Dr. Richard Bosshardt Reveals Deadly Truth: Most Surgeons Aren’t Fit to Practice. Here’s Why.

So let me ask you, you, 2022, became famous for a day or two because you got into it with the American College of Surgeons?

I'm still into it with them, yes.

You're still into it with them?

It's approaching its third year.

Its third year.

Can you just give us a quick reminder of what that contra-temp was about, what happened?

Sure.

I am a surgeon. I'm a plastic surgeon, but I was a general surgeon for a while.
One of the things that I did after I became a surgeon was to apply for fellowship in the American College of Surgeons, which is an honorary sort of a thing to have attached to yourself. If you become a fellow, you're allowed to put the letters FACS after your name.
And something I sought to do. So I became a fellow on the ACS, American College of Surgeons, and went along for 30 plus years as a practicing surgeon doing my thing.
And then what happened was, in and around 2018, 2019, you could say I woke up.

I realized that there was something going on in my area of surgery. And it began with a transcript of a lecture by an invited lecturer to the American College of Surgeons Clinical Congress that they have every year.
The lecture was titled, A Pathway to Diversity, Inclusion, and Excellence. That was the title of the lecture.
And for reasons that I can't explain, I read it. I wouldn't normally have done that, but I read the entire transcript.
I read twice, and not once with excellence mentioned in there. And so I wrote a commentary that was actually published in the bulletin of the ACS, where I expressed some concerns about taking down excellence as the primary directive for surgery for surgeons and replacing it with diversity, inclusion.
At that time, the equity, they didn't throw that in there um and that

commentary didn't really do much uh so fast forward a couple of years and you have covid which you know its own thing and then you have the um uh the george floyd killing and i think you could realistically say that the country went crazy after george floyd i mean everything from riots and whatnot to this mass movement to adopt the idea that the country was systemically racist and every institution, every organization was racist and we had to radically transform the country. And the American College of Surgeons was no different.
They jumped right on that bandwagon. And within weeks after the George Floyd killing,

I mean, literally weeks,

they had assembled a task force on racism.

And they published this in the Bulletin,

which is their quarterly newsletter.

And the Bulletin basically said

that they were doing this

to deal with racism in the ACS.

It wasn't like, is there racism in the ACS? There is racism and we need to figure that out. Like refusing to operate on black people? Not, that would be pretty extreme.
No, I'm joking. I mean, like, where was the racism in surgery? It's almost as bad, Tucker.
The idea is that well let me let me take that step they they claim that surgeons were racist that the acs itself was racist and the practice of surgery was racist okay and the reason why they made that last claim was because there are known disparities we know that the outcomes for surgery are not as good statistically for we just call it black and white because it just makes it easier to deal with that. That is not as good for blacks as it is for whites.
And so the idea is that there is some element of racism or discrimination that impacts the outcome of surgery. And of course, if you take that to the next step, it means that, you know, blacks are not getting as good care.
Their surgery is not being done as well and whatever. There's a whole lot of reasons why you can have disparate outcomes.
This was the one reason that they latched onto and they have never let go. And then, have you heard of the term racial concordance? No.
That's a really important concept. And this is something that's being promoted by the ACS.
The ACS has explicitly stated that blacks would do better if their surgeon is black. As simple as that.
That's a racial concordance that you are going to receive better care by a doctor, surgeon or other doctor, if they are of your same race, ethnicity, gender, that you might get better care.

Pardon me.

Better care. better care by a doctor, surgeon or other doctor, if they are of your same race, ethnicity, gender, that you might get better care, pardon me, better care if you're a woman by a female surgeon, for example.
And they've hung on to that as well. So that was the idea behind segregation in the South, of course.
Well, that's the whole thing. They're trying to redo that.
People should stick with their own, yeah. They're trying to reinstall segregation into surgery, which, when you think about it, is a pretty despicable thing to do.
So I get a white male surgeon, is what you're saying? Exactly. Okay.
Well, you might need to get a white male surgeon of whatever your, I think, heritage is. Okay.
You might do better with… Kind of happy with a Swedish surgeon. It's fine.
Sorry. I feel like I'm going to win in this, yeah.
I need a Brazilian one, because my mother is Brazilian. Meaning German, by the way well i'm half german half brazilian there you go yeah so uh what happened was this i the uh the task force came out with the recommendations at the end of uh 2020 uh and uh the recommendations were oh my gosh i mean it's just a litany it was basically a playbook for how to instill dei They still weren't really calling it DEI that often.
They were calling it anti-racism still. And that term kind of fell out of favor.
And then DEI became the nice, the more acceptable term for adopting critical theory, critical race theory into surgery. So the recommendations were to add anti-racism, Abraham Kendi's anti-racism, into the ACS as the value of the ACS.
They opened up a brand new department of diversity, which had not existed before. And this is what they call a regental department, meaning that the head of that department, the clinical director, was now one of the members of the Board of Regents, had its own clinical director, its own executive director.
They

installed all these initiatives. They started training their staff and even the leadership

on things like microaggressions, implicit bias, ally and active bystander, white privilege.

And when I saw this, this is one that I guess it really hit me. I never thought I would be

Thank you. Privilege.
And when I saw this, this is one that I guess it really hit me. I never thought I would be doing this at this point in my career.
I'm retired. I'm three months retired from 38 years as a surgeon.
And to be an activist was never on my radar. Yes.
But I couldn't let this stand. It just really bothered me.
May I ask you to just go back to the core assumptions that drive this? Are they rooted in science? Absolutely not. Okay, so is there any research at all that shows that the outcomes in surgery are better when the surgeon is matched racially with the patient? Absolutely.
Do no Harm, the organization that I joined as a result of this whole issue, has actually published, you can go online and you can read it, they've done a systematic study. Well, actually, they've looked at five systematic studies of this issue.
Does racial concordance, does concordance of ethnicity and race and so forth correlate to better outcomes in surgery? Short answer is no. There's no scientific evidence that having a surgeon of your own race will provide better outcomes.
Has there ever been evidence? No. So, I mean, just to ask a dumb question let me let me let me qualify that there was a study put out that's that's been repeatedly referred to i mean even today it's referred it's been completely discredited uh but a study showed that uh the survival rates for black babies is better if they have a black doctor whether obstetrician or or whatever than then it's not.
And so they keep repeatedly referring to the study. But if you look at the study, the study design is terribly flawed.
The reviewer, if you're familiar with Vinay Prasad, who is a data geek and very good at parsing clinical studies and so forth, came out and said,

this study is catastrophically flawed. And even though this study does not by any stretch show that this is the case, it's still referred to as the primary evidence for this idea that racial concordance is a real thing.
And it's still in the ACS. Were there any, was there any push to make certain

that white patients got white doctors?

