by Miguel A. Faria, 403 pp, $41.95, ISBN 0-9641077-0-8, Macon, Ga, Hacienda Publishing, 1994.
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According to an old Cuban proverb, "Camarón que se duerme, se lo lleva la corriente" (shrimp that sleep are swept away by the current). Some physicians may find Dr Faria's wake-up call as welcome as a blast of Arctic wind. In his view, the current policy of most medical organizations—"nonconfrontation and cooperation"—could make them, in effect, accomplices of the barbarians.
From Faria's historic perspective, the currents that some consider the wave of the future are as old as the Code of Hammurabi. Because of the threat of severe government reprisals, the most knowledgeable physicians in the civilized world at that time recommended against treating patients—the ultimate "defensive medicine."
As an example of a leader who forestalled imminent collapse in a time of crisis, Faria points to Diocletian. Although he subdued military enemies and reestablished law and order, his domestic "reforms" accelerated the corrosion of the foundations of the Roman Republic.
Orient JM. Vandals at the Gate of Medicine: Historic Perspectives on the Battle Over Health Care Reform. JAMA. 1995;273(11):892-893. doi:10.1001/jama.1995.03520350074036