Will the Great State of Tennessee

 Please Withdraw Senator Frist's 

Medical License

By Barry B. Sheppard, M.D.

On occasion, in the history of the  world, there have been those individuals who, after having been appropriately credentialed with medical degrees, have exhibited behaviors that fly in the face of the most basic tenets of physician behavior; individuals like Dr. Frankenstein, Dr. Jekyll, and Dr. Mengele, for example. In such circumstances it becomes appropriate for the medical profession to protect the public from those individuals by withdrawing their licenses to practice and, in the most egregious circum­stances, to distance the ethical medical community from such a physician by withdrawing that physician’s medical credentials altogether, as was done posthumously in the case of Dr. Josef Mengele.

I would like to make a case for withdrawing the medical license of Bill Frist, MD, our current Senate majority leader. Senator Frist’s statements during the debate preceding last month’s congressional “Schiavo” bill was to my mind the final example of a physician gone far astray, but before considering that situation in detail, allow me to provide some pertinent background information that has bearing on my case.

The basis of the Frist family fortune, which among other things has allowed the purchase of a Tennessee senatorial seat for one of its own, is the Hospital Corporation of America (HCA), the largest for-profit hospital chain in the country, which was founded by Bill Frist’s father and brother. Senator Frist’s personal investment in the family business is estimated at approximately $26 million for him and his wife. The senator skirts the issue of “conflict of interest” by declaring that this is held in a “blind trust,” the holdings of which are determined by an independent trust manager. The approximate amount of HCA stock is fairly easily assessed by Dr. Frist, however, since he knows how much HCA stock it contained in 2000, when it was converted from a “less blind” trust, and since he must divulge the amount of income the blind trust generates every year when he files his annual financial disclosure statement to the secretary of the Senate. Knowing these figures he can easily calculate a ballpark figure of his holdings. I am absolutely confounded how anyone can consider this flimsy excuse of a blind trust as removing the senator’s conflict of interest. If Senator Frist truly wished to minimize conflicts of interest with his congressional deliberations, I submit that he sell all of his HCA stock. Even then the influence exerted by the financial well-being of his first-degree relatives would not be inconsequential.

The business practices of HCA are of some concern to the House of Medicine. One would hope that businesses owned in part by and certainly under the influence of physicians would hold themselves to a higher standard than the business norm and certainly not ascribe to a lesser standard. In December of 2000 and December of 2002, HCA was fined a total of $1.7 billion for massive Medicare, Medicaid, and Tricare billing fraud, the largest fraud settlement in the history of the United States. Interestingly a decade-long probe into the fraudulent activities of HCA was brought to a precipitous close immediately prior to the ascension of Senator Frist to the position of Senate majority leader. The Bush administration saw fit not to incarcerate any of HCA’s officers, and the settlement allowed the continued participation of HCA in Medicare.

Bill Frist was instrumental in passing the “Trojan Horse” amendment to Medicare in the guise of the November 2003 drug benefit bill. This bill does little to alleviate the financial burden of pharmaceuticals on patients but codifies a moratorium on negotiating bulk discounts with drug manufacturers, forbids the importation of less expensive Canadian drugs, and opens wide the coffers of federal funds to HMOs, pharmaceutical companies, and corporations that agree to extend prescription drug coverage for their retired employees.

As yet another example of his protection of the interests of corporations at the expense of patient interests, Frist engineered the insertion into the Homeland Security bill of a provision that would protect Eli Lilly from lawsuits over Thimerosal, a mercury-based preservative used in its vaccines. Eli Lilly has had thousands of lawsuits filed by the parents of autistic and other neurologically impaired children alleging Thimerosal as a causative agent in these neurologic injuries.

As final evidence that Senator Frist has lost the ability to act as a physician, free of financial, political, and personal conflicts of interest to the contrary, is his behavior during the recent congressional deliberations regarding the fate of Terri Schiavo. Despite the fact that his specialty is thoracic surgery and not neurology, Senator Frist testified to his fellow senators that in his expert medical opinion, Mrs. Schiavo was not in a persistent vegetative state. “I question it based on a review of the video footage which I spent an hour or so looking at last night in my office...,” stated Frist on the floor of the Senate. This “medical opinion” was based on watching a four-year-old video spliced together by Schiavo’s parents, of choice images appearing to support their protestations that their daughter reacts to environmental stimuli. In a voluminous report on Schiavo prepared by Schiavo’s special guardian in 2003 (Wolfson spent 30 days with Schiavo), Dr. Jay Wolfson points out that Schiavo makes noises regardless of whether somebody is in her room or not.

Frist’s diagnosis was based on his review of none of Schiavo’s voluminous medical records. Frist’s pronouncement was made without the senator having ever examined or even been in the physical presence of Terri Schiavo. This assessment was very probably heavily influenced by Bill Frist’s desire to court the religious right element of the Republican Party with an eye toward a presidential bid in 2008.

Bill Frist’s actions do not, unfortunately, preclude his ongoing designation of senator. They do, however, speak strongly against his claim of being a physician. His transgressions warrant the withdrawal of a practicing medical license. We could then only hope that he not publicize his prior inclusion in our ranks.