When you say a push,

but push by whom?

I'm just being perverse.

Like,

did they really believe it

when they said this?

They didn't really believe it.

This is just a way to lower the standards

to change the racial composition

of surgeons, right?

I think the only thing

that's pushing this is ideology.

I think that's thing that's pushing this is ideology. I think if you're really science-based, if you follow the science as the saying goes, if you look at that, you can't possibly believe that.
So either you have an ideology that supersedes factual science, or you're clueless and you're following whoever it is that's taking the lead on this. And who was taking the lead in the American College of Surgeons? I can't give you names.
I could probably name a few people that I know that were instrumental in pushing against me, pushing back. But I think it's a very small vocal group of very, very committed anti-racist or DEI zealots.
And I think the others have gone wrong. I think some members of the ACS have really not researched this to the extent they understand it.
And they kind of go wrong. Because it sounds, you know, DEI, diversity, equity, inclusion, it sounds wonderful.
Who would not be for those three things? Are those the rules in surgery? Like if the other kids are for it, you just do it? You'd think not. You would think not, yes.
That's the thing that was so disconcerting to me. Let me carry the story just a step further down the road.
I wrote to the president of the ACS, and I expressed my concerns. And I'm a writer.
This is what I don't, talking is not my thing. But I love to write.
And I wrote a three-page, single-space letter in which I outlined my concerns. Never got a response from that.
And so the next thing I did was I actually posted the ACS of the website, of course, and they have a thing called the communities, which is a forum for surgeons to communicate with one another. If you have a question, you can pose it and surgeons will weigh in and provide advice or answers.
If you have something, a topic you want to discuss, do the same thing. So the largest forum is the general surgery.
And so, I posted on that forum basically that I was concerned about this rush to embrace anti-racism DEI in the ACS. And if this continued, I didn't see how I could maintain my fellowship.
I would drop my membership in the ACS, which is something I never imagined I would do because I've been a proud member of the ACS for over 30 years. And I'm not here to bash the ACS.
I want to be very clear about that. I'm still FACS.
I'm still a fellow. They consider me a fellow, even though I'm permanently banned, which is kind of an interesting situation to be in.
And so I posted this thing saying that I would leave the ACS if this continued. And that generated a comment thread.
And if you're familiar with comment threads, if you look at the engagement in the comment thread, usually it's only about 1% to 10% of people that are reading the comment thread that actually engage. Because that's just the nature of things.
That comment thread ran for four months. And 75 individual surgeons and over 1,000 comments.
It broke the system, basically. I mean, they had to open up a second comment thread because they'd never had this much engagement on anything.
And two-thirds of the surgeons that engaged weighed in favor of my position as opposed to the ACS. And they kept saying, why are we doing this? Tell me where the racism is.
Let's deal with the racism, but don't just call us racist and go with that.

And they repeatedly refused to do that.

So who is they?

This is the leadership of the ACS.

And this is my beef is not with the ACS, with my fellow surgeons.

My beef is with the leadership of the ACS.

It might be interesting just to hear if you can recall some of the names of the leadership who did that just for the record.

I don't have any problem because it's public record. The general secretary was a fellow named Tyler Hughes, just retired.
Tyler Hughes. Yeah, general surgeon.
And he was the editor-in-chief of the communities. So he was kind of moderating.
And he would weigh in sometimes if it seemed like, you know, surgeons were getting a little bit too heated and so forth. And my position was, you know, we're professionals.
We're, you know, surgeons are opinionated. We're not shrinking violets.
We state our case. We're certainly qualified to have conversations without a chaperone.
And I didn't really like the whole chaperoning thing that was going on. And so, this went forward.
And as common threads do, it kind of ran its life expectancy really beyond what you'd think for months. At which point I was thinking, okay, so I did that.
What do I do now? And I was waiting to see what my next step would be when the ACS leadership, the Board of Regents, reached out to me. Tyler Hughes reached out to me and said, we'd like to have you on a Zoom call.
This was going to happen in 2022. They wanted to wait a little bit.
It wasn't until March because they were bringing on board their new director of diversity, a doctor named Bonnie Mason, who was their clinical director of diversity. And so the Zoom call consisted of myself and Tyler Hughes and Bonnie Mason and a regent of the ACS, a member of the Board of Regents named Tim Eberleand,

who is a very well-known, prominent surgeon in a big institution.

And I had joined a group called FAIR,

FAIR, the Foundation Against Intolerance and Racism.

And I helped found FAIR in Medicine,

which has been working,

kind of like doing no harm in the area of DEI medicine.

And so I went to some of my colleagues in FAIR and said, hey, listen, I'm invited to the Zoom call.

How do you think I should prepare for this?

And the first thing they said is, don't go by yourself because you're going to get jumped on.

I said, okay, that sounds like a reasonable piece of advice.

So I invited a colleague of mine who's a surgeon I've worked with for 30 years.

Her name is Celia Nelson. Celia is a Jamaican-born black female general surgeon, which is unusual.
She's definitely in the minority on the ACS. And she came on the call.
So it's five of us on the call. Very, very civil conversation, well over an hour.
We each stated our position. I stated my concerns.
She expressed the same concerns that I did from her standpoint as a woman, a black woman surgeon. And I left so encouraged from that.
I said, wow, this is great. We got a dialogue.
And this is what I wanted, a dialogue. And I sent an email to everyone that was on the Zoom call and said, thank you so much.
I hope this will be the start of a conversation where we can discuss these things. And a few weeks later,

I couldn't get on the communities anymore. I tried to get on the website and get on the communities and I couldn't get on.
And I thought, okay, there's some glitch here. I think maybe it was on the site had a problem.
I waited and I waited pretty close a couple of weeks before I finally said, I contacted Tyler Hughes and said, Tyler, what's going on? I can't get on the communities. And this is one I was told, oh, by the way, you are permanently banned from access to the communities.
And in addition, you're banned from access to the member directory of the ACS and you're banned from your own private voicemail box. So it was a total, total isolation.
And I said, why? Why am I being banned? And the answer was because of your continuous, and I'm basically quoting, your continuous use of disrespectful language and persistent posting of non-clinical material on clinical forums. So the thing was I was being disrespectful, which I have disputed, and I can prove I wasn't.
And my

non-clinical material was posting

this issue of DEI on the clinical forums.

That they brought up in the

first place.

And what's interesting is this, they're the ones saying

that clinical outcomes in surgery are

being impacted adversely for minorities.

