On July 29th, 1883 a tough little boy was born to two working class parents in the charming town of Dova di Predappio in northern Italy. Growing up there were already indications that he would wreak havoc in society – he was kicked out of church at age 8 and soon after was expelled from school for stabbing a fellow student. As a young man he was arrested for vagrancy and then in a seeming turnaround in 1921 he was elected to parliament only to seize control of the government the next year.
What followed was a tumultuous and ill conceived reign of power that did not end until Italy had been ravaged by the second world war.
At the very height of his power on January 28th, 1932, 10 years into his dictatorship, Benito Mussolini, one of history’s most infamous fascist rulers, gave a speech to commemorate the inauguration of the National Congress of the Trade Unions of Fascist Physicians.
There are different definitions of fascism, but Mussolini put it thus: “Fascism should more properly be called corporatism, since it is the merger of state and corporate power.” In Mussolini’s time the state took over industry and dominated it, nowadays industry has overtaken government via regulatory capture and outsize campaign contributions.
The more modern definition of the term according to Merriam-Webster includes elements of “severe … social regimentation, and forcible suppression of opposition.” Compare this to what we see in our society today, not only in the medical field, but in many others as well.
At the time of his speech to Italy’s physicians, Mussolini’s overarching aim was to create a new model Fascist citizen with the “right” attitudes, beliefs and habits, which would serve the interests of the government.
Those top down interests as they applied to Mussolini’s audience of physicians and secondarily their patients, were to increase the population and become self-sufficient in food production.
To those ends Mussolini urged the physicians in attendance to work at overturning their patients’ prejudices against large families, and convince them to give up their pasta and switch to rice, which at the time was grown in Italy, as compared to the wheat for pasta that had to be imported.
Pasta was attacked as fattening, it was said to cause pessimism and lassitude, it was said to create effeminate men and it was argued by some it should be removed entirely from the country.
The Italians were not so easily swayed.
On April 28th 1945 Mussolini was run out of town, summarily executed and strung up in the streets of Milan, a warning to all those who sought to wield absolute authority over society.
Fascist Healthcare: gestapo-like tactics keep physicians in line
Fast forward 75 years and though our photos and newsreels are no longer monochrome, and we are free to unleash Two Minutes Hate via twitter, we seem to have backpedaled in many ways.
In the medical field 99% of US physicians have lost all autonomy to practice medicine as they see fit, they are cogs in a giant corporatocracy, practicing paint by numbers medicine, carefully keeping within the lines, checking all the boxes, ensuring you’re on your statin, and not on ivermectin.
Even when they want to help you with something outside the mainstream their hands are tied because their paychecks depend on toeing the corporate line.
If it’s something minor that doesn’t threaten a multi billion dollar vaccine rollout – e.g. inappropriately prescribing an antibacterial like Z-pak for a viral infection (something that happens more than 50 million times a year in the US) – despite ongoing anemic attempts by the standards setting medical societies to prevent this, everyone essentially looks the other way.
After all, a Z-pak makes it’s producer plenty of money at the end of the day and patient satisfaction scores are at least somewhat important.
But when the expansion of wealth of the 0.1% and the vaccine agenda is threatened, as it is with ivermectin and other off-label medications for COVID-19, then the full weight of our modern media, along with the American Medical Association, American Pharmacists Association, American Society of Health-System Pharmacists (see joint AMA, APhA, ASHP statement), state medical boards, and corporate overlords is brought to bear to crush physician and patient autonomy.
Elite and Segregated Healthcare
Because Big Medicine is by nature extremely expensive, it concentrates wealth with the 0.1%, and it creates drugs that only 10% or less of the world’s population can afford to use.
Unsurprisingly the 1-10% of the global population that can afford Big Medicine (even if indirectly through access to insurance) is primarily white and asian, leaving global minorities without access to presumably effective healthcare.
Unsurprisingly COVID-19 vaccine rollouts have heavily favored rich, white countries. For some reason Big Pharma gets a pass on being racist.
Controlling the Narrative
Big Medicine dominates the discourse and corporations are in bed with government, legacy media and now social media to maintain their moat, their ivory tower and their control over what is adjudged truth.
Despite repeated proof of severe levels of corruption and repeated mistakes by these gatekeepers of modern medicine, the mainstream narrative is that these billion dollar corporations remain the arbiters of medical truth.
When top FDA physicians refuse to go along with the government/corporate plans sent down from on high they have no recourse but to resign, and their shoes are readily filled by eager corporate lackeys.
Follow the Money
Critics of small, harried, independent minded practitioners prescribing off-label for COVID-19 ingenuously accuse them of profiteering from their recommendations, most often by simply charging for patient consults.
As Upton Sinclair said, “It is difficult to get a man to understand something, when his salary depends upon his not understanding it.”
While it is true that everyone is to some extent biased and corruptible, and there will always be those who take advantage of a situation to fleece others, in general the more money the more bias you can expect.
There is no comparison between an independent small business owner and a multinational corporation with millions of shareholders, including thousands from the billionaire class.
Despite the present lip service to stakeholder capitalism, the primary aim of any company, including healthcare companies, is to turn a profit by expanding market share and selling goods or services at the highest possible price with the lowest possible cost.
Since costs are always heavily front loaded for new medications (development is expensive, but unit production costs are negligible) revenue streams and market growth of Big Medicine depend primarily on marketing the latest “greatest” solution, but despite the hype, new medications are rarely an improvement on the older, cheaper off-patent ones.
Independent reviews undertaken over the last 35 years show that only 11 to 15 percent of new medications were significantly better than older standbys.
