Most of you know that I am still working part-time for V.A. doing dermatology clinics—something I love! However, at this time I need to report to you on the abysmal condition of medical practice. It is currently extremely skewed toward the prevailing philosophy of Extreme Rationalism, with epidemiologists at the top of the current medical model. In the setting of a novel pandemic this leads to a paralysis of specific care, that is a refusal to take any therapeutic risk, even on the battlefield of daily life-and-death Covid-19 decisions. Former patients and dear friends, we are now clearly seeing THE HYPOCRITICAL PARALYSIS OF EPIDEMIOLOGISTS directing the current pandemic. (Consider their opinion on Azithromycin, Hydroxycloroquine, Budesonide nebulizer and many other specific antiviral agents being used effectively in countries like Japan, Singapore and Taiwan.)
Extreme Rationalism has thoroughly permeated most of modern medical practice since the seminal Flexner Report (1910) revolutionized medical education. Prior to this a largely empirical model of medical science prevailed. Rationalism has gone hyperbolic during the past 20 years resulting in a radical medical model REQUIRING EXTREMELY EXPENSIVE AND TIME INTENSIVE MULTICENTER, HIGHLY CONTROLLED, RANDOMIZED CLINICAL STUDIES WITH LARGE NUMBERS OF HUMAN SUBJECTS (N-1000’S) with strict data controls and statistical analyses before, during and after the studies are performed, under the scrutiny of the ethics committees, BEFORE THE MEDICAL CONCLUSIONS CAN BE TRUSTED OR APPLIED TO ROUTINE PATIENT CARE. Any other standard of medical care is either denigrated or held to scorn and called QUACKERY. This is of course all in the favor of large vested interests retaining their financial monopolies. In the process any other philosophy of medical practice or even just common sense practice has been marginalized and/or demeaned.
WORSE YET, the medical conclusions and recommendations drawn from this mined data ARE FOR THE GROUP ONLY, and specifically apply truly only to the median/average individuals — NOT FOR THE MAJORITY OF THE SUBJECTS STUDIED!
That’s right, modern medicine has steadily progressed down a long road of Extreme Rationalism, with the focus on how the large GROUP responds to the test variable (usually a novel patented drug), with NO CONCERN FOR THE INDIVIDUAL! Yes, these so-called experts say that you can draw a conclusion from these large expensive studies for the N-1 (individual patient), but it is only an approximation and really only strictly applies to the median/average patient tested. This is, of course, medical Socialism, where the GROUP is valued and the individual is denigrated. THIS IS THE MAIN REASON WHY THE QUALITY OF MEDICINE HAS DROPPED TO IT’S LOWEST POINT SINCE THE EARLY 20TH CENTURY. Totalitarian control based on this philosophy of Extreme Rationalism has been debasing independent medical practice since Flexner and gradually drawing it into a Socialistic model, where the State practices medicine through mandatory medical guidelines. The Government in collusion with other vested interests, such as large insurance companies, big pharma and drug wholesalers with their retail drug outlets have commandeered the practice guidelines from the doctors. THEY NOW TELL DOCTORS WHAT, WHEN AND WHY they can test and treat patients—ALL BASED ON A SOCIALIZED MEDICAL MODEL OF THE GROUP, from large expensive studies with conclusions that only strictly apply to the median/average individuals tested.
THIS IS THE TRUTH! I am sorry we as doctors have not done a very good job of defending the individual practice of medicine, which is largely based on the philosophy of Empiricism. This is ALL ABOUT the individual patient, thus, I refer to it as N-1 Medicine. It requires an intelligent, studied and eclectic (often times even intuitive) approach to medical practice. Empiricism cannot be directly compared to
Extreme Rationalism, because the tenets, values, beliefs and presuppositions and results are very different. The chief value of Empirical Medicine is independence and freedom of choice. Do you want the doctor to practice medicine, or the Government/Insurance/Pharmaceutical Complex (GIPC) to practice medicine, based on their vested interests? Do you want the patient to have a choice in their medical care decisions?
We are truly at the crossroads now in modern medical practice. Let’s shine some light on these two dominant medical models of the past 200 years:
1. Empiricism (dominant during the 19th and early 20th Centuries).
Sacred Doctor/Patient Relationship.
Prevailing dictum: What is BEST for the N-1 (individual patient)?
Based on personal knowledge of the individual, compassion, experience, trial
and error, as well as intuitive ability.
2. Extreme Rationalism (progressing since the Flexner Report, with crescendo
in 21 st Century.)
Sacred Provider/GIPC Relationship.
Patient rights and freedoms marginalized.
Provider expected and/or required to use tests and treatments that should
work on median/average patient.
