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Culture & Society, Doctors, Healthcare Reform, Medical Ethics, Medicine, Op-eds

Physicians Victims of Body Snatcher Invasion

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Invasion of the Body Snatchers: Where Have All the Doctors Gone?

By author/contributor Marilyn M. Singleton, M.D., J.D.,

After a 20-hour encounter beginning at 9:30 p.m. in the emergency room at my health plan’s hospital, I honestly don’t know what it means to be a doctor any more. When my husband who had a history of bilateral pulmonary emboli developed chest pain, I thought it prudent to go to the emergency room.

We were triaged to the hallway, as there were no rooms. There was an empty room a few feet away, but it had dirty dressings on the floor from the last patient.

After seeing our admitting physician in our hallway “room,” I had high hopes. She had a smile and a white coat over her scrubs and had a note pad and pen. She listened to us.

When my husband offered that I was a physician, she asked what kind and asked what my concerns were. (The next day, she sent my husband an email thanking him for being a good patient, my input, and that she appreciated that we were doing our best to stay healthy.)

Then we were left to the nursing staff and two shifts of physicians who seemed to think they were very special, like stars on a television show called “ER.”

In the charting room, people in scrub attire or T-shirts entered data at more than 20 computer screens. This scene reminded me of a telemarketing sales boiler room. And this fit the level of caring of most of the staff.

I told the evening shift nurse that the pulse oximeter was not working. As an anesthesiologist, I am familiar with the machine. She said that it had been broken all day. My husband, an engineer, asked, smiling, “Then why did you put it on my finger?” She said they were supposed to put it on—and left it there.

Another nurse wanted to put my husband in the dirty room since it was “just for a x-ray.” I advised that there were dirty dressings on the floor and the last patient could have had an infection. He acquiesced and let us go to the cast room for the x-ray.

One of our day nurses kept his back to the bed during his questioning, focusing more on the computer than the patient. He wore a red T-shirt that said “emergency room” on it – the kind you get at a trade show.

He spoke in jargon and abbreviations, and my husband constantly had to ask what he meant. Are they in the new text-talk generation where URROFL (you are rolling on the floor, laughing), or are they showing how superior they are?

Are these the people to whom the authors of the Affordable Care Act want us to cede our profession?

My husband was to have a treadmill test at 9:45 a.m. By 6:00 a.m., after 9 hours without an IV or eating or drinking, I asked could he have anything to eat or drink—even water. The doctor said “no” without thinking.

I said it seemed counterintuitive to have a low blood sugar and dehydration while doing an exercise stress test. He handed us the treadmill instructions. I read aloud the instruction stating that the patient is to have a light meal up to three hours before the test.

Instead of owning that he misspoke, he tried to equate a treadmill test to a general anesthetic where patients should have an empty stomach. At the test my husband was offered water.

When discharge time mercifully arrived, my husband asked our discharging physician about co-pays and whether we needed to pay on our way out. He dismissively said he didn’t know—and didn’t need to say that he didn’t care. He gave the impression that he was content to do his shift and go off to Pilates class.

All but three of the 18 “health professionals” with whom we were in contact in the emergency room were unprofessional and resentful of questions. This appears to be the future of “healthcare reform.”

That is why physicians who still believe that medicine is a calling must resist. They must assert leadership, and not simply follow the flock of sheep.

Dr. Marilyn SingletonDr. Marilyn M. Singleton, MD, JD is a board-certified anesthesiologist and member of the Association of American Physicians and Surgeons (AAPS).

Dr. Marilyn Singleton ran for Congress in California’s 13th District in 2012, fighting to give its 700,000 citizens the right to control their own lives.

While still working in the operating room, Dr. Marilyn Singleton attended UC Berkeley Law School, focusing on constitutional law and administrative law. She also interned at the National Health Law Program and has practiced both insurance and health law.

Dr. Marilyn Singleton has taught specialized classes dealing with issues such as the recognition of elder abuse and constitutional law for non-lawyers. She also speaks out about her concerns with Obamacare, the apology law and death panels.

Congressional candidate Dr. Marilyn Singleton presented her views on challenging the political elite to physicians at the Association of American Physicians and Surgeons annual meeting in 2012.

Follow Dr. Marilyn Singleton on Twitter @MSingletonMDJD

More info about Dr. Marilyn Singleton

Culture & Society, Doctors, Medicine, Op-eds, Politics

Black History Month Tribute: Strength, Persistence, Talent

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Author/contributor:  Marilyn M. Singleton, M.D., J.D. 

