MD Whistleblower

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. Some time ago, a young man came to see me in the office accompanied by his mother.  I cannot recall a single detail of what led him to see me.  But I remember very clearly a medical intervention that he had as an infant that bore no relevance to the forgotten reason for his visit.  One of the tasks that physicians perform on patients we see is to review the past medical history (PMH).   We do this to assemble a medical portrait of the individual who is before us.   Oftentimes, the historical medical events are not directly relevant to the issues at hand.   But often they are.   For example, if a patient has been experiencing chest discomfort, and the PM...

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. I have written about labor unions on the blog from time to time.  I have lambasted the teachers unions , for example, for their self-serving positions during the Covid-19 pandemics.   On the other hand, I have supported hospital nurses organizing as the power imbalance between them and their employers has stifled needed reform.  And I have mused about employed physicians who are threatened with burnout and endless burdens seeking union protections. Earlier on the day that I penned this post, I read of a labor agreement between a dockworkers union and its employer.   Fortunately, a strike was avoided.   The agreement has yet to be formally ratified.   ...

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. When an individual is hired to do a job, one would think that his or her skills would be carefully assessed prior to tendering a job offer.  Let me offer some examples. If one is applying to a newspaper (yes, they still exist but print editions will soon be visible only in journalism museums) seeking to become a reporter, the hiring professionals will carefully scour through the applicant’s prior writings.   If writing well and under pressure are job requirements, then the newspaper will want to verify that the applicant has these skills.   It’s possible that the applicant would be asked to submit a writing sample on the spot. If a man is applying to become a salesman in...

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. I have had 3 jobs in my long career in gastroenterology.  My current one will be lead me to retirement, but I have no firm date in mind.  In fact, it could be years away.  I have reached a station in life where I asked routinely if my retirement is imminent.  I hope that these patients are inquiring wanting me to stay on rather than to leave the scene! My current employed position has been the most enjoyable and satisfying, particularly at this stage in my professional life.   In my current post, I have divested myself of the most onerous aspects of medical practice – hospital medicine, nights & weekend work and on-call responsibilities.    Yes, it’...

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. Some time ago, I performed an upper endoscopy, or EGD, on a patient who had a family history of Barrett’s esophagus (BE).  In this condition, the esophagus has developed a new internal lining which is readily apparent when examined with a scope.  These patients are followed periodically because of an increased risk of developing cancer, which fortunately is a rare event in this condition.  I discovered reflux esophagitis at the lower portion of her esophagus. Curiously, she had no heartburn or other symptoms of reflux.   I did not identify BE and the biopsy results were benign.    One of the mysteries of gastroenterology is that at times we discover fairly i...

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. Where have all the ulcers gone?   Peptic ulcers are very common lesions in the stomach and the first portion of the small intestine called the duodenum.  Why, then, do I – a gastroenterologist - rarely discover them in my patients?  The answer is twofold.  First, my gastroenterology practice is now limited to outpatients exclusively.   It’s been years since I’ve done hospital rounds.   Back in those days, one the most common reasons I was called in to consult on a hospitalized patient was to evaluate internal bleeding.   I saw hundreds of these patients and many of them had ulcers responsible for the bleeding.   As an aside, most folks commonl...