The hovering vultures: how greedy physicians prey upon patients

USA Today (Society for the Advancement of Education), July, 1993 by Charles B. Inlander

They are more interested in lining their pockets than providing competent medical care, often performing unnecessary procedures at outrageous costs.

In the desert, when a distressed animal is on the verge of death, vultures gather above. This hovering horde of bone pickers sense, with great precision, the near-terminal condition of the creature. Patiently, with uncanny determination, the birds plot their moves. Then, at the very minute they witness the last gasp of their would-be feast, they strike. In short order, they have engorged their victim, ravenously consuming everything edible that hangs from the carcass. Finally, they depart, but behind they have left a warning, maybe meant as a boast. Scattered across the desert floor are the bones of their prey. Left to decay in the hot sun, they remain as a sign to the rest of us that another creature is just waiting to take advantage of our suffering.

Not all vultures operate in the desert, nor are they all winged creatures of the Cathartidae family, identified by their dark plumage and naked head and neck. Some can be identified by their white coats, luxurious automobiles, and average after-tax income of $120,000. Many have the initials M.D. or D.O. after their name. They often are spotted at meetings of local or state medical societies. Many migrate to warm-weather resorts in the winter or to Chicago in the summer - the nesting sites of the American Medical Association's conventions.

Even if you do not spot these vultures visually, you may hear them. They often perch on radio talk shows or leave their verbal droppings in the local newspaper. While their chirping tune can vary, it generally is recognized by complaints about Medicare reimbursement, patients' lawsuits, failure of consumers to understand how tough it is for birds of their feather, and the lack of respect most mortals have for such an important species. Indeed, it is this species - the Vulture Medicus - who today pose a very serious threat to most American consumers.

While economists are in dispute about whether we remain in a recession, the Vulture Medicus continues to stalk its prey, having spotted indicators on the nightly news. The stock market is highly volatile. Oil prices are creeping back up. Housing starts remain at long-time lows. Interest rates are down, meaning invested income earns less. Unemployment still is rising. Companies are delaying expansion. Truck and auto manufacturers are shutting down plants. Steel manufacturers are hurting and making joint deals with foreign competitors. To the Vulture Medicus, these signs are a call to hover. While the rest of society gives in or gives up, the Vulture Medicus is planning its move. Americans should take heed. The bones from its previous attack still are out there. They have been bleaching in the sun since the last recession and can not be ignored.

The Vulture Medicus remembers the early 1980s, recalling how companies fired hundreds of thousands of medically insured workers. Consumers came to its office less likely to accept the creature's suggestion to have some elective surgery done. This creature saw costs rise, but the number of patients remain static. So, it raised prices, making sure to keep its increases at least twice that of normal inflation. Why should Vulture Medicus have to alter its lifestyle? Vulture Medicus is smarter than steel workers, craftier than car salesmen, and more deserving of the good life than teachers or municipal workers. In the early 1980s, when many of these people put the word "former" before their occupational description, Vulture Medicus flourished. Its income rose. Hospitals were giving it bonuses to bring in more patients. The creature started its own laboratory, dispensed medication in its own office, maybe even bought a free-standing emergency center.

Life was so good that more Vulture Medicae were bred. In fact, the number hatched since 1980, compared to the growth of the general population, has caused most major metropolitan areas to be overrun by the species. Some experts argue that their numbers constitute as big a public health hazard as their pigeon relatives. Only a glut of Vulture Medicae can account for the creation of such medical specialties as sports gynecology or sports medicine.

The signs of another Vulture Medicus attack are emerging. They are complaining to the government about being overregulated. They carp about patients who can not afford to pay. They come on the radio or write to "Letters to the Editor" columns whining about the enormous increases in their cost of doing business. They have the unmitigated gall to acknowledge that they overtest and perform unnecessary surgery, all in the name of self-defense.

Women seem to be particularly prime pickings. Ornithologists may attribute this to the three-to-one ratio of male Vulture Medicae to the female variety. Whatever the reason, the facts are clear: The female human is the most obvious victim.

For instance, 25% of all babies born in America are delivered by Cesarian section. In 1970, only five percent of births were surgically assisted. England, with an 11.5% C-section rate, considers that number to be a national disgrace, brimming on scandal. The defensive medicine argument doesn't hold up in the C-section fiasco. In places where hospitals have made concerted efforts to monitor unnecessary C-sections, some rates have dropped by as much as 50%. Some insurers - the principal feed providers to the species - have started paying the subspecies Vulture Obstetricus the same amount whether the delivery was a natural one or a Cesarian. Figures on the effect of such financing changes show a drop in C-sections.