Lesson in Leadership

"But men remain so simple, and governed so absolutely by their present needs, that he who wishes to deceive will never fail in finding willing dupes."

The Prince, Nicolo Machiavelli

The word, machiavellian, refers to political artfulness and diplomacy "which is as shrewd as it is false, and is as smooth outwardly as it is sharp inwardly, and shameless."

In line with the quotation from the ancient handbook for princes on how to get ahead, and to illustrate the nature and methods of medicine's current adversary, we have borrowed the President's Page from the May issue of the Montgomery County Medical Society's Medical News (Dayton, Ohio), which follows. We've had many inquiries concerning the widely publicized White House Visit of the 28 physicians who presented the Administration with a statement supporting the King-Anderson Bill. The statement was signed by 40 physicians.

The inside story of this hastily conceived political maneuver appeared in the April 20 issue of New York Medicine, the official publication of the Medical Society of the County of New York. The complete article follows. I think you'll find it interesting and revealing.


The desperation of the Secretary of HEW and the Administration to get medical support - any support from any source with an M.D. after the name, for H.R. 4222, and the social security plan of payment for care of the elderly, is pinpointed by the recent White House reception of Dr. Caldwell B. Esseltyn of the Rip Van Winkle Clinic in Hudson, NY.

President Kennedy greeted Dr. Esseltyn and 27 other physicians personally on March 27, 1962, and they assured him of their support against the A.M.A. opposition to King-Anderson legislation.

Heading a group known as something out of a stuttering linotype machine with the initials PCHCATSS (standing for The Physicians Committee for Health Care for the Aged Through Social Security), Dr. Esseltyn found White House doors magically opened for him and other doctors who showed up and read a statement signed by a total of 40 MD's.

One may suspect that the doors did not magically open, but rather that the committee itself was magically created to move through a door ready and waiting for just this sort of presentment.

Knowing some of the doctors who were asked to join the group, and who did not do so, we have at hand correspondence and records of telephone calls indicating that as late as March 12, and even up to March 28, this hand-picked group on a national basis was frantically making phone calls among themselves trying to find out what it was all about. Indeed this was the day after President Kennedy and Secretary Ribicoff welcomed the delegation amidst full press coverage. The N. Y. Times was especially extensive in its coverage. (Ed. Note: similarly the Atlanta Constitution).

The Esseltyn group of PCHCATSS is the perfect example in this modern day and age of how to create a paper committee without many of the men who will be on the letterhead later knowing really what it is they are asked to do.

The whole thing - at least the first letters of invitation - went out from Dr. Esseltyn's Clinic on February 20 and enclosed a draft of a proposed statement explaining that the group would be welcomed by the President at the White House.

The exact date of the meeting was left open, but on a ten-day standby notice. The letter then carried a list of names of physicians who had been invited to join the group.

One particular doctor who received this letter knew many of the men named, and ordinarily he might have gone along blindly and agreed. But he did something different. He sat down and made long distance phone calls to many of his friends on the list, across the nation. What he learned was astonishing. None of the men knew what it was all about. They thought that he knew something about it.

The doctor then called the Esseltyn Clinic to learn the facts. What he learned was that Dr. Esseltyn had testified at hearings on July 28, 1961, on behalf of the Group Health Association of America in favor of H.R. 4222. Group Health Association is the organization of closed panel medical practice plans associated with insurance companies like H.I.P. in the east, and Permanente on the west coast.

In a subsequent letter the doctor received three things:

  1. The copy of testimony of July 28, 1961,

  2. A reprint of a laudatory article in the Harvard Medical Alumni Bulletin from the fall issue of 1961 dealing with the virtues of Dr. Esseltyn's Rip Van Winkle Clinic, and

  3. An article by Dr. Esseltyn based on a speech to the New Hampshire Medical Society on May 19, 1961, entitled "The Next Ten Years in Medicine."

The doctor declined to join the White House visitation group.

But there is still more.

We have at hand another letter from still another doctor who received a similar invitation to sponsor the visit to the White House. His letter of declination starts, "Dear Essy" . . . and it ends, "I hope you will reconsider your unfortunate stand. Your organization will hurt the country and the medical profession. Finally, I want to see the old people cared for as much as you do, but I don't want the Federal Government to administer the program."

As a sequel to the above we have at hand the April 8, 1962, newspaper of the Retail, Wholesale and Department Store Union AFL-CIO, which gives full and intensive coverage to the doctors at the White House with photographs of the President greeting the group, and selected quotes from individuals. This is fast work to spread the gospel among the labor councils.

Further, and in the way of a rebuttal, is the recent statement of Rep. Thomas B, Curtis of Nebraska who was amazed by the episode. Referring to the 42 doctors who signed the statement, Mr. Curtis said in Congress, "One doctor was the chairman of the platform committee on health in the 1960 Democratic Convention. Seven of them (the doctors) testified before us at the Ways and Means Committee in support of the Kennedy Plan. One organized a `Committee of Physicians' for Kennedy during the 1960 presidential campaign. Three are officials of `citizens' groups' which have been in the forefront of lobbying for H.R. 4222. Three are employed by international unions. Two are New York employees of Mayor Wagner, and one is the director of a hospital supported entirely by federal funds."

Thus endeth the lesson of who went to the White House, and why.

(c) The Bulletin of the Muscogee County (Georgia) Medical Society, "The Doctor's Lounge", Jul 1962, Vol. IX No.7, p.15

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