This exposé, Whistleblower Doctor-The Politics and Economics of Pain and Dying, concerns Dr. David K. Cundiff’s efforts over 17 years to improve the quality of palliative care and hospice services for cancer and AIDS patients at the LA County + USC Medical Center. Over a nine year period, he helped improve the care of terminally ill cancer and AIDS patients at the LA County + USC Medical Center by directing a popular “Pain and Palliative Care Consultation Service.” Unfortunately for the financial bottom line of the hospital, better pain and symptom control of terminally ill patients led to more patients at home and fewer patients occupying Medicaid-funded hospital beds. The unintended consequence of Medicaid’s dysfunctional hospital-centric funding system was the closure of Dr. Cundiff’s Consultation Service in 1995.
After Dr. Cundiff blew the whistle on poor pain and symptom management following the closure of his Pain and Palliative Care Service, a sham peer-review was conducted concerning his judgement call to stop anticoagulant drugs in a man with multiple bleeding risk factors. The man later died of pulmonary embolism. This led to Dr. Cundiff’s firing and subsequently to the loss of his medical license. It also led to Dr. Cundiff’s years long investigation of the evidence basis for anticoagulation for multiple medical indications.
The major goals of this book include:
• improving the pain and symptom control of cancer and AIDS patients,
• stopping the epidemic of deaths and injuries from the use of anticoagulant drugs,
• changing the Medicaid reimbursement system for the LA County Department of Health Services and other places where it fosters inefficiencies and poor medical care, and
• reinstating Dr. Cundiff’s medical license.