I need to complete the chronicle of Keith Alan Lasko, MD, begun last week in my Health Tip Pigs At A Trough with the story of the physician who wrote The Great Billion Dollar Medical Swindle some 35 years ago and then seemed to vanish. But completely disappear? Hardly. Based on what I’ve been reading online, it’s a safe bet the entire medical profession continues to wish he’d just go away for good.
As a quick profile on Dr. Lasko, he emerged, as I and many of my medical school colleagues did, from the middle-class, largely Jewish background of West Rogers Park. Our grandfathers had been Maxwell Street peddlers and junkmen so our fathers could be pharmacists, podiatrists, and small businessmen so that my generation (compelled by ambitious parents wanting the best for us) could be doctors, dentists, lawyers, and accountants, the four horsemen of Jewish immigrant pride. All this hard work permits the fourth generation–our own kids—to pursue a long menu of life-fulfilling occupations, free to be choreographers, writers, designers, executive chefs, and whitewater rafting guides.
I remember Lasko in both pre-med and med school as hardworking and intense, definitely very smart. Getting top marks was never an issue for Lasko, but I never saw him once we’d completed our second year. After he got his MD, he had a residency in internal medicine and then in cardiology, ending, according to my internet research, by moving to the West Coast and starting a practice in Van Nuys.
Lasko was ahead of his time
You can get some idea of what prompted him to write The Great Billion Dollar Medical Swindle by listening to one of his surviving radio interviews. He’s not only quite articulate, but because he’s decades ahead of his time he expresses pretty much the same ideas that Steven Brill would advance years later in the special issue of Time Magazine devoted to our insanely expensive health care system.
35 years ago, no one had the nerve to say such things. Brill, protected by Time and backed by an enormous amount of incriminating data available online, could easily take on the health care system. Lasko was alone. His local hospital in Van Nuys moved quickly to get him out of their lives and out of the medical profession forever. The best way to do that? Come up with some evidence that he’s been irresponsible and negligent (you don’t need patient complaints for this) and join forces with the state medical board to yank his medical license.
Let me pause here to tell you it’s actually quite difficult for a doctor to totally and permanently lose his or her license to practice medicine. Even if a felony is committed, the license is suspended during incarceration but the physician can reapply for it on release. Actual permanent revocation is rare. Multiple malpractice suits almost never result in revocation. In fact, most doctors who lose their licenses have really hit the skids, having sunk to drug dealer status, using their offices as pill mills to dispense narcotics.
But even in the absence of such egregious behavior, if a group of doctors has an axe to grind and unites against you, it’s curtains.
So the doctors in Lasko’s local hospital, embarrassed by the author’s ubiquitous talk-show appearances blasting their sacred profession, report him “negligent” during his care of nursing home patients, ordering too many tests and unnecessary procedures. Since I’ve been a physician, I have never, ever heard of anyone losing a license for these reasons. Reprimanded, yes. Placed under supervision, yes. Banished, no.
During his defense (much of it still online), Lasko argues something like, “Am I here because of my book and my appearances on TV?” and says “I want my case reviewed by a peer–namely a board-certified internist and cardiologist.”
But when you’re doomed, you’re doomed. And not only does Lasko have his California license revoked, but the California Board notifies the other states Lasko’s licensed in and gets them to revoke his license too, so that within two years of publishing his inflammatory book, Lasko can no longer practice medicine.
Now begins the saga of Lasko’s revenge
Before I start, you need to know something about medical specialties and medical associations. There are a total of 130 medical specialties officially recognized by the American Medical Association (AMA), from Allergy and Anesthesiology down through Urology. Each has its own board exam for certification and its own professional association for members. There are also dozens and dozens of unrecognized, unofficial specialties, including Anti-Aging Medicine and Environmental Medicine, whose membership is based on common interest rather than specific credentials. The AMA really dislikes these unofficial specialties, probably because it can’t control them.
