On September 3, 2008, Sarah Palin stood before the Republican National Convention and gave a speech that ushered in a new era of right-wing rhetoric once confined to talk radio pundits. As soon as Palin finished her mavericky tirade against President Obama and community organizers, a new breed of gasbags was born, complete with fallacy-ridden arguments, loud speech, and big egos. Graduating from the school of Rush Limbaugh rhetoric, Palin attracted many people with her brash and brutally honest speech.

When I was reading Wayne Liebhard’s Elephants in the Exam Room, I immediately recognized the confrontational tone of Alaska’s former governor. Of course, I have no way of linking the two, but Liebhard does pride himself on his brash tone, which reveals how he sees the world through a lens of an egocentric male medical doctor.

Liebhard’s goal in this book is to give a “big picture solution to today’s heath care ‘crisis.’” Liebhard examines issues of personal responsibility, the role of insurance companies, and the government’s influence on the health-care delivery debate. What is left out of Liebhard’s big picture is the role of the doctors themselves. This book is a prime example of a person’s failure to see his or her own role in creating and solving a problem. Liebhard leaves the reader with the impression the physician is nothing but a victim in this debate, while quietly saying doctors might have become “laissez-faire” (26).

Doctors have been aware of these issues for years, but no one with any power listens to doctors anymore” (25).

So, the state government, the federal government, and the insurance industry all bank on the ethics of doctors to do the right thing while simultaneously being screwed” (141).

Give me a break. Liebhard would like the reader to believe doctors are the victims of lazy, obese patients who make poor choices, money-grubbing insurance companies, and a government that interferes in all the wrong ways. Liebhard points the finger at everyone except his fellow doctors. If the health-care delivery system is a failure as Liebhard suggests, the failure includes those very same doctors who write the prescriptions. If no one is listening to you, you have failed at delivering your message. This means you need to either deliver your message better or evaluate your message to find its flaws. If you think your message has no flaws, you are flawed for believing you are perfect.

Any potential solutions in Liebhard’s book are drowned out by his sexist rhetoric and poor argumentation. Here are some disturbing examples.

You may choose to write your congressman” (12).

The last time I checked, both genders are represented in congress.

The American Medical Association shouldn’t think so either, but in a politically correct, castrated sort of way, its initial take on the subject was to list ‘guidelines’ under which these clinics should operate” (90).

Liebhard assigns a gender to the AMA by suggesting the organization has testicles. This is an enlightening view of how Liebhard views the AMA as a male-only organization and how he views political correctness as a feminine idea that is violently undercutting the Good Ol’ Boy AMA Club.

Get ready, restaurant owners, obese people have a right to be thin, and since you are somewhat involved with food (and, by God, we know you have the money), maybe you should be taxed to send these people to fat farms” (82).

Not only is this an attack on body image, this is also a slippery slope fallacy. Fallacies abound in this book, making Liebhard’s arguments lacking in logic. They are also offensive and exclusivist.

Note to these physicians [the kind Liebhard believes that don’t work hard enough or do the work he believes primary-care physicians should be doing]: We’re already training these kinds of practitioners. They are called mid-levels (PAs and NPs). Because they are less expensive and you are not willing to put on the big-boy pants, they are starting to replace you and becoming many people’s de facto primary-care doctors” (114).

According to Liebhard, if you are not a doctor to his definition, you are a mere child. Moreover, Liebhard believes any real medical practitioner would be a male primary-care physician, judging by his reference to big-boy pants.

My advice to Liebhard would be this: If you are going to offer a big picture solution, look deeply at yourself and see how your actions and words inhibit a big picture solution by excluding people from the picture. If you exclude, your solution is incomplete and not a big picture. It is a small and incomplete picture just as broken as the health-care delivery system.

This makes you the largest and most ineffective part of the problem because you fail to see your own faults.

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Non-Fiction Health Care, politics, Wayne Liebhard