But I mean, you were a

I mean, you spent over

30 years just being a surgeon, cutting and healing people.

Right.

You're not the one who brought this topic into the ACS in the first place. They did.
Yeah. But because you discussed a topic that they introduced, they said you weren't a serious doctor and needed to be banned.
I was disruptive and I was being disrespectful. And so I did ask, I said, can you please show me a single example of anything that i have said at any time that justifies this ban and they have never done that they've i've asked several times they refuse every single time so i appealed i went to the board of regents and appealed and i said you know you know this is this is wrong and they came back and said that we reviewed this and we uphold the

ban and uh this is this is interesting they said and we feel that you have received due process well due process means that they're saying it went through the proper channels in the acs well the channels are there's a fixed process for disciplining a surgeon you have to be informed that you're being investigated for some issue.

That has to go to their central judiciary committee, which is empowered to investigate their members. They decide if there's merit to this, you know, allegation.
And if there is, they send it back to the board of regents who then has to, you know, does the punishment, whatever that may be. Could be expelled, could be whatever.
They never did that. It never went to the Judiciary Committee.
They never informed me that I was being investigated for a possible lifetime ban. As a member of VACS, I am entitled.
My privileges include the right to having a hearing. If I'm looking at being disciplined by my organization, I have a right to have a hearing to defend myself.
And they denied me that hearing. And the reason, it's like a catch-22.
It didn't go through the Central Judiciary Committee, therefore I don't deserve a hearing. Even though, I mean, the gaslighting is unbelievable, Tucker.
It's just unbelievable. So I exhausted every avenue I had to address this with the ACS internally.
And that's when I went public. And that's when I wrote my article to the Wall Street Journal.
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Paid for by the Merchants Payments Coalition, not authorized by any candidate or candidates committee, www.merchantspaymentscoalition.com. I wanted to hear more about it, not simply because you're the victim of grotesque injustice and authoritarianism, but because the consequences of this kind of thinking are so dangerous to the public health that I think people need to know.
Because everything you're saying suggests that they're going to radically lower the standard for surgeons. Not that they are.
They have. They have.
That's— So how is that not a felony? How can you do that? How can you lower the standard for surgeons or air traffic controllers or anyone who's got a job with the public health in his hands, you know, a critical job, the critical jobs in our society, and you lower the standards for that? That's not a crime? I think the way you do it is you do it really slowly over a long period of time, and no one really notices until it gets to that. Until people die's that well until yeah that's interesting thing you say that you work with a knife in your hand i mean this is like the highest level of trust you're saying to somebody i'm gonna let you cut me open who would you say that to only a surgeon and so the consequences are just if if there was ever a field you know people talk about airline pilots.
If there was ever a field where excellence is a sine qua non of the field, it has to be medicine. And even beyond that, it has to be surgery.
Exactly. Because, you know, when you're the guy with a knife in your hand, first off, you know, if you're a decent human being, you want to feel like you are competent in doing the best you can for your patient.
But, and I apologize, by the way, for putting you on the spot when we spoke.

I think I may have, remember I asked you a question. I said, what's the most important thing you look for in a surgeon? And you said excellence, which was exactly right.
But I wasn't

looking for excellence. I was looking for trust.
You have to trust.

Well, one flows from the other.

You have to trust your surgeon. And if you are wondering if you're going to get the best care because your surgeon looks different than you do, right off the bat, you're starting handicapped.

I mean, you're really hurting yourself and the patient if you can't get that trust pretty quickly.

Because when you walk into the ER, you don't have a lot of time to connect.

You can't be doing those nice social things.

So my ban remains in place. I'm still banned.
The ACS will not engage with me. They have not engaged with you in three years.
Oh, no. Not at all.
Not at all. They will refuse.
I've written multiple letters. I wrote letters to the last two presidents.
I never get an answer back. I wrote letters.
Well, I would just encourage anyone watching to to let's google these people and do not accept medical care from them you don't i don't want to be cut by an unreasonable ideologue problem is you don't know who those ideologues are unless you start naming that it would be nice to have their names so um you you said not only do they plan to lower standards, but they already have. Can you tell us what you mean? In fact, I'm delighted you said that because I don't want this to be about me.
Yeah, I'm the one sitting in front of the microphone. I'm the one that was banned.
But the issue is so far beyond me. In my 38 years of surgery, I have gradually watched the quality of training in young surgeons deteriorate.
Noticeably in my own little

backyard, watching young surgeons come out that have no business operating by themselves.

You've seen that?

I've seen that oh yeah

absolutely

I can

I can

Thank you. watching young surgeons come out that have no business operating by themselves.
You've seen that? I've seen that. Oh, yeah, absolutely.
I can give you some examples. Please do.
I had a young, this is actually a few years back, I had a new surgeon in town at a hospital that I worked at. I do breast reconstruction, so I work a lot with the surgeons.
Together, they'll remove the cancerous breast sometimes. A lot of times they'll remove the other breast simultaneously.
And then I will come in and do the reconstruction. And I was doing a lot of these cases where you take the abdominal tissue and you create one or two breasts with the abdominal tissue, which is a great procedure, but very significant, time-consuming and whatnot.
And there's a lot of things that have to be done. And this surgeon offered to help me close the abdominal part of the operation or to do it for me so that I could concentrate on the breast.
I said, great, this probably cut an hour and a half or two hours out of my operating time. And so I glanced down to see what he was doing.
And he's taking these massive bites of tissue.

And every time he ties a stitch down, I mean, the abdominal wall is being distorted.

I'm looking at him thinking, wow.

And I was able to, I couldn't watch more than two or three stitches put in. And I said, Joe, listen, you got things to do.

Go ahead. I'm fine.
I don't need the help and he left um and uh was this in a someone who's out of medical school this is a fully trained surgeon just newly just what you know opened a practice in my community and he didn't last very long it became very obvious soon because in small hospitals you can't hide um that he was not very competent and he eventually moved on i don't know where he went or what he did but it was obvious to you just from looking down this guy was not this guy had no clue how to close an abdomen i mean it was really bizarre um and that's kind of an extreme example he become a surgeon that's the thing um lowered standards basically was this person from a protected racial group or no no he was not he was your your heteronormative white male like me basically but he was incompetent oh yeah yeah well i only saw this one example but you know the thing speaks for itself if a person is doing this in such a simple situation such as closing an abdominal wall wall, then you've got to wonder what he's like. And I've worked with other surgeons that were, there's a couple that I refuse to work with that were so bad that you often have to ask yourself, is it something that I report? I don't report.
I've spoken to colleagues and so forth. And I've only actually reported one or two doctors in my career because the circumstances are egregious.
And these didn't happen to be surgeons, by the way. But kind of getting off track a little bit.
I work with a young surgeon, arguably a good surgeon. And I was doing, again, a breast reconstruction.
And he made a comment to me that I found astounding. One of the common accompanying things you do in breast cancer treatment is a lot of times you go after lymph nodes in the armpit because you want to see if there's cancer there or if there's cancer there you want to remove the cancer and that's called an axillary node dissection.
Yes. Basic operation.
Even I know about it. Every general surgeon learns that.

