Another Unintentionally Revealing Response From the American Medical Association

A few weeks ago I blogged about the lame response of the American Medical Association to HealthTap, a website that solicits doctors’ answers to medical questions. Their criticism was so weak it amounted to praise.

More recently, the AMA was asked about its position on doctor rating websites. Here’s what happened:

Robert Mills, a spokesman, sent me a statement that he said was from the A.M.A.’s president, Dr. Peter W. Carmel, that read, in part, “Anonymous online opinions of physicians should be taken with grain of salt and should not be a patient’s sole source of information when looking for a new physician.” This, however, is almost exactly the same statement it provided to its own publication, American Medical News, in 2008, when it was attributed to Dr. Nancy H. Nielsen, the president-elect of the A.M.A. at the time.

Such plagiarism is more consistent with what Jane Jacobs in Systems of Survival called guardian values (where honesty is unimportant) than commercial values (where honesty is very important). When you grasp that doctors follow guardian values rather than commercial ones their behavior becomes far more predictable — and plainly in need of control by outsiders. That doctors are allowed to charge for their services resembles allowing policemen to write as many parking tickets as they like and pocket the fines.

Thanks to Bryan Castañeda.

5 Responses to “Another Unintentionally Revealing Response From the American Medical Association”

  1. Glen Raphael Says:

    I do not understand why people keep trying to apply the concept of “plagiarism” to domains in which it’s not relevant. There is nothing wrong with saying something that other people have said before. It is quite common that a company (say, Apple) or some other organization (say, the AMA) has its PR people come up with a set of “talking points” to answer particular kinds of questions. After that has been done, no matter who you ask, you’re likely to get something resembling that answer.

    So the AMA president either did say this line himself (and it wasn’t original) or was willing to have it said on his behalf in his name. Nobody ever claimed this statement was “original research” so there’s no dishonesty here. The correct term for this sort of reuse is not “plagiarism”, it’s “consistency”.

    An earlier place I noticed this odd trend was in connection with the Wegman Report – when Congress asks somebody for a summary of technical information it seems to me like a downright *bad idea* for it to be all original research – copying from whatever the best sources available are and saying “I stand by this” is the best way to efficiently get good information into the record. Originality is nice and all, but it doesn’t trump accuracy. If you ask a question and get an answer, the important issue is whether the answer is *accurate*, not whether it is *original*. Indeed, the more “original” the answer is, the less likely it is to be accurate.

  2. Tuck Says:

    “That doctors are allowed to charge for their services resembles allowing policemen to write as many parking tickets as they like and pocket the fines.”

    LOL. I wouldn’t have a problem with policemen like that if I was allowed to fire them and hire their replacement.

    I think a big part of the problem with the medical industry is that it’s been distorted by a government-mandated payment scheme that makes absolutely no sense (insurance through the employer).

    Many folks have noted that the medical industry works much better in those realms, like plastic surgery and laser eye treatment, which are outside the government scheme, i.e. are forced to operate more like an auto-repair business.

    +1 to Glen’s comment, also.

  3. Jim Says:

    I agree with Glen as well. “Plagiarism” does not apply to that (repeated?) statement. Also, the statement regarding online ratings seems pretty fair. He just says they shouldn’t be a patient’s sole source of information when selecting a doctor. Sounds fair to me. As for the grain of salt, I agree as well. I’m sure if we look at the online reviews for the SLD book, there will be quite a few, ahem, “outliers.”

    Seth: I would like to think the president of the AMA is not brain-dead. He could have said “This has come up before. Our position is…”. As for the actual content of the statement (e.g., shouldn’t be sole source of info), it reminds me of scientists who say “I think we should be cautious when interpreting this result.” Oh really?

  4. Nancy Lebovitz Says:

    The quoted statement is so cliched that I really can’t worry about plagiarism.

  5. Tom Says:

    I think a big part of the problem with the medical industry is that it’s been distorted by a government-mandated payment scheme that makes absolutely no sense (insurance through the employer)

    I don’t get where all weirdo libertarians spouting these bizarro falsehoods are coming from.

    Insurance through the employer is not and never was “government-mandated”. It was something employers came up with after WWII to attract workers in short supply. They kept it up because it reduced worker mobility, keeping an artificial ceiling on wages. The group-buying power of large employers vis-a-vis insurers enabled them to buy insurance far cheaper than an individual could, making changing jobs extremely risky and expensive. Further, despite the vastly higher health premiums paid by individuals, the coverage in reality is practically non-existent for major health problems.

    My late father was a heart surgeon. He was always reimbursed immediately with no problems by a given insurance company when the worker was employed by a large employer (say, General Motors.) When the same insurance company insured an individual who needed the same operation, it was pulling teeth to get the insurer to honor the policy.

    Blue Cross simply didn’t dare fuck with General Motors. But individuals were dead meat.

    And this was thirty years ago. Forgive me if I doubt that insurers are more ethical now.

    Sorry if that doesn’t jibe with your fantasy of how magnificently corporations always behave, vis-a-vis the moustache-twirling government.