By Dr. Evan Levine, MD

You might imagine there are many duplicitous physicians out there abusing and cheating the system at every turn. Sadly, there are. But now, more than ever, even the best of hospitals, the so-called Top Rated Hospitals in the country, who do business, and it is quite a business, under the guise of Non-Profit institutions, are equally as guilty in pillaging the healthcare system and contributing to our ultimate bankruptcy as a nation and as individuals. Some of these Top Rated hospitals who, in the past, vetted physicians before allowing them the privilege of becoming a member of their staff are seeking out, and giving, hospital privileges to the lowest scum, the cheaters, and the unqualified, because some of these doctors can bring hospitals a fortune; a real suitcase full of money!

Since the publication of my book I have been labeled by one of the most senior administrators of a university hospital as someone who cannot be trusted. I hope that after you read my new book you will agree with him -- though with an appropriate touch of irony. For I cannot be trusted to withhold the truth from the public, to hide the horrors I see every single day, to turn a blind eye to schemes that doctors, large pharmaceutical corporations, medical societies, and hospital administrators concoct to make themselves richer and more powerful while the rest of us get poorer and sicker.

Some folks with a cynical turn of mind suggested, when my book was published, that all I sought was fame or riches, but for me it was all about telling a story that needed to be told. And for those who suggest I made no sacrifice in writing my book, you will learn how much of a sacrifice I did make professionally and how my income has been diminished by far more than any advance money I received from my publisher. (I remain indebted to Putnam/Penguin for taking such a big risk on an unknown physician who thought he should try to do something more important, and far more risky, than treating patients.)

I want everyone to know that there is a covert and very dangerous black line that professionals in the healthcare world will step over only at their peril, and at great risk to their reputations and livelihoods. I liken this line to the infamous blue line within the New York Police Department during the 1980s, where murder, theft of property, and rampant intimidation by bad cops was allowed to go unchecked because of the dire consequences to any honest cop who came forth and told the truth. I’m no Serpico here, I don’t run with the gun toting criminals, but I have been shunned and condemned in like fashion for not keeping my mouth shut.

And so this is why I wrote my book eight years ago. I hoped to alert as many folks as possible, and give an impetus to others who might consider coming out, about the horrors going on in medicine -- not just those perpetrated by the crooked physicians working in dingy offices but by the very doctors who make the rules and head the largest institutions.

Our media concentrates on the most obvious and sensational bad actors: the mafia dons, the serial killers, the drunk drivers and abusive parents, yet they ignore institutions that murder thousands of people a year. Did you ever stop to wonder if a chief hospital administrator who pushes seriously ill patients, not to mention their doctors, to “select” their handpicked surgeon, even while that doctor’s surgical mortality rate is five-times the rate of others, is any less culpable of killing a person, and an innocent one at that, than a mob boss who puts out a hit on another killer? The irony is, of course, that the mob killer ends up on the front page of the tabloids and in jail till he dies and the hospital boss ends up with a building named after him and millions in the bank.

So why should I risk my livelihood again, create more powerful enemies, instead of doing what most other doctors and health care professionals do, like most good police did, by staying quiet, and obeying the rules, even if innocent people are harmed or killed? I have a wonderful wife, and two beautiful little girls. What sort of fool am I? I have lain awake wondering for too many nights. My reputation. My livelihood. To put it all at such risk....

For a while there even I shut up, but I am haunted by the fact that there are many men and some women who earn millions a year who the uninformed and unsuspecting unquestioningly admire and listen to, who no better than any other person who puts profit and self-interest ahead of the wellbeing of others.

So, here I go, with my attempt to get the story straight. To help the great doctors out there who are as much a victim of our healthcare system as are the patients who are harmed by it. I hope you will help me start a revolution to replace the leadership of what I like to call our health-don’t-care system.

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About the author: Evan S. Levine, MD FACC, is Director of the Cardiovascular Center at Saint Joseph’s Hospital and a Clinical Assistant Professor of Medicine at Montefiore Medical Center – Albert Einstein College of Medicine. He is also the Editor-in-Chief of the Journal of Medicine. He lives in Connecticut with his wife and children.