Yes.

And we were doing a case,

and he was doing a biopsy in the armpit,

removing a single lymph node.

And he commented,

he says,

you know,

I'm really glad I don't have to do an axillary node dissection because I've never done one before.

And this is a fully trained,

board-certified general surgeon.

Had never done an axillary node dissection

in the course of his five years of general surgery training. Let me stick back a second to when you ask about quality and how it's gone down.
It's not a conscious thing. It's not been deliberate.
I don't think that we have gone out deliberately to create a decline in the quality of surgery. I think a lot of circumstances have come together to do that.
One was in 2003, the American Graduate Medical Education. They came out and they took a law that was basically confined to New York from 1964 and made it nationwide.
And that law was a reduction of residency hours. In other words, you can't take a trainee in any medical specialty and make them work more than 80 hours a week or more than 24 hours at a stretch.
And so that reduced residency hours dramatically because when I trained, it was not uncommon to work a 90 to 110 hour week. That was pretty typical.
And be on call, you know, 36 hours straight. I once worked 48 hours straight.
Not that that's a great thing, but you know, you do what you have to do and you learn. You learn to operate under circumstances when you're tired and things like that.
And the idea was to reduce medical errors and things like that, which has been disproven. Studies have shown that that reduction in hours did nothing to improve medical errors but that was one thing that that cut back the hours for training and surgery you know you have a very limited motive there the the idea behind it the reason that it occurred was because of a death a young woman died in new york because of a medical drug error, a very rare drug reaction.

And her father happened to be a very prominent attorney.

And he decided that the reason was that these residents were working too hard.

They were too tired and we needed to change that.

And there was a spate of New York Times stories about this.

Yeah.

I remember this.

Yeah.

And that was only confined to New York until 2003. Then it became a nationwide thing.
General surgery is a five-year residency program. Okay.
In the first two years, you learn patient care. You learn how to take care of patients before and after.
You assist in operations. You do diagnostic, differential diagnosis, and you learn how to work up a problem.
And if you're good, if you're a good intern, if you're a good first-year, second-year resident, you know, they throw your bone on again. They'll let you do a hernia, and they'll let you do an appendectomy, and they hold your hand while you do it.
And then in the third and fourth years, you start to operate more. but you're always operating under the direct supervision of a senior resident or an attending, attending as a fully trained surgeon.
And again, you're having your hands held. I mean, they have to let you work.
They got to put the knife in your hand, but they have to be good enough to do that and keep you out of trouble. And if you get in trouble to get you out of trouble.
And so you spend those three to four years kind of honing your skills. And then in the fifth year, when you are what we call a chief resident, you're basically regarded as being a surgeon.
And you do your cases, you assist the younger surgeons in their cases. And the only time you call an attending surgeon in is if you're doing something very major, very complex, or if you haven't done this before.

And so at the end of that fifth year, you should be able to walk out of the hospital and go anywhere and operate as a general surgeon and function fully independently. a study done in 2014 in the annals of surgery reported that 80% of the graduating general surgeons were not going into practice.

They were going on to do a fellowship.

Fellowship is additional.

80%?

80%.

Fellowships in whatever.

Thoracic surgery, vascular surgery, colorectal, you name it.

And that was in 2014. They surveyed program directors.
These are the chiefs, the heads of surgical programs to find out what these residents that they were getting, what these surgeons that they were getting in Phillips were like. they found that 66% of them could not be relied upon to operate independently for more than about 30 minutes.
That something like 30% or so could not handle tissues in a manner that was appropriate, atraumatically, if you will. 20%, 30% couldn't sew properly.
Close to the same number couldn't identify the early signs of a complication. Some could not identify an anatomical tissue plane.
These are people that are graduates of general surgery residencies coming out of these programs and going to fellowships. The saddest thing is that when they survey the young surgeons themselves and say, well, why are you going into this fellowship instead of going out and practicing, more than half say it's because they did not feel comfortable operating independently after five years of training.
So there's something very wrong with the training they're getting. They're not getting enough cases to do.

They're not being allowed to operate.

In some places, the attending surgeons are very hesitant to hand over a case to a younger surgeon

because, number one, they're responsible for that case.

Number two, you're never going to be as efficient or fast as a young surgeon as you will later on when you've had more experience. So it takes longer and it impacts your day, your schedule.
It's sad because they recognize this. I mean, these young surgeons recognize this.
So the question is, I mean, it sounds like a total failure to train the next generation of surgeons. It's a system failure.
And the ACS recognizes this. And you know how I know that? It's because since 2014, they've initiated what they call a mentorship program.
And what they do is they try to find experienced surgeons that will mentor these young surgeons to help them come up to speed. Okay, so a young surgeon out of training that should be able to work on their own and finds that they're struggling or not really able to do that, they would have an experienced surgeon to, I don't want to say hold their hand, but to oversee them, supervise them, scrub with them.
They can't find enough surgeons to do that, for one thing. Here's where the DEI really comes in, too, is they have this idea of racial concordance that what they need to do is find, if it's a black surgeon, they got to find a black mentor for him.
And if it's a Hispanic surgeon, they got to find a Hispanic mentor. And there's not enough of those to go around.
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So in addition to what are demonstrable, provable failures of medical schools to train the next generation of surgeons, and can I just say parenthetically, I feel like if they're not training surgeons adequately, you know, surgeons are a small percentage of all physicians, probably the most important, but they're probably not, and probably the smartest and most driven, then they're probably failing. I'll agree with you on that.
Yeah, yeah. They're surgeons, right? It's the most straightforward kind of medicine.
So, but in addition to that, they overlay these racial mandates. They decide that racism is the real problem, not incompetence.
and then they put these mandates in where like you have to somehow have doctors of all these different backgrounds which you don't have so what happens when everything starts to go downhill yeah really quickly i have um i get people contact me just because of my my profile has been elevated by being out there a little bit. I got a call from a young plastic surgery resident that had been fully trained in general surgery and went on to begin her plastic surgery training.
And she was concerned because she wanted to get the most out of her training. And so she reached out to me to find out what things she could do.
She told me things that were unbelievable. I mean, I never imagined these things.
And this has been confirmed, not, it wasn't just my conversation with her. I've confirmed it from other sources as well.
A couple of things. One is she talked about the difficulty getting enough cases under your belt.
That is, you know, not getting given cases to do, not having operations that you can actually perform, not having the attendings turn things over to you. This I could not believe.
One of the requisites to become board certified, at least in surgery, is you have to turn over to the board of examiners for the american board of surgery the american board of plastic surgery uh a log of the cases you have done in the course of your residency program so they list you know every case you've yeah done to the surgeon as an assistant and whatnot well they're now permitted to list operations in there as part of the surgical experience that they've only watched.

