A healing patient-physician relationship depends on mutual trust. Patients need to trust that their doctor is working for them. In the Oath of Hippocrates, doctors swear to prescribe “for the good of my patients,” to the best of “my ability and judgment.” Such a physician does not lie to patients or treat them in a way he believes will harm them. He does not reassure them that it is fine to do something he believes will lead to incurable disease, unhappiness, guilt, or early death.
But what if their physician is working for a hospital and knows that he’ll lose his job or even his entire career if the employer is displeased? And what if the hospital lets insurers, government, or political advocacy groups control the message to patients?
The case of Dr. Paul Church should alarm patients everywhere. Dr. Church just lost his final appeal of his expulsion from Harvard-affiliated Beth Israel Deaconess Medical Center (BIDMC) in Boston. These days being expelled from any hospital medical staff for any reason can and probably will have a domino effect—loss of privileges at all other hospitals, removal from insurance panels, a report to the National Practitioner Data Bank that could foreclose all future employment opportunities, loss of board certification, and even loss of medical license.
Dr. Church, a urologist, had been on the medical staff for 28 years. Did anyone accuse him of incompetence? Did he throw a scalpel at a nurse? Was he impaired by alcohol or drug abuse? Did he humiliate, discriminate against, or harm anyone in any way? Did he make any statement that the hospital disputed as untrue?
NO, to all of the above. His record was exemplary.
The hospital clearly wants to make an example of him, to deter anyone else who might dare to act as he did. But not a very public example. There has been almost no news coverage. Usually, when a doctor gets booted from a hospital, the press is all over the story. People love to read about the comeuppance of a successful doctor. But not this time.
Apparently both BIDMC and the press are themselves afraid—of backlash from the public, in the case of the hospital, or of the anger of a powerful political constituency, in the case of the press.
So what was Dr. Church’s heinous, unmentionable crime?
He told the truth—discreetly, through internal hospital communications channels. A truth that many on the hospital staff agreed with—silently.
He protested the hospital’s pressuring its staff to support Gay Pride events. Uniformed members of BIDMC staff are pictured marching in the Gay Pride parade, along with people promoting sado-masochism, or displaying gear for bondage and domination, or showing children as sex objects.
Dr. Church stated that such hospital policy contradicted its mission to protect the public welfare and to promote healthy, moral choices. He challenged the hospital to be honest about the unhealthy consequences of homosexual behavior, and “respectful of the diversity of religious and moral views regarding homosexuality.” His quotation of a few verses from the Bible might have ultimately been the unforgivable sin.
Unquestionably, men having sex with men, an activity that even has its own acronym now (MSM), have a much higher incidence of sexually transmitted diseases. Though AIDS is not the automatic death sentence it once was, infected individuals face a lifetime of costly, toxic drug treatment. The CDC recently reported that homosexual men, lesbians, and bisexuals experience a much higher rate of sexual assault, including rape, by an intimate partner. Transgenders, vociferously insisting that they be considered normal, are simultaneously demanding insurance coverage for costly treatments, including lifelong hormone therapy.
Can your physician, without fear for his career, tell you the truth about the risks of your behavior? Only if it involves smoking or drug use or something other than sex. Doctors are supposed to affirm the notion that the only problems facing LGBT patients are caused by societal disapproval. This gag on physicians must be enforced by totalitarian methods because reality is so hard to deny.
And if your physician lies to you about one thing, can you trust him to tell the truth about anything?
Dr. Jane M. Orient, M.D., has appeared on major television and radio networks in the U.S. speaking about issues related to Healthcare Reform.
Dr. Jane Orient is the executive director of the Association of American Physicians and Surgeons, a voice for patients’ and physicians’ independence since 1943.
She is currently president of Doctors for Disaster Preparedness and has been the chairman of the Public Health Committee of the Pima County (Arizona) Medical Society since 1988.
Dr. Jane Orient has been in solo practice of general internal medicine in Tucson since 1981 and is a clinical lecturer in medicine at the University of Arizona College of Medicine. Her op-eds have been published in hundreds of local and national newspapers, magazines, internet, followed on major blogs and covered in the Wall Street Journal and the New York Times.
Dr. Jane Orient authored YOUR Doctor Is Not In: Healthy Skepticism about National Health Care, published by Crown; the second through fourth editions of Sapira’s Art and Science of Bedside Diagnosis, published by Lippincott, Williams & Wilkins; and Sutton’s Law, a novel about where the money is in medicine today.
Dr. Orient’s position on healthcare reform:
“The Healthcare plan will increase individual health insurance costs, and if the federal government puts price controls on the premiums, the companies will simply have to go out of business. Promises are made, but the Plan will deliver higher costs, more hassles, fewer choices, less innovation, and less patient care.”