years I have not given up on the expectation that he was wrong and that something can be done to force medical schools to offer or provide a formal business education for all medical students. That would be a fantastic and critical objective
to accomplish.

     When I think about it, if government takes total control of the medical education system and the medical profession, it would be in position to do to medical education the same as they have done to the medical profession and healthcare.

     The government could accomplish what I think needs done. Create laws that mandate medical schools to include a formal business education for all medical students. If and when that happens, it will likely be the result of a continued destruction of healthcare as we have known it in private medical practice.

     On the other hand, it is also likely that the opposite will happen. I doubt if our government/congress would ever attempt to do anything that would increase the business knowledge of anyone, including medical doctors. The dumber the population becomes, the more our government will abuse us, to gain more power.

     If you compare the stock market to our congress, there are similar patterns of actions that inevitably affect the economic welfare of every person, business, and the whole economy. In both cases, there is a pronounced effort to maintain a large number of monetary system secrets from the general public. They travel in the world money stream making use of tactics and procedures that are rarely made public to earn outrageous amounts of income covertly.

     The lessons I’ve learned about money management, everyone should know. But again, government probably doesn’t want people to know. The proof of this is clearly visible in our downgraded public education school system.

     Of all the classes taught in grade school, high school, and even in college, the one topic that is lacking, or intentionally locked-out, are those concerning money management and the economic and business principles all people should know about. There must be a reason for that.

Yes—the medical profession is not the only industry taken over by our government—like taxes, church and religion, railroads, among others.

     The conclusion that seems obvious is that if you find great advantage in taking over one element of our foundational businesses, there likely is an even greater advantage to take over as
many as possible.

----Professional Probe----

"It's very likely that our government already
has physicians locked into a position that we
can't escape from."

Articles©2013-2022/CGG INVESTMENTS LLC. All rights reserved. #102, 3-16-22