So if they sit behind the anesthesia screen or look over the shoulder of the surgeon and watch an operation, they can list that in the logbook as part of their surgical experience.

And I can tell you personally that you don't learn surgery that way.

You learn about getting your hands in there.

I've watched a lot of medical shows. I'm not a doctor as a result.
And that's what's scary. And that allows them to qualify for taking their boards.
The other thing they do, which is really— What would be, again, the motive there? Why would you allow that? Well, the ACS has already anticipated there's going to be a shortage of 19,000 surgeons by 2030.

Five years from now, we're going to be shy on nearly 20,000 surgeons in this country.

Right now, the USA is short 1,200 trauma surgeons.

There are places that need a trauma surgeon that can't get one because they're just not around.

So one idea, you know, as bad as it may be, is to put out anybody and everybody, and you don't want to drop anybody just so you can get the numbers up there. Gosh, there's so much to this, Tucker, that goes into this.
Well, back to the – I mean, all of this begins at the front end of the pipeline, which is medical school. Yes.
So the standards for admission to medical school have been dropped dramatically for race reasons. Mm-hmm.
Yeah. Yeah, they've taken the medical licensee examination, the three-part medical licensee examination, taken it from a graded exam to a pass-fail.
And to pass it, you only have to be above the bottom 5% in grade. If you are above the bottom 5%, you are going to pass the medical licensure examinations.
And in spite of that, which is an abysmal standard when you think about it, in spite of that, something like 10% or more students at UCLA, 10% or more students flunk one or more of the exams. And a number of them flunk these exams two and three times.
And yet they're still putting put through medical school. They don't want to drop you.
I know what I wanted to say. Again, back to the DEI for a second.
If you're an attending in a surgical training program and you have a surgeon that is inadequate he's just not cutting it and i i saw this i i had and while i was in training there were surgeons or people that came into the program that were dropped after a year two because it was clear that they weren't going to be able to do it they just didn't have the dexterity they didn't have the whatever. Today, if you do that, and it's a minority or underrepresented in medicine, you know, minority surgeon, as intending, if you hold them back or if you drop them, what's going to happen is you're going to get reported.
You'll get reported to the DEI establishment in that program. And invariably, they're going to side with the resident and not with the attending.
Why do they have the moral high ground if they're putting people's lives at risk, which they are? I mean, I think that's a crime. But how did they get to attack you for upholding objective standards of surgery? I just don't get the – like, are there no sane people left in American medicine?

Well, the thing is this, how do you recognize the quality going down? How do you recognize bad surgery? And one way that you recognize that is by complications. So, the question would be, are people dying? Are complications going up, okay, in surgery? Right now, you can't answer that question.
And one big reason why you can't answer the question is that, at least, and I'll have to say, this is my opinion, I can't keep quoting this, but I know this is how surgery has evolved. The vast majority of surgery done today is done as an outpatient.
So, you know, the people that are in the hospital and have an operation are not the majority. They're the minority.
So if you do outpatient surgery, you do the operation, you know, the patient goes home that day or after an overnight stay. Most complications don't arise immediately.
You know, bleeding occurs in the first day or two after. Infections, three, four days, okay? Pulmonary problems.
in my particular profession if i do a flap reconstruction i may not know if that flap's going to live or die for five six seven days or more so when you do have complications they occur after the patient's out of the system so to speak out of the hospital system so there's no required reporting it's all self-reporting you know you you know, periodically from the hospital to say, hey, can you please tell us how all of your patients did? Do you have any complications? They did great. And it's human nature.
Of course. If a patient gets an infection, you treat them with antibiotics, you know, do you report that as a complication? And the patient ultimately did okay.
You could argue, no, you would probably, you might not report that and you could rationalize that it's okay. So that's one of the issues.
The other issue, and I got this directly from one of the examiners. I know someone who has been examining surgeons for 15 years for their boards.
So when you go to take your board examinations, so he's one of the people that sits in the room and asks you questions and whatnot. And what he's noticed is that a lot of these residents are coming in and he's looking at their cases and he's thinking, oh my gosh, they're taking way too long to do these operations.
Now, one thing that's interesting is when you go for your boards, the cases that they look at are not cases you did in training. These are cases you've done since you've been out.
You know, when you finish your residency, you're allowed to go out and practice. I could practice.
I practiced for two years before I became board certified because it took two years to get my board certification. So, of course, I have to be able to practice.
And I'm regarded at that point as a board-eligible surgeon. And I'm entitled to full privileges and all those things.
So when I go to take my board examination, I present them, you know, in my case, I present them with a log of everything I had done for the past year. And they select cases to examine you on and so forth.
It's an interesting experience to do that. So these are the cases that these examiners are looking at.
And he's saying, they're taking way too long. You know, here's an operation that should normally take three to four hours.
It's taking seven to eight hours for this person to complete this operation. And I've seen this locally.
I've seen this in my own community where, you know, nurses who know the good surgeons from the bad surgeons say, Dr. So-and-so, I mean, he's so slow.
He just takes forever to do, you know, this operation. And complications are directly tied to length of surgery.
I mean, absolutely, positively correlated. The longer the surgery, the more potential complications.
Exactly. And this is recognized, and it's recognized in a very interesting way.
The CMS, the Centers for Medicine, Medicare and Medicaid. Right, exactly.
They've come out and they said, we are not going to pay for anesthesia beyond a certain time. So if we have, for example, a breast reduction, which for me is about a three and a half to four hour operation, we'll pay for four hours of anesthesia for breast reduction.
If it goes beyond that, we're not paying for that additional time.

