When I started medical school I was thrilled to have been chosen to pursue this time-honored profession. I was starry eyed and dazzled, looking forward to the bright future ahead. I was naïve and wanted to follow the road of my physician role-models. I hurriedly joined the AMA (the “real” doctors’ group) and the Medical Association of Georgia (MAG) and received their journals. I was on my way, studying hard and joyously reaching ever closer to my goal. The Dean of our school and his staff were deeply involved with the legislative issues at our state capital and I felt safe. Surely, my school and the AMA were looking out for my future; after all, they both represented physicians, and of course, my future patients too. I was “taught,” along with the rest of my class, about how to view the “issues” (I now surmise they thought I had no acceptable views myself). We even had mandatory classes called “medical ethics” where we were instructed how to think and, therefore, behave with patients. The main theme of our institution was that we are not physicians anymore, but health care consultants, and I began to see that all was not well and good. Unrest stirred in my soul.
Then I had the good fortune to meet a very impressive doctor who stood for truth. TRUTH! I thought I had been given truth. I began to realize that, like countless other medical students, I was being groomed to be a non-procedure oriented, insurance/government regulated puppet for the great patient caretaker — the government. The truth, I found, was that the government planned to take care of my patients. Government bureaucrats would decide what tests were needed to ascertain and make the diagnoses (even though I was the one who went to medical school while they sat in their offices with unrelated degrees hanging on the wall or bureaucratic titles displayed on their desks). Government bureaucrats would decide not only how much money I should receive for my services, but how my patients should be treated given the “necessity for the proper allocation of scarce resources.” What was really frightening though was not the realization there was so much deceit, but how easily we, as students, could be led down the primrose path to our demise.
Dr. Miguel A. Faria, Jr. is the doctor I met in my first year of school who stood for truth and has had the conviction to stand for justice, fight for the rights of physicians to provide ethical medical care for their patients, and the rights of patients to be treated with dignity and privacy. I followed Dr. Faria’s writings in the Journal of the Medical Association of Georgia (JMAG). Because he was the editor, I had hoped truth would prevail as he led a faction of MAG against the politically correct leadership of the AMA and the intolerant, liberal media like The Atlanta Journal and Constitution, to whom truth (and the free exchange of ideas) was anathema. Sadly, the leadership of MAG capitulated and ultimately did not support Dr. Faria’s fight; they buckled under political pressures and I could no longer trust them. I also came to see the AMA for what it represents, and I didn’t want to be associated with it anymore. I recently read an article about the “flickering torch of the AMA.”(1) The article stated the AMA membership includes only two-fifths of America’s doctors. Yet, in the usual socialist/government mentality, Dr. P. John Steward, the new Executive Vice-President, and its Board of Trustees have set their goals for physicians: “One would cede some of the state-society power within the group to the specialty societies. The other would transform the AMA into a certifier of practice quality or a managed care plan.” The AMA stated goal is that “physicians and health care plans would seek an AMA seal of approval as a mark of good practice. Among other things, the plan would beef up physicians’ meager influence and control, via the AMA, in the managed care world.” Dr. Seward further stated that the seal would allow the AMA to become “the principal entity certifying physicians as fit to practice and to become the judge and jury of physician quality.” The AMA wants to create a dossier on every physician using credentials, practice-site reviews, clinical performance, and who knows what else. Plainly, this sounds like the socialist regime of a Big Brother society. These authoritarian ideas of the AMA are an outrage. Where is organized medicine’s outcry!
Fortunately, I learned about the AAPS. I sent for literature, and as I read it, I began to see the dust rising above the horizon. I could hear the sound of the cavalry’s hooves and the tune of the Battle Hymn of the Republic. I am thankful there is one strong group that stands for medicine in its time-honored traditions, cares about physicians and their patients — and is not politically correct, but morally correct.
To round off my medical school memories, I had the fortune of being used once again as a platform for my school’s political agenda when we, as the graduating class, presented our choices for speaker for commencement, Newt Gingrich being one of the class’s top choices. Yet, someone in a position of power at our medical school took it upon himself to invite a speaker who wasn’t even on the student list, none other than Dr. Seward, who promptly accepted. It is against these types of machinations and political coercions I want to fight by standing with AAPS.
It is an honor to be a member of this Association that places principle above politics. It is inspiring to know there are still heroes in our midst. Oh, I admire many physicians’ medical skills and some have great finesse, but the real heroes are the physicians who put great effort into the crusade against socialized medicine. Of what use are those skills if they are hindered from use by a totalitarian state.
It seems that my reflections upon graduating might be more thoughtful for the patients who I have learned from, or for the long hours spent studying for the boards I have passed, for my family who gave me unending support — and for God, who gave me strength. I cherish it all, but as warm and endearing as all this is, all my hard work and compassion would be in vain if I was reduced to a government owned pet, following commands and performing operant tasks in Pavlovian fashion, for this is exactly what I would become if not for the work and noble deeds of the courageous and truly medical sentinels of the AAPS.
1. Neel JR. Chief certifier of practice quality. Physicians Weekly, April 22, 1996.
Connie L. Nickelson is an internal medicine resident at the Medical Center of Central Georgia in Macon, Georgia.
Originally published in the Medical Sentinel 1996:1(2):30, 37.