Lasko, on the other hand, feels contempt for them all, approved or unapproved. To his thinking, the whole bunch is one vast den of thieves.
Of course, anyone–even you–can start any association of any stripe. Put the right paperwork together, submit it to the right registering agencies, and you have your own association. You could even start your own medical association. Go ahead, name it anything you want, send out a mailing to lure some members, collect membership fees, and issue membership cards, certificates, and plaques. You can even award your members new initials after their names.
And this became Lasko’s revenge on the medical profession.
From what I’ve gathered, he purchased physician names and addresses from the AMA, which is happy to sell this data to anyone with a credit card. Lasko then created literally dozens of new medical associations, sending mass mailings to physicians around the country, inviting them to join such entities as the “American Surgery Association,” the “American Association of Geriatric Physicians,” and even the “American Association of Ethical Physicians.” Dozens of associations, literally dozens. To my mind, his contempt for physicians knew no bounds. If a doctor was willing to pay for a few more initials after his name to impress his patients, Lasko would supply them.
After all, he was unemployed and very angry.
Soon the conventional medical associations got wind of this and exploded, filing cease and desist lawsuits to stop him. But as I read through the lawsuits, the warnings, and the judgments, as fast as he closes one association he’s opening two more. If he was a loose cannon with The Great Billion Dollar Medical Swindle, now he’s a Howitzer. Here’s a warning from the American Board of Internal Medicine (likely he was once a member) listing a couple of his fictional associations. And one from the surgeons.
Second guessing Lasko, I think he genuinely felt all professional associations were glorified trade guilds, existing primarily to keep away outsiders. There’s nothing wrong with learning to become a physician, or even establishing standards for credentialing expertise. But when professionals band together to create associations that exclude anyone who thinks outside the box, Lasko objects vociferously. This has been standard operating procedure for the medical profession over the past 100 years. The AMA spent a fortune trying to eliminate chiropractors from the healthcare landscape. It was only after a US Supreme Court order that they gave up and set their sights on midwives and acupuncturists.
And if you think things are better in the 21st century, there’s a case being heard right now, the nation’s highest legal apparatus at work deciding whether or not to prevent non-professionals (whatever that means) from engaging in teeth whitening.
The next phase of Dr. Lasko’s life somebody smarter than me can explain. Sometime in the 1990s, he adds a second title, referring to himself as “The Reverend Doctor Keith Lasko.” Links begin appearing to a church he’s founded, The Worldwide Ministries of Christ, with an online series of sermons, presented in all-capital-letters Unabomber fashion and railing against issues like abortion of babies already born (never explained).
Personally, I thought Lasko was Jewish (Pratt Avenue, West Rogers Park in the ‘60s? What else?), but Jews can become enthusiastic Christian fundamentalists just like anyone else. So where is he now? The ever-reliable internet locates him in Las Vegas, with his church in Virginia and his weekly sermons appearing online. He’s still creating and selling memberships in medical associations, closing them down as fast as he loses a court order. Still a Howitzer. Just five months ago he filed lawsuits against the American College of Surgeons and the American College of Physicians, the two largest physician organizations after the AMA, accusing them of violating the Sherman Anti-Trust Act.
I thought I was at a loss about all this, but maybe not. Lasko was morally outraged by what medicine had become. He wrote an angry book. Was drummed from his profession on what look like seriously trumped-up charges (I can find neither a record of a patient complaint against him nor a malpractice suit). Being closed off from his profession, he chose to move earth and its mountains against it, creating non-existent medical associations (remember, he believes the real associations basically exist to support the evils of the profession) and ultimately filing lawsuit after lawsuit hoping that somewhere the chicanery can be exposed.
One medical article after another calls him a “scam artist,” but not one refers to his book or to the brutal ending of his livelihood all those many years ago.
Ultimately, of course, any judgment is up to you. As always, your comments enrich the conversation.
David Edelberg, MD