The “Journal of American Physicians and Surgeons,” the flagship publication of the Association of American Physicians and Surgeons (AAPS) can be found here, free of charge.  Many of the articles are layman-friendly, particularly those having to do with health policy.  I have an article on Bastiat in the current edition.  Not to be overlooked are the book reviews on the final pages.  

Dr. Tamzin Rosenwasser of Venice, Florida provides an interesting review of a book in the current edition called “Open Wide and Say Moo!  The Good Citizen’s Guide to Right Thoughts and Right Actions Under Obamacare.”  I don’t know about you but the title of the author’s (Dr. Richard Fogoros) book is enough for me….I have to read this book.  He has made it available free of charge at

Coincidentally, I read Dr. Rosenwasser’s review just moments after reading an article in our local paper (“The Oklahoman”) by Paula Burkes.  Let’s start with Burke’s article then examine the same material through Dr. Rosenwasser’s lens.

Burkes writes: “Imagine if your doctor-before prescribing a drug or ordering a scan, lab work or some other kind of test-was prompted by a computer screen that told him whether his diagnostic or treatment plans aligned with medical evidence for best health outcomes, and then gave him the choice to change his mind and, potentially, your well-being.”

Continuing: “The Commonwealth Fund President David Blumenthal is a former primary care doctor who worked at Massachusetts General Hospital, where he saw the use of evidence-based medicine, engineered into the network’s electronic health records, dramatically reduce the number of radiology tests ordered, and ensuing costs, ‘by simply reminding doctors of best practices at the point of making a decision.’”

Blumenthal said that building a high-performance health system will be about “unleashing that kind of bottom-line, innovative spirit,” including standardizing claims, processing and billing services, and bundling payments for acute hospital episodes. 

Burkes writes: “The Houston-based Actuarial Research Corp. has shown that The Commonwealth Fund’s initiatives would slow health care spending by an estimated $2 trillion by 2023, holding increases in national health expenditures to no more than long-term growth.”   ?

She continues: “The benefit to individuals would be the real win.”   ????

Stuart Guterman, the fund’s vice president said, “I don’t think the answer (to controlling costs) is to make a frail 85-year-old woman a better shopper.”

Wow. These guys must be really smart.  Burkes is sure impressed by them.

Now the part Burkes has missed.  Evidence-based medicine is an arrangement whereby a bureaucrat steps in between a doctor and patient and quite simply interferes with whatever suits them.  Sure, this sounds optional and voluntary at first, but down the road are the usual penalties for “non-compliant” physicians.  How many of the radiology studies not done at Mass. General resulted in harm coming to a patient because the patient didn’t fit some cookie-cutter mold?  Do any patients fit a particular mold? 

Blumenthal thinks that standardizing claims, processing and billing services and other such blather will improve care.  He also likes the idea of bundling payments to hospitals who then pay the physicians.  Think the corporate hospitals like this idea?  Guterman attempts to denigrate all savvy health care consumers with his distorted example of the frail 85 year old.  God forbid the elderly woman’s family should be part of her care decisions.  I guess in Guterman’s fantasy world, the government should be responsible for our health care decisions.

Contrast Burke’s article with Dr. Rosenwasser’s, who writes of evidence-based medicine:  ”Obamacare’s accountable care organization (ACO) is characterized accurately as the final noose around the necks of physicians, who will be practicing ‘herd medicine’ in which they will be interchangeable puppets in a pitiless machine, and their patients will be reduced to anonymous members of a herd.  Herd medicine will choke off innovation and lives.”

Dr. Rosenwasser continues: “(Dr.) Fogoros explains how Obamacare will stifle medical progress, using examples anyone can readily grasp.  He uncovers what has been concealed from many, including major conflicts of interest involving the central authority.”  ”He (Fogoros) explains that the central authority determines what constitutes healthcare and what does not; if the government says it’s healthcare, it must be covered; if it’s not covered, you cannot have it.  No physician will actually make a medical decision, and patients will be pieces of livestock on a government ranch.”

Burkes appears to be gaga over the central planners.  Dr. Rosenwasser finds their methods chilling, a start down the same road that all totalitarian health plans have taken.  Burkes would do well to familiarize herself with the writings of Dr. Rosenwasser and others in the AAPS.  Her article inadvertently grants legitimacy to the health statists who would control our lives and those of our loved ones.

G. Keith Smith, M.D.