MD Whistleblower

Posts

The Doctrine of Implied Informed Consent; Can Doctors Go Rogue?

I wouldn't call it rogue, but at times we do go it alone. In fact, I recently performed a medical procedure on a patient without obtaining formal informed consent. Was this a brazen violation of medical ethics? Should I be reported to the Ohio Medical Board? Could my action be considered as a criminal battery? Hopefully, none of the 3 above inquiries will be responded to in the affirmative. Obtaining informed consent for medical testing and treatment is a bedrock precept of medical ethics. Patients are entitled to know the risks, benefits and alternatives to our proposed recommendations. Too frequently, informed consent is regarded as a pro forma exercise. Signing consent forms drafted by hospital attorneys may offer the hospital legal protection, but this is not obtaining informed consent as I understand it. I have summarily signed my own medical consent forms without reading through the documents. I surm...

A Patient's Loyalty to his Doctor

A few days before preparing this post, I greeted a patient who was about to undergo her 5 th colonoscopy. I was the pilot for the 4 prior excursions. “You should’ve signed up for the rewards program,” I quipped. “This one would’ve been free!” Our patients, with rare exceptions, enjoy our light atmosphere seasoned with some humor. This does not detract from our seriousness of purpose and commitment to their welfare, and they know it. Our endoscopy team is comprised of outstanding medical professionals. I care for many patients for whom I have performed all of their colonoscopies, which may exceed 10 procedures. I recently performed an examination on one of my colitis patients who has unique findings which have remained stable for years. I know his colon as well as I know his face! Indeed, if I were shown a photo of his colon, I would immediately be able to name the individual. So, when we gastroenterologists c...

Test Your Medical Knowledge with a Three Question Quiz!

Over the last decade, I’ve shared many vignettes about many gastroenterology medical conditions, diagnostic strategies and treatment options. However, this is not a medical blog; it’s a medical commentary blog. In other words, these posts are not a resource for readers who want understand how the pancreas works or how best to treat Crohn’s disease. My angle would be more likely discussing why patient with Crohn’s might think twice before pursuing a second opinion. I don’t present the diagnostic possibilities of abdominal pain that could serve as a primer for patients. But I might point out why a CAT scan casually ordered on patient with stomach pain can tear open Pandora’s box. Pandora should have 'kept a lid on it!' So, in this spirit I’ve prepared a 3-question quiz for readers with the answers found at the foot of this post. Regular Whistleblower readers will cut through all three of them like a buzz saw Even t wo of correct answers ...

Cologuard or Colonoscopy?

Many patients are aware of Cologuard as a colon cancer prevention option. The appeal is obvious. One can submit a Cologuard stool test and forego the joys of colonoscopy. Indeed, what motivates patients to select the easier option is not belief in the product but an opportunity to avoid a much less pleasant alternative. This is analogous to how many of us vote in elections. Rather than vote for a candidate we are often voting against another candidate. Did you vote for or against a candidate? Cologuard is much more sophisticated and expensive than the conventional stool testing for occult blood which has been standard fare for decades. Cologuard will also detect microscopic blood in the stool but will also pick up abnormal DNA which could indicate the presence of a large precancerous polyp or even a cancer. Hen...

Is Professional Football Too Dangerous?

I am a casual viewer of professional football. I have come to realize that sports for many who live in Cleveland is a religion. Many of these religious zealots who have invested so much time and devotion to the Cleveland Browns have become apostates after what have been seasons of disappointment and failure. Indeed, as of this writing I suspect that it is unlikely that the Browns will reach the Super Bowl this coming February 9 th , but one can always hope for divine intervention. But I am not writing to opine on the Browns’ performance. For decades, I have been jarred by the violence of the game and the devastating injuries that routinely occur. Indeed, one can expect players to be walked off or carted off the field in just about every game. I treated a Cleveland Brown in his later years who had played for the team for 13 seasons in the 1950’s and 60’s. I think every part of this body either hurt, didn’t work well or both. He was a...

Customer Service Is Worse Than Ever

Readers of this blog are well aware of my frustrations and criticisms and even a soupcon of anger regarding the disappearance of customer service in our society. This unfortunate reality is undeniable and is only going to worsen. Corporations and businesses – with few exceptions – abuse their customers because they can, knowing that we have no recourse available. Do you think the battle of Man vs Airline Industry, for example, which I fantasize over, will achieve a just outcome? Two recent developments are relevant to this rant. First, businesses are poised to start charging a fee to customers who are returning unwanted items. And secondly, Amazon Prime will soon be showing commercials during their broadcasts. Of course, for a surcharge, customers can still enjoy Amazon streaming without ads. Let me distill this down using plain language. We are going to further squeeze our already squeezed customers because we c...