The ideal drug from the perspective of a pharmaceutical company is one that everyone needs to take indefinitely to prevent disease and which either has a low incidence of serious side effects, or for which the companies are shielded from litigation from those harmed.
Vaccines check all the boxes and represent the holy grail of drug development because the potential market for them is every living and yet to be born human being, all their pets and perhaps one day, if we extend this to its logical conclusion, all wild animal reservoirs as well.
Despite a lack of increased efficacy and significantly increased costs, new drugs are heavily marketed to physicians via journals and to consumers via large media buys. Indirect corporate control of our government ensures that Medicare is barred from even negotiating prices on these expensive medications.
Expensive, fancy, but inherently biased studies are designed and implemented to “prove” that the latest batch of wonder drugs work.
Any studies that fail to meet the standard of proof are quietly shoved into the back of the corporate sock drawer, never again to see the light of day, while those that manage to make the right case are given entree into the best journals, whose editors are laden with unacknowledged and significant conflicts of interest, oftentimes being on the payroll of the very pharmaceutical companies they are tasked with gatekeeping.
The journals’ prestige is boosted by publishing industry funded trials, widely distributed due to industry money, which serves to boost a journal’s impact score. Journals also make millions a year on reprints of these high impact articles.
There is an ever thinning veneer of respectability protecting the reputation of the major medical journals, though many have lost faith in them, including such prominent critics as Richard Smith, MD, former editor of the prestigious British Medical Journal (for 25 years) and Marcia Engell, MD, former editor of the equally, if not even more prestigious New England Journal of Medicine (for 20 years), both of whom went on to publish influential books revealing the corruption behind the Big Medicine, Big Journal distribution and marketing model.
Dr Engell sums up her conclusions nicely: “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.”
Meta analyses of thousands of small real world studies conducted by independent researchers the world over beat monolithic pharma funded DB-RCTs.
Big Medicine has sold us a fairy tale. It has convinced physicians and the lay public that multimillion dollar double blind randomized controlled trials (DB-RCTs) are the gold standard of medical evidence when they are demonstrably not.
A gold standard is what you measure everything else against. You can sink your teeth into it and you can take it to the bank. The gold standard isn’t fools gold.
Large DB-RCTs sound good and look good, but John Ioannidis has famously shown they are far from infallible, despite their impressive p values:
In a 2005 paper, Ioannidis analyzed “49 of the most highly regarded research findings in medicine over the previous 13 years”. His paper compared 45 landmark studies that claimed to have found effective interventions with subsequent studies conducted with larger sample sizes: 16% of the initial studies were later completely contradicted, 16% had effects that were significantly larger in the first study than the second confirmatory one, only 44% of studies were actually replicated, and 24% remained mostly unchallenged (neither confirmed nor denied) by any further research, so presumably another 16% of that 24%, or nearly 4% of the total would, if tested, also be disproven, which brings the total number of studies we would expect to be overturned close to 20%.
However, even these numbers are thought to belie the true rate of false findings. In an even more damning paper titled “Why Most Published Research Findings are False”, which kickstarted his illustrious career in the US, Ioannidis wrote: “(s)imulations show that for most study designs and settings, it is more likely for a research claim to be false than true. Moreover, for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias.”
Large, well conducted meta analyses are the real gold standard, and when done properly and in the absence of outright fraud are rarely if ever overturned.
Just use a Pencil
Big medicine is incentivized to solve healthcare problems with the most expensive solutions. Like NASA’s apocryphal pressurized space pen that could write in zero G upside down, but according to urban legend took many years and many millions to develop, Big Medicine always loses out to thousands of lone researchers using pencils.
The End of Tyranny
Perhaps Thomas Jefferson said it best when he wrote, “The tree of liberty must be refreshed from time to time with the blood of patriots & tyrants.”
Now liberty is being stolen from a drugged populace scrolling through Netflix feeds and lining up for the latest round of medical experiments.
There is yet time for a peaceful return to a sane society. There need be no more than a metaphorical bloodletting, but it requires courage and insistence on the part of every man, woman and child whose life is endangered by the powers that be.
Brilliant and timely! I truly appreciate the historical reference.
Thanks for your courage and perspective. Those not on the inside of medicine can only guess what goes on inside. What actions can we take that would be most effective to stand our ground?
Patients should be contacting their state boards of pharmacy and their state and local governments and telling them to back off physicians and allow them to practice medicine as they always have.
Beautifully written, Dr. Haider. Thank you for your continued efforts in this noble fight!
“99% of US physicians have lost all autonomy to practice medicine as they see fit, they are cogs in a giant corporatocracy, practicing paint by numbers medicine, carefully keeping within the lines,” THANK YOU DOCTOR HAIDER for being one of the 1 %
“primarily white and asian, leaving global minorities without access to presumably effective healthcare.” Why did you go (classic not neo-racist CRT) racist on us? I thought this was about killing COVID-19 and not politics?
Not sure what you mean, I’m just pointing out the double standard in the media. They’ve weaponized the word racist and cry racist at the drop of a hat unless it serves the interests of the truly powerful in which case everything possible is done to normalize the behavior, rather than call it out. If a word has become a weapon and we are waging a war of words against a much more powerful opponent we have no choice but to engage in guerrilla tactics and use their weapons against them.
Thank you for your response. We are on the same page here and I hope my comments haven’t diverted you from your great and valuable work. I am a big fan! I was just trying to say that vaccine availability and lack of interest in an affordable therapeutic isn’t a “white and Asian” issue. I believe it is a pharmaceutical/government-collusion-profit issue which is resulting in people of all races to suffer and die unnecessarily.
Yes, I agree, what’s happening is certainly affecting everyone.
Beautifully stated! Thank you Dr Haider you are amazing.