Black history in American has certainly had its ups and downs. It’s troubling when, for political theater, those who should know better fail to emphasize the inspirational stories that highlight the strengths of blacks and the humanity of whites.

While it is undeniable that cruelty and suffering are part of this country’s history, at some point it is counterproductive to paint blacks as weak victims of the white man’s callousness.

There were always free blacks in America (including my family). Indeed, in 1641, Mathias De Sousa, an African indentured servant who came from England with Lord Baltimore, was elected to Maryland’s General Assembly. The first census of 1790 counted 19 per cent black Americans, 10 per cent of whom were free.

Black Americans served on both sides during the Revolutionary War. The British promised freedom to slaves belonging to Patriot masters who served. Because of his manpower shortages, George Washington lifted the ban on black enlistment in the Continental Army in January 1776, creating his so-called “mixed multitude,” which was 15 per cent black. Economist Walter Williams is so correct that necessity can overcome prejudice.

Nestled in the back of some folks’ minds was (is?) the notion that blacks were not as intelligent as whites. They certainly couldn’t have had the smarts to be doctors. James Derham (c. 1757-1802?), born a slave in Philadelphia, proved the naysayers wrong.

He was the first known black American physician, although not professionally trained in medical school. As was common at the time, physicians were trained in apprenticeships. Young Derham was fortunate that his three early masters were physicians who taught him to read and write.

Derham’s third owner taught the young teen how to mix and administer medicines. After this owner, who had been arrested during the war for being a Tory, died in prison, Derham was sold to a British officer, and he served as a doctor to soldiers. After the war, he became the property of a Scottish physician (appropriately named Dr. Love) from New Orleans, who hired him to work as a medical assistant and apothecary.

By 1783, Derham quickly saved enough money to buy his freedom, and he set up his own medical practice in New Orleans. Derham, who spoke English, French, and Spanish, was a popular and highly regarded doctor, who treated both black and white patients. By age 30, Derham earned more than $3,000 annually.

Derham’s medical paper on his success in treating diphtheria caught the attention of Benjamin Rush, a physician who signed the Declaration of Independence, served as surgeon general of the Continental Army, and has been called “the father of American medicine.”

Rush invited Derham to Philadelphia in 1788 and was so impressed that he encouraged him to stay. There, Derham became an expert in throat diseases and in the relationship between weather and disease.

In 1789, Derham returned to New Orleans, where he saved many yellow fever victims. He stopped practicing medicine in 1801, when the new city regulations required a formal medical degree to be considered a doctor. Nothing is known of his whereabouts after 1802.

The first university-trained black American physician was James McCune Smith, born in 1813 to slave parents who were emancipated by New York law. Despite his scholastic achievements at the Free African School of New York, he was denied admission to American medical schools.

When he was 19 years old, the Glasgow Emancipation Society helped Smith enroll in Scotland’s University of Glasgow. He received his B.A. degree in 1835 and his M.D. degree in 1837. A skilled debater and lecturer, Smith was a founding member of the New York Statistics Society in 1852, and was elected as an early member of the American Geographic Society.

The first American medical degree was conferred on David J. Peck, born circa 1826 into a free black family in Pittsburgh, Pa. In 1846, after studying two years with a private physician, he enrolled in Rush Medical College and graduated in 1847. Peck practiced medicine in Philadelphia for 2 years before moving to Central America to start a homeland for free blacks in Nicaragua.

Thank you, doctors, for paving the way for my grandfather, my father, and me.

Dr. Marilyn SingletonDr. Marilyn M. Singleton, MD, JD is a board-certified anesthesiologist and member of the Association of American Physicians and Surgeons (AAPS).

Dr. Marilyn Singleton ran for Congress in California’s 13th District in 2012, fighting to give its 700,000 citizens the right to control their own lives.

While still working in the operating room, Dr. Marilyn Singleton attended UC Berkeley Law School, focusing on constitutional law and administrative law. She also interned at the National Health Law Program and has practiced both insurance and health law.

Dr. Marilyn Singleton has taught specialized classes dealing with issues such as the recognition of elder abuse and constitutional law for non-lawyers. She also speaks out about her concerns with Obamacare, the apology law and death panels.

Congressional candidate Dr. Marilyn Singleton presented her views on challenging the political elite to physicians at the Association of American Physicians and Surgeons annual meeting in 2012.

