Sunday, October 21, 2018

The Fallacy of dEthics

Meet dHealth (video).

dHealth is digital, algorithmic, group-based health care delivery using blockchain technology.

Who are the dHealth promotors and visionaries? The exact same ones who lead the ABIM and ABIM Foundation in 1999 when it set out to "define medical professionalism" for us. Their final product, the 2002 Physician Charter on Medical Professionalism still stands tall as the guiding light of dEthics for much of organized medicine.

dEthics demands that devotion to the best interests of each individual be replaced by an ethic of devotion to the best interests of the group for which the physician is personally responsible.

dEthics is now driving corporate medicine. Data control. Information control. Education control. More with less; profit before person.

No one saw this more clearly that Dr. Richard Fogoros on his now quiet Covert Rationing blog:
The intent of the 2002 Charter on medical professionalism was to repair the problem (i.e., to cure the “frustration”), not by confronting the forces of evil doing the coercion, but rather, by simply changing medical ethics to make bedside rationing OK. And that’s just what the document did, though only after careful re-editing to make this radical change to medical ethics sound as benign as possible.
dHealth is the next great hope. The vision for world health sees blockchain technology allowing nurses (video) to access to a "complete file" of a patient's health information and to "see into the future in health" to deliver scalable care worldwide remotely using corporate dEthics as their guide.

What could possibly go wrong?


h/t: to james gaulte at the Retired Doc's Thoughts blog.


Anonymous said...

So the scam continues with the same scammers!

Anonymous said...

Not surprising to see the list of who's who in d'Ethics. Christine Cassel has been doing a lot of writing, policy-making and editing over the years on d'Ethics. Starting out with grant money from George Soros decades ago.

Anonymous said...

JAMA surprisingly hired Ms/Dr d'Ethics as "editor-in-name-only" for many recently published JAMA submissions. Go figure, you'd think the money savvy AMA would steer clear of the tainted queen of conflicts of interest.

I believe Washington politicians and the labor unions associated with Kaiser Permanente have already had it with C.O.I. Cassel (not participating in MOC) and her bad brand name in healthcare policy circles. So Christine must be scraping the bottom of the barrel deep-diving for dollars swinging her puny bat as designated hitter for Silicon Valley. (Sleeping on Bob Wachter's couch. Ouch!) Or maybe granny d'Ethics is just a sitter for d'team in Silicon Valley teaching them some of her patented brand of cartel ethics.

Anonymous said...

LOL! It all has the same flavor of the ABIN MOC cartel with Chris Cassel and Troyen Brennan's names written all over D'Health with the same laundered "foundadtion" money and dividends they stole from ABMS physicians and taxpayers.

Cassel and their team of healthcare mobsters must have awfully sweaty hands and a wet face to match by now swinging at all those low balls in the dirt for years.

Everybody sees the Empress and Emperor have no clothes as they swing away fanning out with more and more of the same dry hot air.

Anonymous said...

We used to think it was all about the money, but it really was mostly about control and ego that made them sell out.
It is a good thing that they don't have any power left in their incoherent swings. They might hurt themselves.

So sad when you realize their only real power lies in the fact that they bullied folks and made physicians fearful of losing their jobs through regulatory capture and industry mandates. Cassel et al did it mostly through convincing doctors that they are not lions, but merely meek sheep who must always bend over for them or kneel and kiss their rings.

Anonymous said...

"We propose that devotion to the best interests of each individual be replaced with an ethic of devotion to the best interests of the group for which the physician is personally responsible.

“The Ministry of Peace concerns itself with war, the Ministry of Truth with lies, the Ministry of Love with torture and the Ministry of Plenty with starvation. These contradictions are not accidental, nor do they result from from ordinary hypocrisy: they are deliberate exercises in doublethink”
― George Orwell, 1984

They want the physicians to have all the responsibility and no authority

ABMS D'Speak said...

Rather chilling statements from Orwell's 1984 hitting close to home.

Arrogance replaces humility as truth is replaced with lies in the country of the blind.

Moore O D'Same said...

I'm puzzled why Christine Cassel does not devote her retired years to meaningful "social activism" rather than chasing industry board positions and receiving huge consulting fees in Silicon Valley.

I see Cassel has been teaching the technocrats how to make a profit monitoring/collection data on the aging population health habits, and somehow creating cost savings for the various healthcare austerity programs.

All this interest in innovation in Silicon Valley geriatric startups, because she landed a lucrative 150K+ paycheck as visiting professor to UCSF via Dept of Medicine Chairman buddy Bob Wachter?

