AAPS and Immunizations
I have been a member of AAPS for a number of years now, but have never attended a meeting. I, like many others I am sure, support your efforts from the sidelines.
I just wanted you to know I especially appreciate your strong position on the immunization issue and the resolution which was passed at the October 2000 meeting.
Immunizations contribute to the enormous and tragic increase in autism in this country and it is about time that physicians take a stand on this issue and defend the patient's right to choose.
Currently there are only 19 states in this country that allow a philosophical exemption to immunizations. All but two, West Virginia and Mississippi, allow a religious exemption.
It seems imperative that the first step for physicians who have not carefully studied this issue is to become informed. To that end, I publish a weekly newsletter that is free to subscribers. It focuses on many of the travesties the government and drug companies are imposing on the public. The web site is http://www.mercola.com and I have over 5,000 pages of articles that are available for review to help get physicians up to speed.
Joseph M. Mercola, MD
Bullets as Pathogens
Dear Dr. Faria,
Let me take this opportunity to thank you for your courageous efforts to present "the other side" of the rather strained assertion which I will summarize as, "Bullets are a pathogen, and guns are thus a medical epidemic, which we are justified in treating with the same kind of public health measures we would direct toward the elimination of, say, an outbreak of Salmonella typhi."
If I recall correctly, you were among the first to allow rebuttal arguments in print in the medical literature, offering both sides of this debate...and thereafter paid an all-too-predictable professional price for challenging this somewhat bizarre orthodoxy.
When time allows, maybe you would even consent to a phone interview on that topic, as well as on some of the newer developments in the field of medical privacy and government "medical tracking" --- an idea which John Taylor Gatto contends got its start in the works of a particularly depraved early nineteenth century Prussian, though the name escapes me.
Assistant Editorial Page Editor
Las Vegas Review-Journal
AAPS and the Court
I have been a member of AAPS for several years now. I do appreciate what AAPS has done through the court system to help physicians. I believe it is mainly through the courts in a manner similar to the civil rights movement, American Civil Liberties Union, the Southern Law Poverty Center, and others that physicians' rights can be protected and consequently patients' rights and health. Therefore, I encourage AAPS to pursue legally those paths in the courts that will achieve the goals that AAPS stands for --- namely, physicians' and patients' inviolate relationship to maintain good health and treat illness in patients as the physician sees best.
Obviously, we cannot all go the the courts. But there are many things that we can do individually to achieve these goals. I find that AAPS rails against government especially Medicare and against insurance companies with little constructive action for individual physicians. We can all go yelling and decrying what Medicare and the insurance companies are doing but the fact of the matter is they are here to stay. Therefore, we need to develop actions and plans that will be of value to individual physicians (and thus benefit patients).
It is to be remembered that there are less than one million physicians in the United States compared to 37 million seniors. Congressmen and state legislators will vote to please 37 million people. Our only recourse, then, is the court system and individual action.
Thus, I recommend that AAPS continue to keep us informed on developments in Congress, but without making it such a dominant part of the newsletters. And, that AAPS inform the membership of legal action it is taking on various issues. Finally, that AAPS help guide physicians regarding how best to practice within the current framework. Examples of the latter include: (1) making as many patients on Medicare non-assigned, (2) guiding doctors to balance Medicare and non-Medicare patients so as to protect income, and (3) recommending that doctors avoid any managed care contracts. (The doctors who have done that in this community continue to do well financially, are happier, spend more time with their patients, and treat patients as they know is most appropriate.) There are other suggestions for physicians for articles on individual physician's success in approaching practice in the present context without compromising quality. These would be useful. Even the Medical Sentinel could have more of these kind of articles much like Medical Economics used to have before they moved on to stories about managed care and the like.
Many doctors do not know that there are options for them that are viable, can result in satisfactory income, and personal satisfaction. If more doctors took these steps the tide would eventually change. These are not easy solutions nor can they be taken lightly, but for the individual physician they can be of great value emotionally. We are not going to make millions like sports figures, but I do not know of any doctor who cannot make a decent living and I am sure we will always continue to make a decent living in the future if we take the proper steps.
I trust this is helpful as you lead the AAPS onward and upward.
