Fears over becoming hostage to soaring health insurance premiums has Wisconsin's teachers and other public employees protesting in downtown Madison for the second week running. It's a very real threat to their economic stability, one they'll be ill-equipped to tackle without the unionizing rights proposed legislation would deny them.
No doubt many members of the University of Wisconsin's Department of Family Medicine share the teachers' concerns. Public employees are joining a struggle already familiar to most patients. Family doctors work the front lines advocating for our interests amidst a disintegrating health care system, summoning the will to keep battling with insurers and administrators all while trying to hold on to their belief that they can change human behavior. Family doctors feel your pain and have the battle scars to prove it.
But last week some of these weary warriors carried their patient advocacy too far. In videos breathlessly presented throughout the conservative mediasphere this weekend [scroll down to see], doctor after doctor is videotaped writing patently fraudulent sick notes so that the protesting teachers (whose contracts specify that missing work without an excuse can result in dismissal) can keep marching on against the state's union-busting Republican government.
After viewing the videos at my request last night, Dr. Arthur Derse called me up exclaiming, "Holy mackerel! It's much worse than it looked in the paper. I'm stunned, absolutely stunned." Dr. Derse is the Director of Center for Bioethics and Medical Humanities a the Medical College of Wisconsin. "When all's said and done, it's really the profession of medicine that has the black eye in this case," he says.
There is no question these doctors are masking political opinion in the white coat of the medical profession, Dr. Derse believes. "The videos are pretty damning."
It's sad, but what puzzles me most is how in the world three of the four physicians I can identify from these videos and other media reports are faculty members of UW's Family Medicine department, and one is a senior resident in that same department. It's a good training program, committed to providing sorely-needed primary care doctors to the state of Wisconsin. It teaches professionalism, and its faculty are supposed to model integrity. What were they thinking?
They've managed to belittle a public trust between physicians, employers and patients. A doctor's sick note is a serious document. It represents an employer's desire to verify through a respected, independent, medically qualified third party the fact of an illness and the true need for convalescence. In the videos now circulating online, we witness multiple members of a noted family medicine department trash one of the well-recognized rights and privileges of their profession, with little forethought as to the consequences.
UW's doctors have demeaned not only the doctor-patient relationship, but in so doing, risked the stature doctors hold in our discourse on public policy. When commenting on social issues, physicians trade on the honor of our profession, benefiting from the public's assumption that the wisdom won of caring for so many at their most vulnerable imbues us with some privileged understanding of collective need.
In one of the videos and a newspaper account, Associate Professor Lou Sanner says he's giving out sick notes for "stress" (not a medical diagnosis). He claims he's forming doctor-patient relationships in his slapdash street encounters with apparently healthy protesters. Besides his work in bioethics, Dr. Derse is an emergency physician, regularly tasked with determining fitness for work. He's offended by Dr. Sanner's thin claims. "I couldn't imagine just walking up to people with a stack of work excuses, 'What's your name? Here you go.' ... It reflects poorly on the practice of medicine, and it reflects poorly on physicians who actually do take the time and effort try to determine whether someone is ill and is legitimately away from work," he adds.