Follow Dr. Marilyn Singleton on Twitter @MSingletonMDJD

More info about Dr. Marilyn Singleton

Culture & Society, Healthcare Reform, Medical Ethics, Politics

A Black Physician Reflects on the 2013 Inaugural Address

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Author/contributor:  Marilyn M. Singleton, M.D., J.D. 

Despite the Martin Luther King, Jr., holiday, many of us were too busy seeing patients to hear President Obama’s second inaugural address. It was less painful to read the transcript.

“What binds this nation together is not the color of our skin or the tenets of our faith or the origins of our names,” he stated. Then let’s end the government’s obsession with African-Americans, Hispanic-Americans, and Asian-Americans (but never European-Americans). We are all Americans. I feel some moral authority and passion on this subject as a black American whose family moved here from England in the 1600s. I am a full-blooded American!

I can’t bear to hear one more person say, “I’m so glad we have an African-American President.” How ironic: Martin Luther King, Jr., urged that we judge people by the content of their character, not the color of their skin.

The head of the Congressional Black Caucus admitted that the CBC treats the President with a “deference” not accorded to a white President, and that the CBC is “hesitant” to criticize the current President. “With 14 percent unemployment [versus 6.9 percent for whites], if we had a white president, we’d be marching around the White House.”

This Administration and/or its tools use race as a crutch when facing legitimate criticism, for example Susan Rice’s willful or incompetent misleading of Americans about the Benghazi deaths. Rep. Jim Clyburn said calling Susan Rice “unqualified” to be Secretary of State was a racist “code word.”

Curiously, “unqualified” was not a “code word” when used against Clarence Thomas in his Supreme Court hearings. It was noted that he was particularly unqualified because he had served on the D.C. Circuit for only one year and four months. God forbid we should raise the same question about Elena Kagan or Thurgood Marshall (whom Thomas replaced), who were never judges at all.

And what about the other Rice? Who can forget how a former Secretary of State, Dr. Condoleezza Rice, was maliciously attacked as a “house slave” in the Bush Administration?

We next learned that the “patriots of 1776 did not fight to replace the tyranny of a king with the privileges of a few, or the rule of the mob.” I guess President Obama and Nancy Pelosi are not part of the Spirit of ’76 since the Patient Protection and Affordable Care Act (ACA or “ObamaCare”) was rammed through Congress with a five-vote margin, 34 Democrats and all 178 Republicans voting against it.

Obama only had one open discussion session, breaking his campaign promise to have open negotiations on C-SPAN. Instead, Democrats in the White House and Congress made private, multibillion-dollar deals with hospitals, pharmaceutical companies, other special interests—and each other.

Moreover, said Obama, “Together we discovered that a free market only thrives when there are rules to ensure competition and fair play.” Rules are fine when the President makes them up along the way. ACA waivers come to mind.

“We must make the hard choices to reduce the cost of health care.” Now that we are learning how “reform” will increase costs, it is clear that naming it the Affordable Care Act was a marketing tool. The most bothersome aspect is that we don’t yet know the identity of the “choosers” who will decide whose care to ration or whose bank account to raid. It is very telling that Obama did not proudly extol the virtues of his signature legislation.

“We understand that outworn programs are inadequate to the needs of our time.” Then, Mr. President, encourage Harry Reid to act on congressional legislation that attempts to restructure Medicare and Social Security instead of deriding these efforts as throwing Granny off a cliff.

Sadly, a thread woven throughout the speech was that Obama will liberate us from our autonomous, free, yet nonetheless pathetic, unhappy existence. He asserted several times that only a select few were making it in America, and he was going to do something about that!

We can only hope that Dr. Martin Luther King, Jr., was right: “A lie cannot live.”

Dr. Marilyn SingletonDr. Marilyn M. Singleton, MD, JD is a board-certified anesthesiologist and member of the Association of American Physicians and Surgeons (AAPS).

Dr. Marilyn Singleton ran for Congress in California’s 13th District in 2012, fighting to give its 700,000 citizens the right to control their own lives.

While still working in the operating room, Dr. Marilyn Singleton attended UC Berkeley Law School, focusing on constitutional law and administrative law. She also interned at the National Health Law Program and has practiced both insurance and health law.

Dr. Marilyn Singleton has taught specialized classes dealing with issues such as the recognition of elder abuse and constitutional law for non-lawyers. She also speaks out about her concerns with Obamacare, the apology law and death panels.

