In Perpetuum of Independent Physician’s surrender to Corporate Employment

Updated: Jun 17

The epitome of self-inflicted White-collar Absolutism

Originally published by Illumination Curated on Medium

Photo by Brandon Holmes on Unsplash

Patient care is an immensely intimate task that is carried out between patient and their clinician. It requires a sovereign Milieu where a patient and physician can independently interact.

In contrast to those employed by large organizations, an Independent Physician owns a majority if not the entirety of their medical practice and has the right to make critical decisions for that practice.

Once a physician decides to give up independent medical practice for any reason, they should also contemplate giving up part or all of the privileges that come with a private practice. Ironically, that includes freedom of expression and publicity.

Although the control over physician self-expression is multi-faceted, including licensing and certification, corporate medicine is one of the most effective means against physician sovereignty.

Tyranny over physician free expression is not new. For instance, during the WWII Seiss-Inquart, Reich Commissar for the occupied Netherlands commanded the Dutch physicians into Germany’s lethal injections program. However, in opposition, the physicians of Holland unanimously rejected Nazi Germany’s order, turned in their medical licenses, and remained adamant even after hundreds of doctors were sentenced to concentration camps.

Independent Physicians Practice state of affair Today

Based on a recent report from American Medical Association (AMA), in 2021, 49.1% of physicians will be in independent practice. That is the lowest ever reported. But the problem does not stop there. As more and more physicians join large practices and become employed, further bureaucracy takes over their autonomy to express their professional opinion. The emergence of the COVID-19 pandemic and politics around it made their already compelled status even more intricate.

Today amid the Coronavirus pandemic, many reports show that doctors and other medical professionals are being silenced about coronavirus conditions. The country’s two largest physician groups say doctors have the right to be heard. For instance, in 2020, a Washington emergency room physician was fired after he spoke out about his hospital’s coronavirus response. This year a Wisconsin-based Mayo clinic employee internist Steven Weiss, MD, was terminated merely for the reason that in his book (“Carnage in America: COVID-19, Racial Injustice, and the Demise of Donald Trump), he introduced himself as the employee of the Mayo Clinic.

For years physicians have been burdened by increasing administrative mandates. They have had almost no voice in the healthcare system. Based on a survey in 2021, over 42% of physicians reported some form of burnout. Physician suicide rates are also on the rise. But amidst all said, active silencing of the physician is a relatively novel phenomenon. That is why we must glisten the telescope of the causes of such atrocities, either compel them to rectify or render them trivial.

The battle against Physician’s voices is just the beginning

Not long ago, I wrote the piece titled “Physicians: The Culture of Complainers. Within, I highlighted the very nature of physicians’ attitudes and their innate characters as “Blackhat thinkers.”

Today, the Black Hat thinking attitude is not working in favor of physicians, after All!

But now, more and more medical community are expressing their frustration in the media. Like members of every other industry, physicians are making their voices heard. Yet still, since they fall into the trap of the employment contract clause, they are penalized for breaking their silence.

After publishing the book about his experience during the COVID-19 pandemic, Dr. Weiss was fired from his position at the Mayo Clinic by the administrators claiming his actions violated the health system’s publishing policy. He failed to submit his manuscript to the institution for review before issuing it. Their prerogative was that Weiss was fired under a “without cause” provision and that problems that prompted their inquiry had nothing to do with misconduct, incompetence, negligence, or a violation of Weiss’s employment contract. Today, the internist is no more allowed to enter Mayo Clinic facilities or see patients. The personnel committee, in fact, and the board of directors chose to expel him from the system. That makes the cause of the worry even more pertinent as it shows utter disregard for Freedom of Expression and overrides equal Opportunity to Prove oneself. The administration intends to legitimize its action based on a policy that is prejudiced simply because the organization is nonprofit; in a statement, regional vice president of the Northwest Wisconsin region at the Mayo Clinic Richard Helmers, MD, alleged that:

“Mayo Clinic Health System is a nonprofit organization. Therefore, since it is not associated with any political party. therefore, patients should be assured that care is not obstructed by political views.”

I believe beating behind the “nonprofit” prefix doesn’t cut it, as it has nothing to do with expressing an opinion.

Dr. Weiss responds:

“I’m still in shock that I was terminated for this,” he stated in an interview with MedPage. I had no idea that they would claim a right to pre-vet a book before publication.”

Then Dr. Helmer held:

“In a statement that “the book authored by Dr. Steven Weiss was conducted independent of Mayo’s knowledge or approval and did not adhere to Mayo Clinic policies.”