And the idea is they recognize that, you know, people are taking too long to do these things. Point is, anesthesia has nothing to do with the length of surgery.
They're just there to keep the patient asleep and stable and alive for you while you're doing an operation. But that's the only way they can think to penalize the surgeon because the surgical time does not come into play unless you look at hospital charges or anesthesia charges.
And so, they recognize this. And this goes back to what I said.
A lot of surgeons are not getting enough surgical experience to be able to operate, one, independently. And two, I would say, efficiently, competently to do.
I i'm not a speedster but i can certainly hold my own with my peers in terms of how long it takes me to finish an operation and do a good job on it i've never tried to be the fastest guy on the block so all those things go to the fact that you're not going to really recognize this decline because it's so subtle in so many respects. And patients don't know that.
And that's the other reason why I'm here, Tucker. I want this to be a wake-up call to my fellow surgeons.
This is what can happen to you. If you speak up and you try to promote excellence in surgery and you try to object or push back against a liberal ideology, politics ideology, call it what you will, in surgery.
And I would love for there to be a groundswell of surgeons coming out saying, hey, wait a minute, what's going on in my profession? Well, the fact that there isn't really bothers me because it's more than physical dexterity. You're counting on as a patient reason.
You want a fact-based, logical physician or else you could die. And so anyone who accepts clearly illogical, unreasonable suppositions and doesn't push back against them is basically involved in witchcraft.
right? So if I could say to you something that is provably untrue and just on its face stupid, which is, you know, a black female patient needs a black female doctor. It's like, what are you even saying? Show me the evidence.
There is no evidence. It's crazy on its face.
It's Nazi stuff. If you go along with that, then you've disqualified yourself because you're not a rational person.
You're a witchcraft practitioner. So that just freaks me out.
So you could say, well, good people are going along with this. Well, no, they're disqualified by the fact they are going along with it.
That's my, as a patient, someone who's undergone two surgeries. That's, I mean, is that a fair view, do you think? Absolutely.
I mean, think about this. You're an intelligent person.
You have probably a wealth of experience because of what you do. You weren't aware of racial concordance.
And, I mean, you ask any guy on the street about that. They're going to just look at you like, you know, you have two heads.
What the heck is that? Well, is it true? And it true and if it's true how is that true again the rest of us trust science not because we trust the people who carry it out but because the idea itself is inherently reasonable prove it or i don't believe it it the burden of proof is on the practitioner the scientist the physician the surgeon and the whole system is based on that if you can it, then you can't know it. I thought that's science, right? Well, that's what they call evidence-based medicine, which is… Well, right.
Yeah, yeah. But that's all medicine should be evidence-based medicine.
And if it's not evidence-based medicine, it's not really medicine, it's witchcraft. So it freaks me out that the average doctor, average surgeon would for a second go along with this.
Well, think about it from this standpoint, too. Think about the, for example, Celia Nelson, the female Jamaican black surgeon that was on the Zoom call with me.
She's worked as hard as anybody to get to where she is. She's an excellent surgeon.
I mean, she's experienced racism. racism and she'll tell you flat out yeah she when she first arrived there uh people wouldn't mistake her for you know ask her to get a cup of coffee in the surgeon right you know those sorts of things and and she also noticed that sometimes when she'd walk into a uh uh examining room in the emergency room that you know the the look she would get was you know who is this is this someone good? And she's worked through all that, okay? She's worked through that.
She just put her head down. She worked hard.
And now she says what happens is when she goes into the ER, that patient has already heard from multiple staff what a wonderful surgeon they're getting. She's going to be in there to see them.
So, I mean earned her place okay but think how unfair it is for the people coming up now the the the minority if you will surgeons that have to face this idea when they go into a room that person may look at them and say gee is this a dei hire or is this a person that really i think everyone thinks that that went through that got here because of their excellence because of their excellent academic performance in college and medical school because their excellent performance in their residency because they met all the standards the standards that everyone should have to meet or am I getting someone who's a little bit less because of this? And that's part of the inference of it. You're getting someone less overwhelmingly.
And that's obvious. And it has nothing to do with race, by the way.
It's that preferences are always destructive of excellence. So if you tell me that you're the CEO of a company that your family owns and you got the job because you're the first son, my first assumption is they lowered standards to make you CEO.
I mean, right? It's obvious. And so if I have a black female surgeon, my first assumption will be this person had to meet lower standards because the school or the certifying board was so anxious to say we have a black female surgeon.
of course it's unfair to the individual but then the whole system is unfair so should you be shocked that it produces unfair results no i mean it's unfair it is unfair on the face of it and in practice and every other possible way yes you know they they think about anti-racism that was so i think uh despicable was it said that you know you cannot be against racism you have to be for this whole anti-racism shtick so attacking whites yeah so you know if you claim to be not a racist that's a racist statement i mean talk about the the but why would anyone go of course i mean it finger trap. Yeah.
You know, the harder you pull to get out, the more stuck you are. But why would anybody...
You're a surgeon. Like, you're at the very pinnacle of our system.
Like, the science-based, reason-based civilization that we've built, which we consider superior to, like, you know, to the witchcraft-based societies of the rest of the world how in the world could you sit and let this happen anybody any surgeon well i'll tell you why i did it i was too busy i was just i had my head in the sand well you're the anomaly you actually stood up i got banned for standing up i'm just saying what about all your colleagues you know i'm I'm fortunate in the sense that I was able to get through a career, and I'm at the twilight of my career. No, actually, at the end of my career.
I have nothing to lose, Tucker. I mean, they can't hurt me.
So I got many messages, private messages, which I can't access any longer, from surgeons, including minority surgeons, that said, you know, we agree with you, but we can't speak up because we're going to get pushed back. You know, we're going to be called, you know, Uncle Toms or racist or whatever if we agree with the premise that you're putting out there.
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No, I mean, of course, I know that you're describing the real answer.

That is the answer.

But it's just hard to let people like that off the hook.

If you work in some normal company, it's one thing.

But if you're a surgeon, you understand that lowering standards results in the deaths of people.

The stakes are just the highest in any part of our society. You have the highest stakes.
So, sure, it could hurt your career. Sure, it could make you unpopular.
Sure, they might call you names, Uncle Tom or whatever. But you balance that against the deaths of innocence, and you think, I have to say something, don't you? And if you don't— That's where I found myself.
Then you're— I can tell. Yeah.
And bless you. But if you decide, you know, people will die, but my career is more important or not being called names is more important, then it's kind of a monster, aren't you? I don't want to say that.
Well, I do. I do.
I think that if you give the power that surgeons have, the power to cut people open unsupervised and someone dies and you're the surgeon. You're like

God in the operating room. You have

that power. In exchange for that power,

you have to hold yourself to the highest

moral standards. Don't you? I agree

with that. You'll

get no argument from me. Who has more power than a surgeon?

Nobody. Yeah.

In that immediate moment, nobody does.

