MD Whistleblower

When I was a kid, it was fun to get mail.  Now, not so much.  My mailbox at home is a receptacle for junk mail, various solicitations for services I will never need, and bills.  Office mail is not much more fun.  Each day I look through the stack and separate them into 3 categories. Important stuff Garbagio Not sure The latter category is the most vexing.  Some stuff is cleverly designed to appear important when, in reality it is drivel and nonsense.  We’ve all seen this stuff.  Sometimes, the envelope will include a teaser label, such as ‘Time Sensitive Material’, or ‘Signature Required’.   Once I have been duped to open up the envelope, I’ve lost the game.  Then, I am forced to scan the printed page as fast as my retinas can process the image with the hope that in a few nanoseconds I can send the page sailing into the waste bin.  Sometimes, however, even after reading the entire page, I simply can’t determine if the document merits calling an office meeting to discuss th

Physicians now practice in the era of patient autonomy.  Most agree that the era of medical paternalism should not be resurrected.  During those days, doctors simply told patients what to do, and patients complied.  The informed consent process then was a shadow of what it should have been.  In general, physicians did not proffer medical options and alternatives for patients to ponder over.  They were told, ‘you need a hysterectomy’. Sometimes, I think we physicians today have  over-corrected  for past arrogance.  Yes, I believe in informing patients, but I often wonder if many patients today really only want us to tell them which path they should pursue.  Even the most informed patients are not medical professionals who can grasp every medical nuance or ramification of a decision.  It can be vexing for them to choose among different medical options that are presented to them in an effort to meet our obligation to apprise patients of all reasonable treatment alternatives.  Conside

The Whistleblower wishes all readers all good things for the coming year.  2017 will launch us into uncertain times where many of us are a mélange of hope, worry, fear, resignation, optimism, anger, skepticism, validation and self-doubt.  Will the ship of state sail straight and true or will we find the nation steaming off course into dangerous waters?   I suspect that it will not be simply one path or the other.  There will be times when we will stray and other times when we will more closely hit the desired target.  This is how every government, and indeed every person, lives and breathes. Off Course or On Target? We can accept the inevitable zigzagging with the hope and belief that the overall trend will take us forward.  Let us celebrate our successes and exercise some forbearance when we or others miss the mark despite good intentions. This blog enriches and challenges me and I hope it brings some small measure of delight to all of you.  Please continue to l

A close acquaintance of mine voiced objection to the lighting of the National Christmas tree, which occurred on the first day of this month.  Red, white and blue LED lights were illuminated.  I find no offense in this practice, which for me is a secularized event, even though I acknowledge its connection to the Christmas season.   Kids who visited Santa, as I did decades ago, do so in the days and weeks before Christmas.  Neither Santa nor his elves visit us during Arbor Day, the Fourth of July or Veterans Day.  He is connected with Christmas, although like the tree, his purpose is far removed from the true religious meaning of December 25 th .  A Christmas tree is not quite the nativity scene.  Readers who have more knowledge of the New Testament than I can inform us if a Christmas tree with a star on top and wrapped gifts underneath is mentioned in the Gospels.  Perhaps, Santa truly is a religious figure, since like the three wise men, he comes bearing gifts. Religious i

Jingle bells, jingle bells, Romney’s at the door, Standing there with cup in hand, “Please sir, may I have some more?” Who will be the chief at State? Mitt or Dave or Rudy? How ‘bout tough guy JR Bolton? Isn’t he a beauty? Kellyanne, she’s our man! Smiling like a shark, Oh what fun it is to see Her ever present snark. Hillary, gets shellacked! Trump has doused her flame, Except for Comey, racists, assorted haters, Fox News, deplorables, poor messaging, Russians and Wiki leaks, She freely accepts the blame. How did he win? How did she lose? Did she have disdain For forgotten heartland’s pleas, While he felt their pain? Will we ever see the wall? Mexico pays the bill? Or was that just campaign red meat. A huckster’s ‘sugar pill’? The game is done. We must move on And think of lessons learned. Demonizing couldn’t halt Millions who’ve been spurned.  I challenge you to reach inside And summon your good sense Is P

Even though I am over 40 – by a long shot – I am familiar with the abbreviation TMI.  We are inundated with so much noise, chatter and static.  I feel that we are bombarded with information that we must sift through and ultimately delete.  The news cycle is 24 hours and hits us from so many electronic sources simultaneously.  I am deluged each day with so many unwanted and unsolicited e-mails from organizations that I have never heard of.  One of my favorite words on their e-mails can be found when I scroll to the end.  UNSUBSCRIBE! Another genre of information assault is the panoply of warnings and disclaimers that we confront.  Of course, we are all numb to them since we have been so supersaturated.  I’ll prove it to you.  The next time you are about to take off on an airplane, the flight attendant will review safety information in the event that a catastrophe occurs.  While one might think that folks would be attentive to information that might be useful if the plane loses alti

Most of us are skeptical that insurance companies are devoted to our health.  Answer the following question.  Do you think your insurance company is more interested in your health or in controlling costs?  Pretty tough question, huh? There is a tension between medical quality and medical costs.  If we had a system that offered perfect quality, it would be unaffordable.  If we imposed rigid cost controls, then medical quality would be compromised.  Where do we draw the line?  It is clear to most of us that the medical industrial complex is riddled with waste.  Keep in mind that one man’s medical waste is another man’s income.  For example, physicians define waste as excessive charges by hospitals.  Government officials define waste as excessively high drug prices.  Patients define waste as high co-pays and deductibles.  Drug companies define waste as outrageous legal expenses to get drugs to market and to defend against frivolous lawsuits.  Primary care doctors define waste as