Having been treated by at least 28 physicians and surgeons in the past three to four years, the subject is close to my heart, and my spine, and my artificial hip, and, and, and. Some are absolutely wonderful but 50 percent of all medical students were graduated in the lower half of their class. Not all are devils but neither are they all angels. Actually, there is another reason for this to be a subject of interest to me but I’ll get to that in a bit.

Some lawyers enjoy lawyer jokes. Others go ballistic. Many in the medical community will take offense at this post. Others, hopefully, will not see it a denigration of their chosen profession.

There may be a few old-timers remaining who remember Fidel Castro being referred to as Doctor Castro. Why was that? No, not why are there still a few of us geezers left. Why was Castro ever called Doctor Castro? It is due to a cultural convention. In some societies, mostly in Latin America, they address lawyers as doctor. It is an honorific.

Surprise, surprise. Here in the States we call lawyers many things, but not doctor. We do, however, apply that as an honorific to physicians and surgeons. They are doctors, you say. Wrong. They are honorary doctors.

The word was apparently first used for the trainers of gladiators. Think of trainers as teachers. Later, the word was used to identify teachers, professors. A master was someone who may have studied the same body of learning as the teacher but was not a teacher. As humans commonly do, some envied the title of doctor but didn’t want to teach. The coverage of the word was then extended to those who had endured higher learning but had also contributed to their academic discipline.

There are two kinds of doctorate degrees: earned and honorary. If it isn’t earned, it’s honorary. How do you earn a doctorate? You contribute something original to your area of academic interest. You write a dissertation. You defend that dissertation before a group of professors. You earn it. Sitting in class and learning an extensive and difficult body of knowledge is commendable. It is not the earning of a doctorate.

Am I straining over a gnat? What’s the big deal? Pharmaceutical companies are required to test their new drugs. They don’t always want their progeny subjected to rigorous testing, real testing. They design the tests. They set down the protocols. They often provide the test subjects. Sometimes they even write up the study. Sometimes a ‘doctor’ conducts the study. Sometimes the ‘doctor’ merely puts his/her name to the study and presents it to a medical journal.

The drug companies have a definite preference for physicians over people with earned doctorates. Why? Those with earned doctorates have had at least minimal exposure to research methods and methodology. Physicians have not usually had the benefit of that same training.

It is easy for someone without expertise, training or experience in research to not recognize the tricks used by the drug companies. They use techniques that contradict the most basic requirements for any scientific study. They frequently design their studies with protocols that determine the results. The study doesn’t even need to be made. The results are already known. Actually, the studies do need to be made, or claimed to have been made, because the FDA needs paper.

The drug companies know that the studies are scientifically worthless. The FDA knows that the studies are scientifically worthless. A few of the ‘doctors’ conducting the studies know that they are scientifically worthless. Very few of the clinicians responsible for writing the prescriptions know. Very, very few of the patients know.

Physicians are trained to treat patients. Researchers are trained to do research. The confusion caused by our traditional, cultural convention of calling a physician a doctor allows the drug companies an opening to exploit. They do not miss many opportunities to pervert the system to their advantage.

The next Vioxx will be the result of unscientific studies being conducted by the drug companies and accepted by the FDA.

Back in the early 1970s, the hubris of some of those in the medical profession reached its zenith. The Kansas Medical Association lobbied the Kansas legislature to pass a bill prohibiting Ph.D.s from using the title Dr. with their name. The honorary doctors wanted to call themselves Dr. and bar the real ones from doing so. There are some great individual physicians but, as a profession, they need to be categorized alongside the legal profession. Perhaps the Latin countries have it right.

Just think of this post as me doing my part for the national morale. It momentarily distracts you. It temporarily interrupts your obsessing over the price of gasoline.