Physician Betrayal: How Our Heroes Become Villains – FREE Ebook

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We are living in an era of institutional betrayal. Trusted medical institutions tasked with training our healers have failed to protect their own students, staff—and patients. When our clinics and hospitals so deeply contradict what is expected, health professionals block their trauma to maintain attachment with their profession—betrayal blindness—a state of denial in which we don’t allow ourselves to see what is happening because the information would threaten our professional standing and world view. Physicians blind themselves to betrayal to survive in a career they believe they can’t escape. Betrayal among medical professionals can be fueled by jealousy, power-seeking, and fear that may push student doctors, resident physicians, attendings, even close friends and family to act against each other for personal gain. Despite well-meaning professors and new crops of idealistic med students year after year, medicine’s culture of betrayal is self-perpetuating and intergenerational. Here’s how patients and health professionals can break the cycle and heal from the trauma.

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4 comments on “Physician Betrayal: How Our Heroes Become Villains – FREE Ebook
  1. Aria A. says:

    Thank you, Dr. Wible, for helping remove the dog experiment from medical schools. Perhaps one day I will receive a thank you note from the next generation of healers as well. Inspiring ending about our heroic journey.

  2. docvet says:

    Hi, Pamela,
    Glad to look at your new book. Veterinarian’s also have physiology lab, and now most of them give permission for alternative practice for the students, and I hear that some no longer euthanize healthy dogs to give the students the first hand experience of the symptoms of strychnine poisoning or CO2 poisoning or cyanide poisoning (in the anesthetized dog of course) as they have decided those experiences are not useful.
    It is true that killing dogs to give teaching experience is probably an unnecessary adjuvant to learning physiology. I do think the purpose of this was more an exercise in teaching obedience than a necessary lesson in physiology; they did the same thing as part of the final training of the SS soldier, having them kill the dogs they trained, in order to put emphasis on the obedience part of the training.
    One of the hardest parts of doing medical training for me was the level and degree of lying all the doctors had to do. A doctor would walk into a room and emerge five minutes later and write down an entire physical exam, which I knew had not been done. The seven minutes given to see a patient is too short to do a full physical exam. It took me a while to realize the usefulness of a population of well paid employees who overtly and measurably lie on a regular basis: these are people who will not rock the boat. If they rock the boat, they can be picked up as systematically lying and fired forthwith. It is a method to create compliance. Compliance in this toxic system is what you are seeing. Sadly, it has left physicians as being among the least trusted medical professionals, behind the less well trained physicians assistants and nurse practitioners. It does have an emotional cost during training.
    Keep up your work, I do see some acceptance of some of your ideas and some folks do at least notice your statistics.

  3. Edward Fontaine says:

    To all the Doctors who are experiencing the bullying, disrespect and inhumane treatment by their “teachers” I’m their residency, you are not alone.

    Although I am not in medicine, I have been studying medicine, in particular, preventable harm.

    I am deeply sorry for your losses, and most importantly the toxic culture that has become the “Great” U.S Healthcare System.

    NO ONE deserves to be treated so disrespectful. I understand the depression, as I am treated for Recurrent Major Depressive Disorder. What I cannot even imagine is having depression and being worked to exhaustion and then bullied, harrased and ridiculed among your “peers”.

    There needs to be changes in Healthcare, beginning with education, training, residency and attending. You start off with nothing but the best of intentions, then the “system” breaks you until you quit residency, quit life, or become that personality you so dispised as you watched the worst perpetrators of bullying and ridicule be rewarded with promotions and accolades.

    My sympathy goes out to all of those who are currently struggling with depression, as well as those who have lost colleagues.

    As a Patient harmed, I know first hand the ruthlessness of the system and many of the doctors who have adapted to the reprehensible behaviors to further their career.

    They have lost sight of why they first wanted to practice medicine, to make a difference, and now they are just a cog in a broken wheel, in a broken system.

    My life has now been ruined and cut short by as much as 30 years because of a simple error. Even the life I have now is not worth living, but I continue to fight for justice in the Healthcare system.

    We are more similar then dissimilar, as we are human beings trying to live our best life in truth, with the pressures of everyday life which may be different by the same.

    I agree that the media are cowards and fail to confront the deaths of doctors, interns, med students by suicide, as well as the 1,000 plus patients that lose their lives to preventable harm every day in the U.S. alone.

    If we can fix the training of doctors, address the bullying, berating and allow for EVERYTHING to be questioned, we may be able to move toward a more compassionate training environment which would in turn produce more compassionate Healthcare professionals.

    My preventable harm has 100% disabled me at 55. After my initial anger I then turned to a compassionate view and wanted to help address the error, how it happened and a very simple manner to insure it doe not happen again. I was shunned by the administration, even the CEO of Rhode Islands largest system had no desire to investigate, instead the system blackballed me, labeled me as “hypochondriac” and said nothing was wrong.

    The Social Security judge took a look at my FACTUAL evidence from my records as well as the research I had done and ruled against EVERY doctor who said nothing was wrong.

    I have had a doctor admit to a large bone fragment from my vertebrae, which I pointed out from the imaging and 3D models I created of my imaging, but still said there was nothing wrong with my back. I cannot sit, stand nor walk for any length of te due to pain in my spine and hips.