Shouldn't the admin require a time card for Chris at UCSF so she actually spends the required amount of time on campus as stated in her contract. Such cheating was problem at the ABIM for ten years where she was just paid to be the CEO but not to actually do any work there - too busy in DC.

Later, when she transferred over to the NQF in DC, it was the same problem of being in the office on K street as she was overhauling healthcare for the White House and keeping the DOJ at bay with crony Bob Wachter. If I recall it was over allegations of fraud involving the NQF recommendations/guidelines and industry bribery of one of their Safety Committee Chairmen.

Huck S Lee said...

What's wrong with this [#BraveNewWorld] picture of Healthcare tweeted by Robert Wachter today?

"Great talk by Chris Cassel, our Presidential Chair @ucsf this year, on future of professionalism in era of digital health, social determinants, consumerism, MD burnout, and rising costs. Need new understanding of what being a professional looks like"

Elites Who Have Never Seen the Inside of a Pearson Vue Testing Site said...

Classic! An elite timecard for Dr. Cassel.

Cassel's timecard at UCSF is a "Tweet" from her longtime ABIM/NQF "Minister of Propaganda"?
That's 30 minutes so far. Let's see how long Bob can keep track of her campus activities.

Meanwhile in the real world where former ABIM CEOs shun MOC (now decertified in geriatrics)

and ABIM board chairs (grandfathered in medicine) don't want to risk taking the hospitalist certification test. The IM pathway that he created for doctors in the trenches, but not for elites like himself.

That's great, Bob, when the "father of the hospitalist movement" and ABIM certification that bears his name is understandably afraid of the possibility of humiliating failure and the discomfort and demoralization of being printed, frisked and surveilled at a Pearson Vue center . . .

As a result of MOC and hypocritical privileged pseudo-professors like Bob and Chris there is no time to live, love or be a responsible citizen

Anonymous said...

It is fairly common to see physicians attacked by patients in China. There are occasional news reports that make it to the United States. The headline "Please don't stab the doctor" is still fresh on my mind. It happens because under Communism, healthcare is used to control and abuse the population.

Please, every physician with any influence--fight Socialized medicine. There has never been anything as antisocial as socialized medicine. Your patients will thank you if you will fight this worthy fight. Alternatively, wait a few years, ignore the problem and one day you may be shot, stabbed or otherwise accosted in a way that you would think back upon and say, "I should have stopped socialized medicine"

Some say, I'll just retire. If you're looking the other way, covering up for people, or actually harming patients then eventually someone is going to come find you, even though you may have already retired or changed careers because you don't want to deal with this. You would long for the days of medical malpractice lawsuits that are the standard for vindication among many. You will regret that tort reform was pushed. Because one day--even if you didn't do something wrong--there will be that person ready to resort to vigilante justice and maybe ANY representative of healthcare will be enough. I'm not threatening anyone, I'm just saying don't put your head in the sand on this because we'll end up being like China.

Anonymous said...

Ahhhh - So that is where "Dr." Cassel wound up after her stint with the Kaiser medical school.

People do not want her brand of FACTORY MEDICINE. Patients don't want it and Doctors don't want to practice it.

In Colorado where people still have a CHOICE, Kaiser is losing money and patients hand over fist. People don't want it. Doctor's don't want it - burn burn burn burn out!

Get a clue Cassel et al!

ABIM InfraThugs said...

Cassel's D'Ethics Squads

State actors and corporate thugs going way beyond their job descriptions dancing outside the margins of the law . . .

Quite a d'Ethics squad that Cassel, Wachter, Baron, Holmboe, and BallardSpahr counsel et al hired, assembled and conspired with at the ABIM/ABMS.

Remember ABIM's big 300K bonus gal strongman Lynn Langdon and their "director of investigations" with his 27-man ABMS goon squad.

The Good Doctor said...

What is the new medical professionalism that the ABMS, Wachter, Baron and Cassel are pushing and what will physicians in the Orwellian digital age look like?

Will the model doctor and his aids be tested globally first possibly in China?

Think again SoftBAnk has its robotic healthcare helpers testifying before Parliament in the UK on how robots will fill the role of humans in providing care to the aging populations of the world.

Meet Pepper the healthcare provider at Middlesex University in the UK who is going to take care of the elderly. (Is the Good Doctor role for Pepper/Dr. Watson next?)

Sean said...