That's what I'm saying. I mean actual power, not

theoretical power. No.
A surgeon has more power

than the president. He can cut open a person

Thank you. surgeon nobody yeah in that immediate moment nobody does that's what i'm saying i mean actual power not theoretical power no a surgeon is more power than the president he can cut open a person the person's unconscious he has total control over his operating room correct me if i'm wrong in any of this and the captain of the ship basically unquestioned right so um and he has a life in his hands like actual not theoretical beating heart person.
And so that person has to be of just the highest moral caliber,

or else, in essence, die.

I mean, that's my view.

Anything which works against that, you have to fight.

I think you have to work against that.

It's disconcerting to me.

I have to say, maybe I could use stronger terms,

but I had a lot of private affirmation from colleagues, from surgeons. I don't get a lot of public affirmation for that very reason, because some of them are older and don't want to deal with the blowback, the repercussions and the recrimination that can occur.
Some of them, a few agree with the whole situation, crazy as it may be, all the DEI and so forth. And most of them were kind of like me.
They were just going along and too busy taking care of their patients to the best of their ability. I understand that.
You know, I've been doing this for 38 years, and it's really not until about three or four years ago that I popped my head above the water, so to speak, and looked around and said, my gosh, the landscape out there has really changed. This is not the field of medicine that I went into.
And you'd like to think when you've devoted your life to a career, a profession, that you're going to leave it a little better than you got it. You know, I'm building my, I built my practice on the shoulders of the people that went before.
And I have a very strong sense of responsibility that I have to honor the traditions and the efforts on my behalf to get me to where I was. And you want to think that you've done somewhat the same.
Now, I'm not, I wasn't a professor, I wasn't a researcher, but in taking care of patients, I've always tried to honor the efforts of the people that train me and feel like I could go off. Well, I've got a generation behind me now.
I've got a daughter who's a physician. I've got a son-in-law, her husband, who's a physician.
And I feel a very strong sense of obligation to someday, when I can't do this anymore, to say, okay, I did the best I could to leave medicine in their hands better than I got it. And I can't say that.
And that's tragic when you think about it, to think that you're leaving a profession that you love and have committed your life to, and it's in much worse shape than than when it was put into

your hands yeah so i take not progress i take responsibility for that i take my own but but at the same time i think it's what happened to me if they if they can if the aecs can ban me with the the impunity that they have done without accountability without even following their their own bylaws, for God's sakes, and they have no reason to engage with me, they can do this to anybody. I mean, there's nobody out there who's safe.
And that's a pretty frightening proposition. And, you know, for those of us watching who, you know, aren't doctors, it eliminates all trust.
Don't trust doctors. I don't want to go to the doctor.
I don't like doctors. I loathe them.
I don't trust a lot of doctors. You don't? I don't.
Why? My trust, COVID. Yeah.
Me too. I haven't been a doctor since COVID.
What happened in COVID was so egregiously wrong that I just couldn't, I mean, I don't look at thedc the nih fda in the same way any longer public health officials and the other issue i don't want to open a can of worms here but the gender affirming care i mean how in god's name did we get to a point where you have in my profession as far as surgery is concerned is probably the one most closely involved in the whole process of gender-affirming care because of the work we do.

And to have this concept that there's no such thing as male and female, that you can take a biological male and convert them to a woman and they're really a woman.

Proplastic surgery.

I mean, that is, when you talk about witchcraft and voodoo, that is witchcraft and voodoo.

And all the scientific evidence is against it. Do you know anyone who participates in it? Oh, yeah.
Yeah, yeah. You know people personally? No, I don't know people that are doing the gender-affirming care in minors.
And I want to be very clear. If an adult male man thinks he's a woman, and God bless them, I feel sorry for them.
Me too. you really have to um but they're you know they're a adult with agency to make decisions for themselves that's one thing minors is a whole different thing have you met any plastic surgeons who've done surgeries on minors uh not that i know of personally no i know some that are doing some of this what they call a few euphemistically surgery where they take off a breast, but they're doing this in women that are adults.
They're taking off their breasts to turn them into, you know, make them look more male-like. I don't know anyone personally who's done this on children so far.
So you saw this with abortion. Even when I was a child, there were doctors who said, you know, I just don't believe in it.
I think it's immoral. I'm not participating in it.
Now it's my impression that it's pretty hard to be a doctor

unless you commit abortion, like you kind of have to.

As part of your training, if you're an OBGYN,

I don't know that you can get through medical school

without participating in an abortion, an elective abortion.

I can't speak of that because I think that there,

I mean, I know from personally that that wasn't the case.

I'm aware it was not the case.

No, I know that.

But my sense is

now, in practice

if not officially,

that is the case. And it's extremely hard

to be an

OBGYN resident and not participate

in that.

And I wonder if we're moving

toward that

scenario with

transgender surgery,

where maybe you don't get certified as a plastic surgeon

unless you participate in mutilating minors

in the service of ideology.

Could you see that happening?

Oh, I could definitely see it happening.

I mean, it is happening.

It is being done.

Are people being forced to do it?

I don't think that's necessarily the case.

I think people that are doing it

are bought into the whole thing

and they're doing that

because they're bought into it.

But that just seems

to act against evidence,

scientific evidence

as a scientist,

physicians or scientists.

It doesn't,

I just,

I'm saying the same thing

10 times in a row,

but it just seems like

you shouldn't be allowed to conduct science if you've shown that you don't believe in it. As a resident in surgery, you don't have a lot of power in the sense of being able to say, I won't do this or I will do that.
You can't pick and choose what you're going to do when i was in training we had an experimental clinical study going on to do bariatric weight reduction surgery yes we were we're approaching these bypasses through the chest and not the abdomen yep and the attendings in our our program came to us the residents said listen we understand this is the experimental program we're not going to make you do this we'll let you decide for yourselves if you want to do these cases there were three of us at my level um and two of us said no i was one of those and the third one said sure he'd do it that you you did not want to participate? Did not want to do that. I didn't think it was a good operation, a good idea.
Long and short is that the study showed that, yes, you could lose weight by doing this, but the weight came back. These patients gained weight again.
And so it was pretty much abandoned. We're talking back know back in 1984 thereabouts and of course i remember one young woman who died you know directly as a result of the operation which was pretty it wasn't that big a group of patients and they had one death in that group so you know you're not always allowed to make the decision about what you could do now if you're in a residency program and you've got surgeons that are doing you know gender affirming surgery and again in minors um and you don't want to participate in that um i can't speak to this i can't say that the resident has the ability to say no i'm not going to do that or i won't do that um i do know that you know are you familiar with the case of etan heim? I've interviewed him.
Oh, okay.