    If he recognize and admits that it is a large fragment broken from a vertabra, and your patient is explaining the pain and how he cannot be hugged as it feels like bone on bone and excruciating pain, along with others symptoms, wouldn’t most people be inquisitive as to which vertebrae it broke off and what is the condition of the rest of it?

    If you were a resident, like he had 2 shadowing him, you would probably think the same as the Patient and want to heal their pain, but that is a situation residents deal with everyday, they CANNOT add their input, even if it is correct as there will be retribution from the attending.

    While I am a patient harmed, I believe we need to protect our residents and med students from harm, both mental and physical exhaustion, creating a more inclusive learning environment and fostering a more compassionate effective Healthcare system.

    It is only putting the spotlight on the dangers our residents and med students face can we begin to heal our healthcare system with the most important component, our healthcare professionals!

    My thoughts and prayers are with all of you.

  4. Kalila says:

    Response 2 after reading the Physician Betrayal ebook:
    Thank you for sending this – it was a gut-wrenching and resonating read. I had to pause multiple times and take a break for a day at a time between the first few pages. As an empath (HSP) myself, I couldn’t bear to read about the animal labs. I’m thankful that we only worked on cadavers (the bodies willfully donated to science) during anatomy in our pre-clinical years.

    I can absolutely attest to some (many!) of my med school classmates acting completely disengaged from actually caring for the patient – they only truly cared about taking history and examining the right way, knowing the clinically relevant knowledge and skills not to help the patient, but to pass the all-important-career-defining exams. It was always a means to an end.

    While I thankfully never was presented with the opportunity to participate in it, many of my classmates reported performing pelvic exams on non-consensual women under anesthesia – to this day I still think twice about receiving care at a teaching hospital after hearing that. What do you do as a medical student or resident? The systemic lack of empowerment, trust and safety is telling.

    Re the physician hierarchy – I agree it is very real and not supportive of a holistic, safe educational environment. “Rigid reductionist ideology” – that is such an eloquent and truthful term when it comes to the cult of medicine. It is one of the many ethically areas I struggled with throughout my medical training. Why couldn’t we look at a person as a whole, rather than just defined by their pathology? As an example, I was laughed out of a rheumatologist’s office when I presented an elderly patient to him. I wanted to present this patient at a Grand Rounds due to the incredible speed of improvement in mobility and joint health because of healthy lifestyle changes the patient made. I was able to taper his medications and told him to keep doing what he was doing because soon he won’t need any medications at all – this felt so rewarding to say to a patient who had been on medications for decades. However, the attending, and by default the rest of the team, laughed and said I was wasting their time – that there were 45 more patients sitting in clinic waiting to be seen. To send the patient home and get back to work – they made it clear they weren’t “interested in patients who were doing fine.” I do believe that was one of the nails in the coffin of my clinical career. The fact that as healthcare professionals we couldn’t make time for health had also been a spurring memory as I built out my wellness coaching and consulting practice.

    Institutional betrayal trauma is one of the biggest challenges I had with clinical medicine – that we were all “okay” with the status quo of medicine. That we would purport to be healers and healthcare providers, but regularly pull 36-hour shifts as a right of passage. Working around the clock as proof that we “earn” the right to call ourselves doctors. Ignoring the lack of support, and the resulting repercussions (mental health issues, substance misuse, negative effects on relationships, suicide etc.), for both mental and physical health of our med students, residents, and attendings.

    Peer betrayal is still something that I encounter regularly when speaking with clinical physicians. Just a few months ago, I was at an appointment for a routine annual check up – me as a patient – with a new family doctor. As the appointment went on and the family doctor found out I was medically-trained but not practicing, she immediately launched into how I “needed” to go back to finish my residency and then work clinically so that I do “lose all that training”. Though she was taking a detailed history, she completely tuned out of the fact that I intentionally chose not to pursue a clinical career, pivoted my life using the transitional medical skills I gained, and was very happy with my career choices. I laughed and looked around the room to answer her, “This you have here – a clinic and seeing patients, is not my dream.” She did not put any stock into my response and continued to list ways that I could return to clinical medicine. Still a trigger for me to this day (that I am working on), but it immediately got my back up. I completed the appointment as a polite patient and vowed never to return to that family doctor. I felt betrayed, and attacked, sitting in the chair opposite of a doctor who was treating me like a wayward subordinate rather than as a respected patient. It’s unfortunate, but with many other encounters similar to this, now each time I walk into a medical appointment as a patient, my guard is always up, along with my heart rate. I don’t feel a kindling trust with the medical profession – instead, I see it as a tool to manage my health with as little interaction with them as possible.

    With intergenerational trauma, I felt this even though neither of my parents were doctors. I had aunts, uncles and cousins who were doctors, and to the rest of the family, they were the held in the highest regard. Though not said in so many words, as a doctor, you could do no wrong – you were brilliant, powerful, and what each child in the family should strive for. What I found curious even as a child was the normalization of the long work hours, lack of family/free time, and deterioration of most relationships (romantic, platonic, parental etc.)… as if being a doctor excused you from participating in the rest of humanity.

    Thank you again for sharing. I feel for all the beautiful souls, both human and animal, who have been hurt, betrayed, or killed because of this profession.

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