What policy would that be to hold back what a physician thinks is the best for their patient?

Doesn’t everyone have an opinion? — or should employers fire anyone if their view contradicts that of the employers?

If so, the world would genuinely be a chaotic place to live.

Allegedly, in his book, Dr. Weiss published regular articles during the pandemic, beginning when the first COVID patient he encountered. Like most other citizens and journalists worldwide, he continually expressed opinions on the influence of politics, religion, and culture on Americans’ perception of COVID-19. Within the even faulted the Trump administration for mishandling the pandemic rejoinder. I believed that was the point since the media talked about it day in and day out and the spokespersons for the primary health organization. I wonder what makes this any different?

Besides, Weiss criticized some of the Mayo Clinic’s policies, including a pandemic policy that he believed limited the use of N95 masks. But, then again, Wasn’t that the truth?

It was not just the mayo clinic policy, but many other facilities enforced similar guidelines in the initial months of the pandemic. In fact, in 2020, Kaiser was reprimanded for failing to treat COVID-19 as an airborne disease.

Interestingly enough, Weiss was also faulted for denouncing the Mayo Clinic’s implementation of EPIC’s electronic health records system in 2017 and 2018 when Mayo Clinic Completed the $1.5B Epic EHR Implementation Project. Well, according to the Washington Examiner, Epic Systems Corp. Chief Executive Officer Judith Faulkner has provided campaign contributions to Democrats and has served as a federal Health Information Technology Policy Committee member. That means she holds control over the future of national health information technology policy.

Today, Epic now retains over 30% of the electronic health record (EHR) market share.

The Mayo Clinic asserted in Dr. Weiss’s termination memo that it performed an employment inquiry into Weiss’s case and concluded; that his book contained “unauthorized use of confidential business information. And that the doctor identified himself as a Mayo clinic employee without prior authorization. He inappropriately used patient identifiers and used derogatory and unprofessional annotation in his book, giving Mayo a lousy reputation.

Isn’t this part of the game of cartel?

As expected, according to Weiss, he did not include any information that would put the Mayo Clinic at a competitive impediment and changed all patient identifiers in the book to protect their privacy. Therefore, it is judicious to substantiate that he would have been terminated if the mayo clinic doctor did not identify himself as a physician employed by the Mayo Clinic in his book.

The Take-Home Message

Physicians are a peculiar breed of experts, as they take pride in what they do and always take that extra step for their patients when needed. Doctors generally put their patients beforehand for their welfare. For that reason, it takes awe-inspiring perseverance, diligence, discipline, and hard work to earn the designation of a medical doctor. But then again, indiscriminate Market drifts are forfeiting Independent Physicians' Practices. Overwhelming pressure from the administrative burden and the Value-based reimbursement model forces physicians to give up the autonomy they need to deliver their best services to the patients and seek employment with large healthcare systems like Mayo clinic. But, the Corporate System Is not quite rewarding to most physicians. Today, once you work for a large organization as a physician, you also give away your individuality.

What the Mayo Clinic internist had signed as part of his employment agreement clause is one thing that makes him bound by whatever was dictated by his employer. Nevertheless, why he had to enter into such a contract is something that we are shedding light on today.

There are more than fifteen challenges that every healthcare organization (Independent physicians are no exception) has to deal with today. However, organizations like Mayo Clinic are well endowed to deal with them, but most independent physicians are not!

Vetting Dr. Weiss’s publication is nothing short of monopolizing the professional opinion buy those with unique interests in an organization, including Nonprofit entities. The medical space is very well known for establishing various Boards to ensure no one who disagrees with the mainstream doesn’t get a chance to express an opinion. That does not preclude the Editorial board.

“It is the healthcare corporate mainstream prerogative to vet all publications because it ratifies the spread of false information just as it prohibits the truth.”“Sovereign Healthcare needs a self-determining patient and independent physician. “ — Dr. Adam Tabriz
“To curb the power of science, tyrants have traditionally exercised rule of dropping the rational; the modern tyranny, yet, begets mastery of unique know-how- thus eliminate the ration itself.” — Dr. Adam Tabriz
“In the modern sense — physician’s responsibility to patients goes beyond the walks of the clinic and exam room but involves making sure technologies and strategies are being implemented correctly” — Dr. Adam Tabriz
“We need to empower everyone within healthcare, be it the patient or physician.” — Dr. Adam Tabriz