These treatments and tests are tainted with vested interests of the GIPC. PROVIDERS HAVE SUCH GREAT ADMINISTRATIVE BURDENS, INCLUDING
DETAILED COMPUTER DOCUMETATION, THAT VERY LITTLE TIME CAN BE SPENT WITH HANDS-ON PATIENT CARE. PROVIDERS ARE TYPICALLY DUMBED DOWN IN THEIR CLINICAL ACUMEN. THEY ARE TAUGHT TO ONLY THINK IN-THE-BOX GROUP-THINK RE-PROSCRIBED VESTED INTEREST GIPC TESTS AND TREATMENTS.
I have been licensed to practice medicine in the USA since 1979. I have seen the gradual drift away from freedom for doctors to practice medicine according to their best judgment since that time. Now, in 2020 my judgment is constantly being questioned by all levels of the GIPC—even now adding Dr Fauci and the Epidemiologists questioning my Covid treatment decisions.
So, what do the Epidemiologists know? They know NOTHING by the gold standard of their Extreme Rationalism about a novel infection; and they know nothing about the individual patient (their only avowed trusted knowledge is re the large GROUP). THEY ARE PARALYZED WITHOUT THEIR LARGE EXPENSIVE GROUP STUDIES. (THEY OF COURSE DENIGRATE ANY MEDICAL DECISION MAKING BASED ON COMMON SENSE OR COMPASSIONATE CARE OF THE INDIVIDUAL.)
So, does the above stop them from making recommendations?? Of course not! They hypocritically, even pridefully run their mouths all day re their OPINIONS on free media time, trying to strike as much FRAUDULENT FEAR INTO AS MANY PEOPLE AS POSSIBLE—ALL BASED ON THEIR OPINIONS. THIS MUST BE QUACKERY!! A good example of this is Dr. Fauci, who I heard on TV say recently that COVOD-19 is his worst nightmare. It is so nonsensical to hear a supposedly educated man say this vis a vis the Spanish flu with a case fatality rate multiple times COVOD-19. Or the HIV epidemic with all of its unknowns in the 1980’s. Or the Black Death in the 14 th Century. Or etc, etc, etc. . .
So, we have Epidemiologists bowing down at the alter of Extreme Rationalism, who have no reliable gold standard data points, but are willing to spew fear all day and night on free media outlets. REALLY, HOW HYPOCRITICAL IS THAT? Now watch carefully, these Extreme Rationalists will soon openly and with great VESTED INTERESTS practice another great hypocrisy. They will passionately and endlessly preach and endorse a VACCINE THAT HAS NOT BEEN TESTED TO THEIR GOLD STANDARD. HOW HYPOCRITICAL AND GREEDY$$$$$
P.S. – No VACCINE to my knowledge has ever been held to their gold standard of testing. WHY NOT?? Maybe because these infectious agents mutate so frequently that it is nigh impossible to have the right VACCINE available to help the right individual prevent the infection at the right time. Case in point is Lyme Disease. I believe Dr. Fauci may have been involved with that VACCINE that was being rushed to market before adequate time for testing. It was pulled right before it was to be released due to genetic heterogeneity of the infectious organism (mutations).
Of course then the Epidemiologists changed their tune—instead of everyone needing prevention of this dread disease, after the failed VACCINE, they said it wasn’t that bad, just don’t get a tick bite. Of yes, SINCE THAT TIME they also have maintained the farce that there is NO SUCH THING AS CHRONIC LYME, only an acute bite, that’s all. This is so nonsensical, seeing that the organism is very similar to SYPHILIS, only smarter genetically. In reality Chronic Lyme Disease is a very common and very debilitating disease in the USA, with very little information or providers willing to buck the Epidemiologist cartel to help these very unfortunate individuals. NOT ONLY HYPOCRITICAL, BUT ALSO DIABOLICAL. JUST BECAUSE THEY COULDN’T GET THEIR VACCINE PERFECTED.
I have not published on these things before, but I have felt that it is TIME to say these things. It is time to recognize that Socialism (the GROUP being more important than the individual) has crept by stealth into medicine and our freedoms have shrunk considerably.
Finally, I believe IT IS TIME FOR THE RENEWED INTEREST IN INDIVIDUALIZED MEDICINE, WHAT I HAVE CALLED N-1 MEDICINE. Let’s let the Socialists and Communists treat their people with Group Care, using providers that have by vested interest a very limited repertoire of tests and treatments. I personally would like N-1 Care, with experienced, even master doctors, who are purposed and focused on treating me individually with all of their eclectic training, with all of their compassion, with all of their unique experience, and with all of their wit and unique
abilities, including their intuitive talents. AND WITHOUT FRAUDULENT FEAR!!
Steven A. Smith, MD
All His Benefits