What you stated sums it up very well, Dr. Wes. It is much clearer now what they have been doing and why. Disgusting.

"dEthics is now driving corporate medicine. Data control. Information control. Education control. More with less; profit before person."!

Intensive Comfort Units? said...

More wise choices from the laptop of Bob Wachter (and ABIM Foundation opinion leaders)

What a difference a word and words can make. Opinion leader Bob Wachter and his UCSF medicine team (including visiting professor Chris Cassel?) recommends in JAMA to change the term ICU (Intensive Care Unit) to CIU (Critical Illness Unit) to under-emphasize the word "care", which has the implication of providing/necessitating "intensive care" to patients.

They seem to recommend "other staffing models" that might turn an intensive care unit into something very different where "communicators" can be brought in to suggest "other goals" for patients in an ICU - communicators who can primarily facilitate families to make critical decisions for their loved ones.

Bob Wachter's Twitter Feed
"Sometimes the name matters – our @ucsfmedicine pulm/critical care fellow Brian Block argues in @JAMAInternalMed that the name "intensive care unit" promotes overly aggressive treatment. He favors "Critical Illness Units" – key paragraphs being . . ."

"Does the Term Intensive Care Unit Promote Aggressive Treatment? Brian L. Block, MD
Author Affiliations: Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of California, San Francisco, San Francisco
JAMA Intern Med. Published online October 22, 2018. doi:10.1001/jamainternmed.2018.5400

First page for those locked out of JAMA by the pay wall

Is this what they had in mind in the ABIM Foundation Physician Charter?

"Summary [Medical Professionalism in the New Millenium]
The practice of medicine in the modern era is beset with unprecedented challenges in virtually all cultures and societies. These challenges center on increasing disparities among the legitimate needs of patients, the available resources to meet those needs, the increasing dependence on market forces to transform health care systems, and the temptation for physicians to forsake their traditional commitment to the primacy of patients’ interests.
To maintain the fidelity of medicine’s social contract during this turbulent time, we believe that physicians must reaffirm their active dedication to the principles of professionalism, which entails not only their personal commitment to the welfare of their patients but also collective efforts to improve the health care system for the welfare of society. This Charter on Medical Professionalism is intended to encourage such dedication and to promote an action agenda for the profession of medicine that is universal in scope and purpose."

S L Greene said...

Offshore investing beyond the reach of the SEC for the elites and their quality assurance cartels.

What is it all for? What does this constant cheating we witness among the major NGOs and corporate players all about? And why is MOC so important to them?

It is evident the ABIM/ACP Physician Charter is not really about equity at all. It is about control and power and more money for the elites.

Listening to Chris Cassel in a recent talk to venture capital groups and innovators in Silicon Valley we can see where she is coming from and what she and her cronies want.

Cassel intimated clearly she and they want . . .
One healthcare for the rich sporting "innovations in longevity" with no stops for elites as Chris Cassel dramatically proposed recently to Silicon Valley.
And Cassel and company want another kind of medicine - rationed healthcare/cost reductions for the elderly with truncated services/interventions - for everyone else.

20 Trillion Dollar Question

Have Bob Wachter, Chris Cassel, Richard Baron and NGO's like ABMS International, ABIM and ABIM Foundation served as instruments for banksters, multi-billion dollar corporations and offshore Hedge Fund managers like George Soros???

It is clear they all have been engaged in mutli-year projects for social engineering and healthcare rationing utilizing NGOs to further their own selfish political and financial interests.

The word "universal" in the Physician Charter appears to mean something else. It is certainly not a bening word when cartel leaders like Cassl and Wachter speak it. Their work is not "universal" but something megalomaniacal, secretive and sinister - frighteningly "globalist" in the pejorative sense of the word.

It always is a global crisis when the competition is over billions and trillions of dollars, precious resources and the power it all brings. Especially so when it leads to military adventurism and the potential for global confrontation of an unprecedented scale and degree.

Lots of money on the table for global banks/insurers/multi-national corporations in China

Soros OSI/IMAP and other NGOs received a blow recently with the crackdown on non-governmental organizations in China. Especially Soros who tried to short the Hong Kong Market, but lost when the Chinese government stepped in to infuse billions in cash.

Seeing Soros as a villain in China may dampen the ABIM/ABMS/OSI/IMAP's ability to spread their version of medical professionalism in the most populous country on earth. If the Chinese have done their due diligence and made the money connection between Soros, the Institute on Medicine as a Profession and the ABIM Foundation corporate propaganda.