Change to Hippocratic Oath

[Aspergers_Aspie]

I realise the Hippocratic oath was changed for reasons, including not wanting to offend religions different from greek mythology and not to offend atheists, this explains the change of the content, but the title still has reference to, so I am a bit confused

 

[Matthias]

I didn't realize it changed. Maybe that's why many doctors no longer follow "Do no harm."

 

[Judge]

A Hippocratic Oath wouldn't mean much these days when the most critical thing for so many physicians need to abide by their contractual obligations to corporate pharmaceutical companies and their shareholders.

 

[Neonatal RRT]

A Hippocratic Oath wouldn't mean much these days when the most critical thing for so many physicians need to abide by their contractual obligations to corporate pharmaceutical companies and their shareholders.

I know where you were going with this, but it's a bit more nuanced. The US medical schools are highly influenced by the pharmaceutical companies... this much is clear. Almost no education in terms of health and nutrition. Nearly all the training is done in hospitals, with the sick, injured, dying, and those in need of surgery. They are taught to "heal with steel" and medications... but only if they are going to be reimbursed by their insurance companies they have contracts with. It's really the pharmaceutical companies and their contracts with insurance companies that tell physicians what they can and can not do... and which medications to use. The physicians also have crazy high liability insurance premiums... and sometimes, this alone will cause physicians to simply walk away from the profession. The physicians are more or less downstream within the system... they are not in control... it's way above their pay grade. Whether the physicians are in with a group... an LLC... or hired within a large medical system, it's all about reimbursement of services. If you cannot make enough profit for your self, the LLC, the healthcare system... you will not survive. Sure pharmaceutical and insurance companies are spending billions of dollars marketing to these physicians... free samples, free lunches, conferences, etc... it is as competitive for these companies as it is a total pain in the physician's rear end to be beholden to them.

 

[Judge]

I know where you were going with this, but it's a bit more nuanced. The US medical schools are highly influenced by the pharmaceutical companies... this much is clear. Almost no education in terms of health and nutrition. Nearly all the training is done in hospitals, with the sick, injured, dying, and those in need of surgery. They are taught to "heal with steel" and medications... but only if they are going to be reimbursed by their insurance companies they have contracts with. It's really the pharmaceutical companies and their contracts with insurance companies that tell physicians what they can and can not do... and which medications to use. The physicians also have crazy high liability insurance premiums... and sometimes, this alone will cause physicians to simply walk away from the profession. The physicians are more or less downstream within the system... they are not in control... it's way above their pay grade. Whether the physicians are in with a group... an LLC... or hired within a large medical system, it's all about reimbursement of services. If you cannot make enough profit for your self, the LLC, the healthcare system... you will not survive. Sure pharmaceutical and insurance companies are spending billions of dollars marketing to these physicians... free samples, free lunches, conferences, etc... it is as competitive for these companies as it is a total pain in the physician's rear end to be beholden to them.

Nothing I haven't heard before from the industry perspective. Not to mention that doctors can float their debt far more efficiently in the eyes of creditors than most of their patients can. Yet none of it IMO excuses a doctor's professional and ethical obligation to their patients either.

However not all of the industry is in lockstep over condoning or tolerating such corrupt practices.

Certainly not the American Medical Association Journal of Ethics:

"Yes, it is considered malpractice when a doctor prescribes medication primarily to receive kickbacks from the manufacturer, as this compromises patient care and violates ethical and legal standards. Such actions can lead to serious legal consequences for the physician, including fines and imprisonment."

https://journalofethics.ama-assn.or...cian-receive-payment-prescribing-drug/2003-07

 

[Neonatal RRT]

"Yes, it is considered malpractice when a doctor prescribes medication primarily to receive kickbacks from the manufacturer, as this compromises patient care and violates ethical and legal standards. Such actions can lead to serious legal consequences for the physician, including fines and imprisonment."

I would agree that there ARE cases where kickbacks are part of some private practice's... but it's not as common as come would think it is. I would suggest it's rare. For the most part, insurance companies are the ones in control of who gets what drug and when... it's this way within the hospitals... it's this way in outpatient clinics. It's all about the reimbursement. Furthermore, behind the scenes, without any input from healthcare systems, insurance companies are always renegotiating with the pharmaceutical companies for the cheapest prices... and as such, one drug that they approved of for a patient for several months, will suddenly be NOT approved another month leaving the patient without meds or some other, potentially inferior medication to replace it with. Physicians are always writing letters to insurance companies in order to receive prior approvals... the process can go on for months... and sometimes the insurance companies will stall and stall and stall until the patient dies.

My uncle was an investigator for the Attorney General of the State of Michigan for several years. It was his job to investigate all manner of crimes within the health care system as an undercover agent... nurses giving half doses of narcotics to their patients, then using the rest themselves... a fair amount of controlled substances trafficking... even a front for a drugs for guns. It was his investigations that led to the widespread installation of the pharmacy dispensary machines (Pyxis) we use within the hospitals... requiring fingerprints and passwords and cosigners before the machine would dispense any meds. Everything is barcoded and timestamped with our ID as well as the patient's ID. This was decades ago, so what may have been more common, certainly isn't now-a-days... almost unheard of in 2025.