MD Whistleblower

Recently, the CEO of UnitedHealthcare was gunned down in a brazen and calculated act by a murderer. The alleged killer had a life of privilege with top drawer education.  He was the valedictorian of his high school class.  We still do not know the reasons underlying his radicalization against the health care establishment. It has been astonishing to hear and read many voices expressing sympathy and understanding for this heinous act.   The enemy of my enemy is my friend.     Really?   It is galling that some out there believe that acting against a health insurance executive should be considered a mitigating factor in a murder.   Indeed, a U.S. senator commenting on the murder decried violence but then added that ‘people can be pushed only so far’.     Public outrage to this forced her to do some clean up a day later, but her initial instincts and analysis remain in plain sight. The senator needed to 'clarify' her initial remarks. If a m...

Some time ago, I penned a post advocating union membership for nurses.  Increasingly, I expect physicians to seek professional relief by joining unions in the years to come. This is not about the money. There have been pockets of unionized physicians in the United States but efforts to organize physicians writ large have not yet gained widespread traction.   One group of doctors who are overripe to unionize is medical interns and residents.   These professionals work endless hours with sleep deprivation and have insufficient days off to recuperate or recreate.   Of course, they are underpaid for the hours they work but this ranks low on their list of grievances.   Yes, there are reforms put in place, but I have it on good authority that existing loopholes and training program policies have rendered today’s residencies very similar to mine over 3 decades ago.    If you track the evolution of the medical profession over the past 20 years or so, unio...

We can all be thankful that the election is over although half the nation is less than thankful for the results.  Hopefully, raw feelings were set aside this year's Thanksgiving a holiday that has often been the setting of spontaneous political combustion.  My own electoral success rate in this year’s election would translate to a grade of ‘F’.  Nearly all of my selections lost.     But in a democratic republic, we must respect the process and the results regardless of the outcome.   Indeed, I am doing so now. He's thankful he was spared! We have heard the perennial whining about the Electoral College urging its abandonment in favor of relying instead upon the popular vote.   Not surprisingly, these proponents are usually, but now always, those whose candidates have lost elections and they are seeking a new pathway to success.   Casting the Electoral College aside would require a constitutional amendment, a very heavy lift. I would assume th...

In the medical profession, there is often more than one correct answer.  Present the same case to 10 seasoned medical practitioners and you will likely hear numerous rational plans of action.  This scenario would be bewildering to patients and their families and is one reason that I have warned patients of the hazards of pursuing a second opinion.  Medicine is not mathematics where there is a single correct answer that can be proved. Medicine is not like math. How does a patient reconcile divergent recommendations offered by medical professionals? Should a formal debate competition be held before patients and their families? How does the medical team reconcile our differing views amongst ourselves? Can we expect ordinary patients and their families to decide if surgery, medication or watchful waiting is the best option?  Despite the current culture of patient autonomy, shouldn’t it be the physicians’ task to direct patients toward wha...

There is extraordinary medical care being practiced in the United States.  While medical breakthroughs do not occur linearly, there is a clear forward trend of progress.  Naturally, there are setbacks and failures which are learning opportunities in medicine as they are in life.  My own medical journals are increasingly populated with studies examining the use of artificial intelligence.  Endoscopic scope journals present examples of technical wizardry which only years ago would have been thought to be science fiction.   Sooner than we imagine, medicine will be offering widespread personalized or precision medicine when treatments will be customized according to a patient’s genetic profile.   Up to now, most of our treatments follow a one-size-fits-all model which is already recognized as a clumsy tool.  Ten patients might both have rheumatoid arthritis, for example, but these genetically unique individuals would likely benefit from tailored ...

Quite regularly, I am asked to comment on the care of folks who are not my patients.  Often, these are friends or their relatives who are suffering gastrointestinal (GI) distress.  “Would you be able to give her a call”?  On other occasions, a member of my own family wants me to connect with someone who has a GI issue. This is tricky terrain and I navigate it very cautiously.   Obviously, I am not the individual’s doctor and would never assume this role.   The individual shares with me only his version of the facts which may not represent the totality of the medical situation. I don’t have the data and have not performed my own examination..   It would be highly irresponsible and unethical for a physician from afar, who has no professional attachment to the individual, to dispense medical advice or to sow doubts about the quality of the medical care rendered.   Indeed, a physician who crosses a line here can cause confusion and doubt which can have d...