This article
by Robert Bransfield, M.D., was published in the
The value and recognition of diversity is a fundamental
concept in biology, ethics, politics, and medicine. Preserving the right to a
diversity of opinions and preserving the right to ethical treatment approaches
based upon this diversity of opinion is critical in protecting the same
freedoms in medicine that are guaranteed by the Constitutional in other aspects
of our lives. There has been a dangerous and dictatorial trend in medicine to
attempt to shift the control of individualized medical decisions away from the
traditional patient-physician relationship, and instead towards centralized
power systems. These centralized systems are sometimes excessively influenced
by bias, bureaucratic confusion and competing financial considerations. In
contrast, preserving the diversity of opinion and the traditional ethics of the
patient-physician relationship is one of the safeguards that deter the abusive
potential of these larger systems.
Lyme disease, mental illness,
and other complex and potentially costly diseases, have been pivotal in the
power struggles seen in medicine today. As a psychiatrist who treats
psychiatric symptoms associated with Lyme disease and
other infectious diseases, I am on the front line of this issue every day. I
recognize that Lyme disease can be a very complex and
serious illness, which may present in many different forms. After performing
methodical and individualized assessments and treatment planning of patients
with Lyme disease, I am often shocked and puzzled at
the resistance these patients encounter from their insurance companies and some
other physicians.
Resistance by the insurance industry follows a
covertly deceptive path. It begins by asking accounting firms, such as Millman and Robertson, to establish financial “goals” for
the treatment of different illnesses. Through a convoluted path, these “goals”
become “criteria,” which become “guidelines,” that become “standards.”
Erroneous and biased articles taken out of context in the medical literature
are then often used as “evidence based” to establish these “goals,” “criteria,”
guidelines” and “standards” to deny needed treatment. Since the conversion of
financial goals into medical standards and the quoting of the medical
“evidence” evolve over a complex and deceptive path, no one is held accountable
and responsible for the final biased and inaccurate “standards.” I have
evaluated and treated many psychopaths in my career, and this is the most
sophisticated scam I have ever seen. The proof of this scam is only seen in
rare depositions, whistle-blowing, and internal higher-level documents from the
insurance industry.
The second major area of difficulty
is within the medical literature. There are many thousands of articles on the
subject of Lyme disease, with considerable
disagreement. There is often confusion between the diagnostic criteria used in
clinical medicine, the criteria used by the CDC for a case definition for
epidemiological purposes, and various criteria used for case definition in
some research studies. Although we need to recognize the right to the diversity
of opinion in this complex disease, we frequently see opinions based upon a
restrictive view of acute Lyme arthritis incorrectly
generalized to the long-term effects of Lyme disease
upon the body and the brain.
We
need to preserve a medical system that protects diversity of medical opinion
and freedom for patients to access ethical treatment approaches.
Sincerely,
Robert
Bransfield, MD
Red Bank, NJ