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Betsy Ashton's avatar

Your father was a great doctor and humanitarian, and raised a daughter with the same dedication, ethics and values — and smarts! The world is blessed to have had you both and for you to continue caring as he did.

David Envers's avatar

My Dad was a retired internist and he died in Nov 2020 at almost the exact same age as your father (4 weeks shy of his 97th birthday).

I remember discussing hydroxychloroquine with my Dad early in the pandemic and was quite surprised when he told me he would have tried it if he was still in practice and had patients with COVID. When I questioned my Dad about this, he made the point that the studies saying HCQ didn't work weren't following the full protocol (which included zinc & azithromycin), and that he didn't believe the reports that it caused heart attacks. To emphasize his point, he said "Look, HCQ has been around forever and, over the years, I've had a fair number of patients with lupus who took it, so I know it's safe. I don't know if it works or not, but it can't hurt and there's nothing else to try at the moment. So I wouldn't hesitate to try it to see if it works".

I think there are at least 3 key differences between doctors & hospitals in our fathers' generation and those today:

The first is that doctors in our parents' generation were either solo practitioners or part of a small group, so no one could tell them what to do or how to practice medicine.

Next there were no hospitalists, and doctors spent part of each day at the hospital seeing patients who had been admitted. My Dad generally saw patients in the morning and visited his patients in the hospitals and nursing homes in the afternoon. A benefit of this was that he would always bump into other doctors while making his rounds, which would give them opportunities to "talk shop" with each other and exchange ideas on the issues of the day.

Finally, hospitals back in those days were mostly independent of each other and they treated doctors well to get their referrals. I can't imagine a hospital back then telling my Dad what medications he was allowed to prescribe for a patient. He would have simply referred his patients to a different hospital if that happened.

In my mind, medicine today is practiced completely differently. Medical practices are big and most of the doctors are mere employees of the practice. Hospitalized patients are seen by hospitalists and doctors spend their entire day seeing patients in 15 minute intervals. The hospitals meanwhile are generally part of a larger group themselves and aren't shy about threatening to withdraw a doctor's privileges if they don't toe the line. Combine this with big pharma capture of the regulatory agencies, and it's no surprise that the Hippocratic Oath has gone out the window.

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