Congressional candidate Dr. Marilyn Singleton presented her views on challenging the political elite to physicians at the Association of American Physicians and Surgeons annual meeting in 2012.

Follow Dr. Marilyn Singleton on Twitter @MSingletonMDJD

More info about Dr. Marilyn Singleton

Culture & Society, Doctors, Health Policy, Healthcare Reform, Medicine, Op-eds

Medicine and the Twilight Zone 2013: To Serve Man

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Author/contributor:  Marilyn M. Singleton, M.D., J.D. 

During a discussion on the future of health care, a clinician-turned-healthcare-executive told me that the way we “deliver health care” (not the same as “practicing medicine”) will change. It will be a “process”—a more mechanized one.

She spoke enthusiastically about the advantages, such as electronic health records. These can improve fraud detection in government programs with computerized cross-checking of services delivered and payments made. This of course misses a larger point. If we didn’t have enormous government programs, fraud would not be so easy to perpetrate.

It’s pretty hard to double-bill a patient when there is no middleman. Patients generally remember whether they were in the doctor’s office last month. A patient who was not in a coma would immediately let the doctor know that she did not have that colonoscopy.

The executive was not concerned about the erosion of privacy. These days, she said, all of our information is in the ether anyway. If you are a random person, no one cares about your information. She did admit that the revelation of some conditions such as AIDS could lead to discrimination.

The prospect that electronic enthusiasts don’t seem to see is that someone who is a “nobody” today could aspire to become a “somebody”—if it weren’t for that pesky counseling that now has her labeled as a mental defective. Let’s not forget that the government will get that information it labels as “preventive medicine,” such as the question about whether there is a gun in the house.

What if your patient is the wife of a law enforcement officer and tells the truth? Has she just made her husband a target of disgruntled perpetrators?

What concerns me most is Americans’ quiet acquiescence to the intrusive nature of many health regulations. Putting the best construction on it, the continuing explosion of heath care regulations may be motivated by a sincere desire to improve the health of every American. But might they be used as the tools of another agenda: to make us feel secure enough to let down our guard as we become ever more dependent on the federal government?

Disturbed by this conversation and by the outcome of the fiscal cliff bullying, I was glad to try to escape reality by watching the Twilight Zone New Year’s marathon. But what I saw was the episode in which some philanthropic aliens came to earth and promised to eradicate famine and war. The aliens became the earthlings’ new best friends; they invited humans to visit their planet and enjoy a life without worries.

The scientists managed to translate the title of a book the aliens brought with them: To Serve Man. The earthlings were now fully convinced that the aliens had our best interests at heart. Just as the last previously doubting Thomas was boarding the spaceship, his assistant frantically tries to get him to turn back, screaming that To Serve Man is the title  of a cookbook!

Rod Serling’s voiceover cautioned that we had gone from being the rulers of the planet [i.e., our medical practice] to an ingredient in someone’s soup.

Does this sound familiar?

Dr. Marilyn SingletonDr. Marilyn M. Singleton, MD, JD is a board-certified anesthesiologist and member of the Association of American Physicians and Surgeons (AAPS).

Dr. Marilyn Singleton ran for Congress in California’s 13th District in 2012, fighting to give its 700,000 citizens the right to control their own lives.

While still working in the operating room, Dr. Marilyn Singleton attended UC Berkeley Law School, focusing on constitutional law and administrative law. She also interned at the National Health Law Program and has practiced both insurance and health law.

Dr. Marilyn Singleton has taught specialized classes dealing with issues such as the recognition of elder abuse and constitutional law for non-lawyers. She also speaks out about her concerns with Obamacare, the apology law and death panels.

Congressional candidate Dr. Marilyn Singleton presented her views on challenging the political elite to physicians at the Association of American Physicians and Surgeons annual meeting in 2012.

Follow Dr. Marilyn Singleton on Twitter @MSingletonMDJD

More info about Dr. Marilyn Singleton

Culture & Society, Doctors, Medical Ethics, Medicine, Op-eds, Politics

Black American Doctor Brings Patient Fight to Capitol Hill

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Black American Doctor Fights for Patients from the Operating Room to Capitol Hill

Author/contributor:  Marilyn M. Singleton, M.D., J.D.

