A Brave New World…in Just Three Years

Healthy Living Magazine was last published in January 2020. The Covid tsunami hit one month later. My office was essentially closed for six weeks. Three years later, the world as we knew it was gone. In its place was a dystopic reality in which science, reason, and enlightened values were not just ignored; they were disavowed. 

Covid continues to dominate the daily news cycle. The US, with an estimated one million dead, has the highest death rate of any nation. That is, if you believe the numbers. On a per capita basis, the US is 18th in death, behind all developed nations⁽¹⁾. The economic and human costs of the lockdowns, mandates, closed schools, and shuttered businesses are still being calculated. We will never know the number of deaths of despair from drugs, alcohol, and suicide, or from missed screenings for cancer, heart disease, and other illnesses. 

And Covid is still with us.

New Covid variants are less susceptible to vaccines and less lethal, yet we still have public health bureaucrats insisting that children and young adults receive vaccines that do not prevent transmission and have unknown long-term risks. Pfizer reported income of over $100 billion in 2022 from sale of vaccines and Paxlovid⁽²⁾, but the necessary studies of safety and efficacy of the current vaccines against the current variants remain undone. Regulatory agencies that are supposed to protect us have been derelict. The data supporting the recommendation for endless boosters comes from a single study of antibody response in eight mice! ⁽³⁾Paxlovid is pushed on everyone with Covid but has only shown efficacy in persons over 60 who are unvaccinated and never had Covid. Today, such an individual is a rare bird indeed. 

The 2020 George Floyd killing caused a reactionary rush to declare our country, its police, and its institutions systemically racist. Churches were shuttered for the pandemic, but unmasked protests and riots were allowed. The country could not jump on the racism bandwagon fast enough. Every university, professional organization, and large business now has a cadre of diversity, equity, and inclusion officers ferreting out racism. My own American College of Surgeons (ACS), founded in 1913 and the largest and oldest organization representing surgeons, declared itself to be structurally racist⁽⁴⁾. Some in the ACS leadership actually advanced the astounding claim that black patients do worse under the care of white doctors without providing any peer-reviewed evidence to support that claim. And any public disagreement was met with cancellation and silencing, sometimes permanently. 

Obamacare was supposed to solve the problem of the uninsured. Most of the uninsured were shifted over to expanded Medicaid programs. The question is, if you cannot find a doctor who takes Medicaid patients, or you have to wait months to see the physician, or drive for hours, do you really have insurance? At the other end of the spectrum, are you really insured if you have private insurance with a $9,000 deductible per family member before insurance kicks in? 

I realize that the cost of medical care has skyrocketed. My practice is paying more than ever for drugs and supplies. When we can get them. Shortages are now routine of basic things like antibiotics, local anesthetics, and even simple sterile saline solution. Reasons given are inflation, lack of workers in the service sector, lack of incentive from manufacturers to produce items that produce low net profits. Yet, quality has gone down. My current surgical gloves are awful. They are too thick, my size for over 40 years too tight, they are so stiff, and they rip easily. And I don’t think scalpels are as sharp as they once were. 

More and more patients simply cannot get in to see their primary physician. When they see someone, it is usually a mid-level nurse practitioner or physician’s assistant. Good luck getting an appointment in less than a month. Urgent care centers practice medicine according to algorithms. If you have cold symptoms, you get an antibiotic. One patient I know with a simple finger cut saw two nurse practitioners before being sent to the emergency room where the physician glued down the skin. The bill? $1,200. 

I have always tried to practice according to the oath I took as a medical student. Most doctors do. As I approach the end of my career, I look back on a medical system I no longer recognize and worry about the care I will get when I need it. It breaks my heart. 

This was my cri de coeur for the past three years. 

I promise to be more upbeat in future issues. If you have a medical question, please send it to me at rtbosshardt@aol.com. 

(1) https://www.bbc.com/news/61333847 (2) https://insights.pfizer.com/fourth-quarter-fy-earnings/ (3) https://www.nature.com/articles/d41586-022-00003-y and multiple other sources (4) https://bulletin.facs.org/2021/01/task-force-reports-on-how-the-acs-can-confront-racism-in-surgery/