Dr. Kevin Pho, MD

As voters fume about the high cost of health care, politicians have been targeting two well-deserved villains: pharmaceutical companies, whose prices have risen more than inflation, and insurers, who pay their executives millions in salaries while raising premiums and deductibles. Although the Democratic presidential candidates have devoted copious airtime to debating health care, many of the country’s leading health policy experts have wondered why they have given a total pass to arguably a primary culprit behind runaway medical inflation: America’s hospitals. Members who voted yea, in turn, received a 25% increase in total campaign contributions and a 65% increase in contributions from individuals working in the health care industry in their home states. In a Rand study published earlier this year, researchers calculated that hospitals treating patients with private health insurance were paid, overall, 2.4 times the Medicare rates in 2017, and nearly three times the rate for outpatient care.

My friend and practice advisor showed me two very negative anonymous reviews of my practice this week. My friend, the practice advisor, felt it was important to identify these situations and try to further identify the author of each review. That’s a problem since 80 percent of patients who are seeking a new physician search online. My advisor has shared with me countless examples of negative physician reviews where there was nothing to indicate the author had ever even been a patient of the practice.

For example, I recently sought the mentorship of second-year MD student Arifeen Rahman, who shared that “medical school has finally given me a bit of the freedom to be like, ‘We’re too far into this to be doing things just for the sake of doing them.’” One year ago, Arifeen decided to volunteer as a clinic manager at Pacific Free Clinic, one of Stanford’s Cardinal Free Clinics. Another clinic manager, first-year MD student Jason Gomez shared a story about his parents, who immigrated to the United States and faced many challenges trying to access our health care system and said: “The seed that health care is a fundamental human right was implanted in me, and it has been the impetus for me being here at medical school … I knew going into Stanford Both Arifeen and Jason shared personal motivations to work at the clinics in a role far too large to choose only for the sake of building a resume.

Late last year the New York Times reported that Dr. José Baselga, the chief medical officer of Memorial Sloan Kettering Cancer Center, had resigned for failing to disclose his conflicts of interest at professional meetings and in scientific and medical journals. For example, the sponsor’s drug may be compared with another drug administered at a dose so low that the sponsor’s drug looks more powerful,” Angell writes. Another article about industry support of medical research notes that “two systematic reviews found that studies sponsored by industry reported significantly greater benefits and less harm than studies with other sources of funding. But the author of the Post piece, who spent several years as a Senate investigator studying conflict-of-interest problems at the NIH, says industry ties to NIH “go back decades and are never really addressed unless the agency faces media scrutiny and demands from the public and Congress for change.