I was born to be a physician.  My grandfather was one of two black students in the 1911 graduating class of Starling Ohio Medical College.  He dedicated his life to medicine and helping the low-income folks of Lima, Ohio.  My father became an Army Air Force flight surgeon at Tuskegee.  As a general practitioner in San Diego, he charged patients what they could afford. Many times we were paid in tamales.

Then came Medicaid. It prohibited doctors from being able to use charity like this. We had high hopes when The Great Society was born: the end of poverty, the end of racial strife.  These poverty programs were good intentions gone awry.

What social engineer devised a diabolical program forcing a mother in hardship to eject her children’s father from the house in order to get financial assistance?  The road to hell began with this kind of “social justice.” Common sense tells me that families in trouble would derive strength from staying together.

The results of the disintegration of the family are fully evident.  Unwed motherhood has almost tripled since the 1960s War on Poverty.  Seventy-two per cent of Black and fifty-three per cent of Hispanic children are now born to single mothers.  Single motherhood quadruples the chance of living in poverty.

Things have gotten worse, not better.  Politicians are so arrogant they tell people to “Trust me!” based on faith, not facts.  Are we to believe that it works to treat people like helpless victims?  The fact is the poverty rate has not changed in 40 years.

Are we to believe that a check from a distant rich Uncle (Sam) can erase core problems such as distrust of authority figures, poor education, promiscuity, drug addiction, and violence?  The facts show no.

Are we to believe that the federal government is effective at public education?  The facts show that the high school dropout rate has remained the same for 40 years, despite the fact that trillions of federal dollars were poured into education.

We must support alternatives that offer parental options for educational opportunity.  A good education leads to self-reliance and social responsibility.  This in turn leads to a good job.

Are we to believe that Medicaid “leveled the playing field” for patients?  The fact is that fewer and fewer physicians can take Medicaid due to payments below the cost of providing the services. Where is the “social justice” in a health care system where NO one has quality, individualized care?

We have to change Washington’s way of thinking from “if a social program fails, expand it” to “if it fails, dismantle it.”  Today’s policies lead to unhealthy dependence on the federal government.  We need instead to encourage independence and freedom.  Everyone – at all income levels – suffer from these government-controlled programs because we have more fatherless and poorly-educated children.

Safety nets don’t cure poverty.  Education and jobs cure poverty.  Family and community are the institutions through which we should help each other.  Voting for government bureaucracy is not a surrogate for personally giving our time.  Community aid is not only direct, more efficient, and more effective, it is personal.  Our personal relationships are crucial to maintaining our civil society.

We can’t let politicians use our differences as a wedge to divide.  The rhetoric of class warfare fosters resentment and envy.  Class warfare does not sow the seeds of success. Our free enterprise system and the free market of ideas have brought more prosperity and a higher standard of living to the greatest number of people, regardless of race or color.

A free market built on integrity should be protected.  We cannot let it be destroyed by excessive entanglement of government with business and crony capitalism.  We can use existing laws to weed out bad apples.  We do not need suffocating regulations and government control for all.

Finally, we must protect one of the most intimate and life-sustaining bonds in our society: the patient-doctor relationship.  Patients entrust their secrets to doctors.  How comfortable does it make you feel to know that the National Coordinator of Health Information Technology is watching…or using your personal medical records against you?

Touching lives one at a time is why I became a doctor.  Fighting for what’s best for patients is what I do as a physician.   These days, physicians must also fight in the political realm so that people can take back control of their own lives.

Dr. Marilyn SingletonDr. Marilyn M. Singleton, MD, JD is a board-certified anesthesiologist and member of the Association of American Physicians and Surgeons (AAPS).

Dr. Marilyn Singleton ran for Congress in California’s 13th District in 2012, fighting to give its 700,000 citizens the right to control their own lives.

While still working in the operating room, Dr. Marilyn Singleton attended UC Berkeley Law School, focusing on constitutional law and administrative law. She also interned at the National Health Law Program and has practiced both insurance and health law.

Dr. Marilyn Singleton has taught specialized classes dealing with issues such as the recognition of elder abuse and constitutional law for non-lawyers. She also speaks out about her concerns with Obamacare, the apology law and death panels.

Congressional candidate Dr. Marilyn Singleton presented her views on challenging the political elite to physicians at the Association of American Physicians and Surgeons annual meeting in 2012.

Follow Dr. Marilyn Singleton on Twitter @MSingletonMDJD

More info about Dr. Marilyn Singleton

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