What a man he is. One of my heroes.
He is. Now, there's someone who has true courage.
I mean, my courage is the courage of someone that doesn't have too much to lose. His is the courage of someone who has everything to lose.
That guy, I don't know if he's, I didn't ask him, I don't know if he's a religious man, but I could feel a moral power on that guy. He is religious.
Okay. I've spoken

I've become friends with him

and

I really

I've

I've could feel a moral power on that guy yes he is religious okay well that i've i've spoke i'm i've become friends with him and uh uh i really i've i've actually call these you know divine moments if you will but i've made a couple of just felt compelled to call him a couple of times yes and it just happened to be when he was in a really difficult down period and just needed someone to to affirm what he was doing and to encourage him and so forth and so um you know i just happened to be the person that made that phone call and um so we become friends good for you and he is a definitely a religious person and i could feel that on him i and more than that he's a he's a moral person and he he has a strong sense of the other no it's you're absolutely right and of all the people i've interviewed boy it's funny you mentioned him i've thought about him many times since that interview no he's still in the thick of it he's still under indictment and he's still facing trial and he's gonna win oh he'll win and i well my suspicion is all going to be dropped because the the the the reasons that have been brought to the accusations are so out there that they just can't stand.

Eitanheim.

E-T-A-N?

E-I-T-H-A-N-H-A-I-M.

Eitan.

Eitanheim.

Eitanheim.

For those following who want to Google him.

Yeah.

So do you think that this can be be fixed i can be fixed yes but you're talking about a long you know the pipeline for surgery is five plus years so you know then you got the four years before the medical school so if you're going to fix the problem you got to go back to the medical schools honestly you may have to go back to universities where people are being indoctrinated in all this social justice stuff where they feel that that's more important than what they're doing. The young doctors think that righting historic wrongs is more important than taking care of the patient in front of them.
And you can't practice medicine that way. That's just not medicine.
So it can be fixed. It's going to be a generational problem.
It's going to take a long time. We're going to be seeing the effects of this and paying the price for these policies and these ideologies for probably my lifetime, I suspect, which brings up the issue.
I'm a healthy guy, but every one of us is going to be someday needing a doctor. And I don't know who I'm going to go to.
I somewhat semi-seriously told friends and family, I said, don't go to a surgeon or a doctor under 40. Because they've been indoctrinated.
Some of these guys are still wearing masks, for Pete's sakes. Masks? Oh, yeah, there's some physicians that still mask patients and things like that.
It's just crazy. There's crazy stuff out there, Tucker.
So, if you're a doctor, I mean, and you're openly mentally ill like that, why doesn't anybody... No, I don't mean that as an attack.
I'm saying that with sympathy, but if you have... It's a great question.
Why doesn't anyone in the physician's group or the hospital say something? Well, first off, there's too few doctors. I mean, there's so few that a lot of these guys, guys, men, women, whatever, a lot of doctors are there because there's just not enough doctors.
I mean, if you try to get a doctor recently and make an appointment, just a routine appointment, you're talking months down the road. You need something more urgently, good luck with that.
You'll probably end up going to an urgent care center where you'll see a nurse practitioner or PA or someone that's got a fraction of the education experience of a physician. so it's it's not a real there's not a simple cure for all of this

one thing I wanted to try to do

with this conversation is not just simply bad mouth you know my organization the acs or bad mouth medicine and surgery because i'm devastated by what's happened i i really want i want surgery to be elevated to where it should be which is a a very highly regarded profession uh that is dedicated uh itself to taking care of all comers regardless okay we don't you know we don't judge on on who or what you are when you're in front of us and you've got a problem that we're trained to fix so my solutions you know my first solution obviously to get DEI out of medicine politics and and ideology do not belong in medicine i mean the the soviets proved that i mean the idea that you can take care of a patient if your first you know uh priority is to judge them based on their their color ethnicity is is counter to everything that hippocratic medicine is all about. The other is to reinstall standards of excellence.
We have to quit lowering the bar. We've got to start elevating the bar again and requiring that doctors and prospective doctors meet minimum standards.
There have to be some minimum, but they have to be higher than the lower 5% for Pete's sakes. They can't be that.
We have to free, you know, the doctors in training to do what they have to do. You can't have restricted hours when you've got such limited time anyway.
In the overall, you know, course of a person's lifetime, you know, three, four, five years in surgery is a drop in the bucket. I mean, to ask a surgeon to devote themselves to learning the craft and what they call the art and the science of surgery, you know, not only do you need the time, you need the person to apply themselves.
One thing I heard, which again is kind of disturbing, is that a lot of young surgeons are more concerned about comfort, you know, work-life balance, as it's often called, as opposed to learning to be the best doctor they can be. They want to know how much time off they have.
They're very jealous of their time off. You know, five o'clock rolls around, they're done.
They check out and they move out. One thing that they found in asking all the program directors about the surgeons coming into their fellowships was that a large proportion did not have ownership of their patients.
And ownership means that, you know, you take that patient as your patient. That's not just someone that you take care of for a 12-hour shift and then you turn them over to the next person.
and then you may not ever see that patient is your patient. That's not just someone that you take care of for a 12-hour shift, and then you turn them over to the next person, and then you may not ever see that patient again, or not until two or three shifts later.
So a lot of young doctors don't have ownership for their patient. I'm hearing that from colleagues.
So how do you treat a rental car? Do you ever change the oil in it? No, I don't rotate the tires. I don't tune it up.
That's exactly right yeah we've certainly wrecked my day doctor but i appreciate you're doing this taking all the time to explain this we still have a good medical system uh it's probably still in many respects the best in the world i i have to believe that but it's in in disarray and it's definitely in I believe, in decline and I believe that

it's going to take some effort,

some will from people

that are willing to make those

difficult changes.

Well, thank you for your bravery.

I don't consider myself

brave, but I appreciate that

thought. Thank you.
Well, nobody else is.

And I can't thank you enough for giving

me a pedestal in which to speak. Yeah yeah i had an emergency appendectomy once um by dr leon pachter who was an amazing surgeon and it you know it saved me so uh and i think most people have had an experience like that and you know it's important with an interesting little factoid yeah ibram kendy the the author of anti-racism not a surgeon, not a surgeon he's an author of Anti-Racism he had colon cancer and he reported that he went to he interviewed several surgeons black surgeons showed the white surgeon for his surgery because he was the most competent shouldn't be allowed nope, you get the surgeon from Burkina Fossa Ibram Kendi.
That's my opinion. Thank you, doctor.
But I'm obviously a vindictive bad person. So anyway, thanks.
I appreciate it. Appreciate the time.
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