Whistleblower Doctor--

The Politics and Economics of Pain and Dying

Executive Summary Chapters Appendices Contact		A one-month experience of working in three hospices in England convinced me to focus my medical career on alleviating pain and suffering of terminally ill cancer patients. After finishing my fellowship training in hematology and medical oncology (cancer) at the UC San Diego Medical Center, I resolved to find a way of integrating hospice principles and philosophy with my practice of cancer medicine. I worked at the LA County Department of Health Services (LAC-DHS) from 1979-1998, including nine years of directing the Pain and Palliative Care Service at the LA County+USC Medical Center (LAC+USC Medical Center). This Service became very popular with the patients, family caregivers, housestaff, nurses, and social workers. We provided their patients with outpatient hospice follow-up and 24 hour – 7 day phone availability that prevented many readmissions for uncontrolled symptoms. Unfortunately for the financial bottom line of the hospital and LA County – Department of Health Services, the better the Service controlled pain and distressing symptoms the less Medi-Cal paid the hospital. In the financial crisis of 1995, they closed my Service. I complained and they retaliated by accusing me of malpractice in multiple clinical cases. A single case of a patient of mine with deep venous thrombosis (DVT: leg clots) who died of pulmonary emboli (PE: lung clots) after I stopped anticoagulant drugs was the basis use to fire me in 1998. I stopped the blood thinners because he had a high risk of bleeding. The Civil Service Court agreed with management’s decision to fire me over this one case. The California Medical Board subsequently followed suit and revoked my medical license. In researching the scientific evidence regarding anticoagulant drug treatment of deep venous thrombosis and pulmonary emboli, I discovered that they do not reduce the risk of death in these patients. In fact, they increase the chance of dying due to bleeding and rebound hypercoagulability (increased clotting after stopping anticoagulants). Up to 20,000 Americans die unnecessarily each year due to bleeding and rebound clotting from these drugs for prophylaxis and treatment of venous thromboembolism (VTE: DVT or PE). My peer-reviewed medical journal publications challenging anticoagulant treatment of VTE have been ignored by drug company funded anticoagulant drug researchers and government health regulators. My Los Angeles County Superior Court appeal for the reinstatement of my medical license will hang on an open and transparent critique of my medical journal publications by leaders of the U.S. Food and Drug Administration and National Institutes of Health. …..more: Executive Summary Book