David N. Reifsnyder, MD
Dr. Orient Replies
Dear Dr. Reifsnyder,
...For many years, we've shared your beliefs that the best way for us to make progress was in the courts. That was before we had so much dismal experience with the extreme high cost, the inevitable long delays, and the corruption in the judicial system. Most judges are not interested in reversing precedent or establishing a new precedent. They will rule as narrowly as they can. We do nevertheless plan a more aggressive program in this department and have expanded our limited legal consultation service to make more expert assistance available to physicians early in the stages of Medicare or insurance audit. As far as I know, we are the only medical organization that has offered any constructive assistance whatsoever to individual physicians. We have filed a number of amicus briefs and helped various physicians structure their cases. We have written letters credited with keeping physicians out of jail. And we continually try to increase the awareness of physicians, the public, and medical societies about what the fraud squads are really doing. All too many people believe that it's only the bad doctors that they are harassing.
We have also been very discouraged with the prospect of making any headway in Congress. The power of the seniors lobby is as you have described it. I do think that the seniors would be on our side if they realized the consequences of planned congressional action. In addition, the younger generation should be on our side. I think we need a better exposure and a better attempt to frame the issues.
The newsletter has a monthly insert from Dr. Robert Moffit of the Heritage Foundation concerning the ongoing political scene. Perhaps you feel that's too much space for that aspect. I could argue that it is both too much and not enough. You have been attempting to write more about physicians who are finding alternatives to entrapment in government programs. We are considering having some local seminars to provide more constructive advice on how to escape the tentacles of managed care and government. We will probably start in Arizona and California, but we would certainly be willing to bring a program to your area. We would need some local assistance in making arrangements and publicizing the program. Let's see how our trial runs go. I will also pass along a copy of your letter to Dr. Faria of the Medical Sentinel.
As I see it, we need both a short-term and a long-term strategy, and that the legal, the legislative, the public relations, and the individual assistance to physicians need to be part of the strategy. I think you will see our emphasis changing somewhat in the coming years. We certainly appreciate your very helpful suggestions.
Jane M. Orient, MD
Executive Director, AAPS
Doctors and Guns --- A Failure of the
Public Health Model (Part I)
The expressed sentiments are so irresistibly logical and articulate, unemotional (which is good, because we put up resistance to emotion most of the time fearing that we will look like kooks if we get caught up in it). I truly like what you all are doing. More than that I love the truth. The truth should sell itself and I think it will if we use the power of repetition more than we use emotion.
As to the government's primary educational obligations to me as a citizen, they are as follows: For my personal security, it is to teach me and each succeeding generation: 1. how to vote, and 2. how to shoot.
As to what the government is not to do to me: For my personal security: 1. It is not to interfere with my hearing or acting upon my philosophical opposition to it, and 2. It is not to interfere with or prevent me from protecting myself physically from itself or from others.
The common rule is for each citizen to manage and defend his own yard first...protecting himself by voting and only by shooting as a last resort. Obeying this rule of responsibility is essential for personal and family protection. On the back of the dollar bill it says, "In God We Trust," meaning that we trust that misdeeds will ultimately be corrected by God....
Jack Tidwell, MD
Brilliant and filled with common sense. Where do I go to off-load liberal philosophy in this society?
Thomas Mueller, MD
Castro's "Doctor Diplomacy"
I just read the article, "Castro's 'Doctor Diplomacy,' " published in the November/December 2000 issue of the Medical Sentinel. Congratulations and thank you for prioritizing the subject of Cuba's health care in your publication, and for exposing, through this article, the fraudulent claims Cuba makes about its system and its alleged "medical achievements."
Toward the end of the article, the authors mention the cases of three other Cuban physicians brutally treated by Castro's government: Drs. Oswaldo de Cespedes, Oscar Elias Biscet, and Dessy Mendoza Rivero (the last two are of Afro-Cuban descent, by the way, a detail that, conveniently, no one mentioned to the U.S. Congressional Black Caucus representatives).
It is about Dr. Mendoza that I wish to speak to you at this time. Dr. Mendoza Rivero, a 45-year-old physician who founded the Independent Medical Association of Santiago de Cuba, was the physician responsible for revealing to the world in 1997 that there was a Dengue Fever epidemic in eastern Cuba, a serious health hazard that the Cuban government kept hidden so as not to scare away tourists from that area of the country during Carnival and the Caribbean cultural festival season (May through July).
After Dr. Mendoza broadcasted the news through the foreign press and media, he was arrested, tried, and sentenced to eight years in prison for "enemy propaganda."
Afterward, the Cuban government had no choice but to officially confirm that there was a serious epidemic...But Dr. Mendoza still went to prison.
