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Testing Doctors for Drugs and Alcohol

I read recently that the left coast state of California is contemplating requiring physicians to submit to alcohol and drug testing.   Citizens there will be voting on this proposal this November.I do think that the public is entitled to be treated by physicians who are unimpaired.  Physicians, as members of the human species, have the same vices and frailties as the rest of us. Traveling leftward I have no objection to this new requirement, if it passes. This will not be a stand-alone proposal on the ballot, but is a part of the ballot initiative.   Why would trial lawyers in the Golden State want to include it?  The meat of their ballot effort is to reverse effective tort reform that had been in place there for several years.   Click on the Legal Quality category on this blog for a fuller explanation of why the medical malpractice system has been screaming for reform, and is slowing getting it.  Sure, there are always two or more sides to every issue.  But, when the different

Should Doctors be Political in the Office?

Our nation is highly polarized today, and often bitterly so.  Democrats rail against the GOP.  Pro-lifers face down pro-choicers.  FOX News disses MSNBC.  Isolationists push back against expansionists.  Traditionalists disdain the politically correct.  Free marketers duel against government advocates.  Carnivores deride the gluten-free crowd.  Martin Bashir trashes Sarah Palin, two proxies in a culture war.   There's a philosophical divide among physicians also.  Would you prefer a liberal physician or a conservative practitioner?  I'm not referring here to fiscal policy or legalizing recreational marijuana use.  Consider the following hypothetical scenario and the 2 physicians ’ approach from opposite sides of the medical philosophical spectrum. Which physician would you choose? Dueling Doctors The Patient:   She is a 50-year-old female with chronic fatigue syndrome (CFS).  She is only able to work part time because of her condition.  She has consulted with a

When Doctors Break the Law

I’m a law abiding blogger.  Laws are meant to be obeyed.  If an individual opposes a law in a free country, then he should operate within the system to modify it.  I recognize that even in free societies, certain laws are so unjust and in violation of natural law that that the citizenry may be justified in relying upon other measures to affect necessary reform.  I’m not suggesting that an unwelcome federal tax on gasoline be greeted with pitchforks in the street.  However, our own democracy is a nation where slavery, ‘separate but equal’, exclusive male suffrage and Jim Crow discrimination were all legal.  In such cases, can we expect a legislature to strike down unjust laws that it enacted? Law and medicine are increasingly intertwined today, and more than they should be.   Physicians no longer practice unfettered from legal encroachments and regulations.  I am not referring here to the unfair medical malpractice system, a subject that has occupied a substantial portion of real e

When Should Doctors Turn Patients Away?

A few days before this writing, a 32-year-old woman came to see me for an opinion on stomach pain.  Why would I refuse to see her again?  Abdominal pain is an everyday occurrence for a gastroenterologist.  She was accompanied by her mother.  I had never met this woman previously.  She had suffered abdominal pains for as long as she could remember.   She recalled frequent visits with the school nurse when she was a young girl. The Stomach - Usually Not the Source of 'Stomach Pain' She has abdominal distress of varying severity every single day. Despite this medical history, she was not ill and appeared well. Why did I refuse to take on her case?   She seemed like a very appropriate patient for my practice.  I have expertise in evaluating and treating abdominal pain.  The patient was pleasant and cooperative.   I believe she would have been comfortable with me as her gastroenterologist. I learned that the patient lived in another state and was only in Cle

Hobby Lobby vs Obamacare: 1-0

Hobby Lobby, unfairly demonized in various corners of the public square, had their religious beliefs upheld in the highest court of the land in a 5-4 decision this week.   The company’s leaders are deeply believing Christians, which I believe is still a lawful practice in this country.  The company tithes to charity and pays its full time employees at least $14.00 hourly, both evidence of a culture of compassion and fair play. No, not these Supremes, the other ones. There is a din of shrill protestations that the company is against contraception and women, which is a complete falsehood.   Hobby Lobby is not the Catholic Church who objects to all forms of artificial birth control as fundamental religious dogma.  The company always intended to cover 16 different forms of contraception, including oral contraceptives, condoms and tubal ligation.  It objects to birth control methods that take action after an embryo has been created. I don’t grasp the notion that an institutio

The Fourth of July - Musings on the Declaration.

The meaning of many holidays can be elusive.  On Memorial Day, are we contemplating our fallen heroes, or grilling burgers?  How many shopping days ‘til Christmas?  Labor Day?  Isn’t that the last weekend at the beach? The Fourth of July has just passed.   Hopefully, we paused at least for a few moments to meditate on what happened in Philadelphia in 1776.  I’ve seen the actual Declaration twice in my life.  The first time was when my mom took me to D.C. as a young child.  Later, I took the kids to the National Archives, where we waited in a long line to be rewarded with a few second gaze at the very faded ink that was sequestered behind thick glass. History is such a thrill.  It’s a dynamic discipline that breathes.  This past week, a scholar from Princeton, New Jersey claims that a punctuation mark – a period – does not appear on the original parchment, but was included in the official transcript of the Declaration authorized by the National Archives.  The omission

Are Your Medical Priorities Straight?

The world is asunder.  As I write this, Iraq is sinking into a sectarian abyss.  ISIS, a terrorist group, now controls a larger territory than many actual countries.  Russia has swallowed Crimea and has her paw prints all over eastern Ukraine.  China is claiming airspace and territories in Southeast Asia increasing tensions with Japan, Vietnam and the Philippines.  The Israeli-Palestinian peace process is in another deep freeze.  Terrorists in Sudan and Nigeria are kidnapping and murdering innocents with impunity.  The Syrian regime has resulted in 160,000 deaths and has displaced over 6 million people.   The Taliban continue to destabilize and terrorize in Afghanistan and Pakistan.  Disease and hunger claim millions of lives in the developing world while other world regions have a surplus of food and medicine.  We have an immigration crisis in this country that gets worse by the day.  Several million Americans are still out of work. Let’s not be distracted by these trifles.  A loo