Under sponsorship of the Center for a Free Cuba (a Washington, DC-based non-profit, non-partisan organization that promotes human rights and democracy for Cuba), Dr. Mendoza and I are co-authoring Dengue Fever: Castro's Secret Epidemic (¡Dengue! : La Epidemia Secreta de Fidel Castro). The book will be out this year.
Author and translator
via e-mail, IFAConsult@aol.com
America: The Most Violent Nation?
I just finished reading Dr. David Stolinsky's article, "America: The Most Violent Nation?" in the November/December 2000 issue of the Medical Sentinel. It was breath-taking. I believe it to be the most concise, even-handed, erudite article I have ever read on the subject, and it should be reprinted in every newspaper in the country for the masses to assimilate and enjoy.
It's "a keeper" for all time, as so many articles in the Medical Sentinel are. Thank you.
Alan Berger, MD
The Nazi War on Tobacco and Cancer
In your excellent review of Robert N. Proctor's book, The Nazi War on Cancer (Medical Sentinel, November/December 2000), you postulate that the drop-off in stomach cancer in the earlier 20th Century was possibly related to better methods of meat curing and preservation.
As an amateur student of history, I have always found the reverse parallel between stomach, oropharyngeal and lung cancers to be most interesting. Having trained at the Alton Ochsner Medical Foundation in New Orleans, Louisiana, I came into contact with the writings of Dr. Alton Ochsner, Sr. As a professor of surgery at Tulane University Medical School earlier in the 20th Century, Dr. Ochsner did some of the finest pioneering epidemiological research on the origins of lung cancer ever seen in the medical world. By his research he factually demonstrated and logically deduced that lung cancer was directly attributable to cigarette smoking. And what he learned and wrote about has been scientifically manifested on the altar of human history.
With the discovery of the New World, European traders engaged in a tobacco commerce with the North American Indian nations. Some men would put it into a pipe and smoke it while others chewed it. Now if anyone has ever chewed tobacco, (and I am not one of those), you know that it is axiomatic that if you swallow the tobacco juice for whatever reason you can get a pretty good bellyache and may even "heave your cookies." As the tobacco habit spread and became more socially acceptable, there soon were so many men chewing and spitting that public hygiene became a real problem. In an effort to make the world spittle-free for democracy, spittoons were made and distributed in public houses so that men could expectorate into these vessels rather than on the floors or in the public places in order to avoid an unavoidable breach in public comity that arose from this regrettable social phenomenon. At a time when tuberculosis reached crisis proportions and was killing off large numbers of people in the 19th century in this country and abroad, public health authorities weighed in to combat the very vector of spread --- expectorated mouth and bronchial secretions. It actually became unlawful to "spit on the sidewalk" --- literally. Inasmuch as a sociolegal taboo was applied to tobacco chewing --- if you can't legally spit you can't really safely chew it --- the numbers of men chewing plummeted and so did mouth and stomach cancers.
But vice is nice, and so men had to get their tobacco fix satisfied another way. Now we come to cigarette smoking, first hand-rolled and then machine-rolled, in effect, mass-producing cigarettes in prodigious numbers. So in an eyeblink of time, chewing was almost completely replaced by cigarette smoking, which was not held to be objectionable to the ways and manners of society at that time. Thus, we see at a moment in history when the TB sanitariums were filled to the gunwales and public health officials had condemned as unhealthy and unwise tobacco chewing, there began a steady meteoric rise in lung cancer rates that neatly paralleled the increasing popularity in cigarette usage.
Again, in reference to your review, you postulate that better meat processing was the cause of lower incidence of stomach cancer, history really reveals that one vice was switched for another. And lung cancer eventually eclipsed stomach and mouth cancers when spitting and spittoons went the way of the dinosaur --- unless you play baseball of course.
W. Patrick Flanagan, Jr., MD, FACS
Dr. Faria Replies
Dear Dr. Flanagan,
Interesting observation. Although both smoked and chewed tobacco increases the risk of oropharyngeal cancer, smokeless tobacco ("snuff") increases cancers of the cheek, gingiva, and inner surface of the lip by a much higher degree, by about 50 times. It would be interesting to learn if these cancers have declined as precipitously as stomach cancer. I would concur with Robert Proctor that the reduction in stomach cancer is more likely related to better methods of meat curing, refrigeration, and preservation. --- Ed.
Correspondence originally published in the Medical Sentinel 2001;6(1);1-4. Copyright©2001 Association of American Physicians and Surgeons (AAPS).