MD Whistleblower

 In one’s profession and in life, we strive to improve our performance.  There are so many pathways available to progress on this journey.  One of the best ways is to emulate others.  Athletes, artists, musicians, writers, parents, tradesmen, educators, clergy, law enforcement personnel and even physicians can better their performance by imitating others.  And while it might seem axiomatic that our best role model is one who is more proficient than we, this is not necessarily the case .  The team captain can learn much from a rookie.  The Jewish Talmud expresses the truth more eloquently.                                                 Who is wise?  One who learns from every man. Over my career, I have tried to improve my practice of medicine from watching other physicians and nurses in action.   As an example, I have heard medical professionals having difficult conversations with patients which taught me how to do this better. So, when President Trump’s doctor recently led several

The year 2020 has been an annus horribilis and it's not over yet.  Seemingly out of nowhere a virus, heretofore unknown, has seeped over the globe like hot molten lava leaving a wake of destruction and despair.  The fatalities here in the U.S. have been staggering and the death count continues to rise.  Millions here have been infected and have suffered greatly with severe illness, hospitalizations and intensive care unit treatment.  Those who have so far escaped infection are anxious that their fate might change at any moment.  All of us have been affected. And, we have had a catastrophic economic melt down from which we may never fully recover.   Furloughs, layoffs, bankruptcies and permanent closures have affected nearly every sector of our economy.   The airline industry – the nation’s circulatory system – now has a very weak pulse, as one of countless industry examples.   Job losses have crippled much of the nation which has caused consequences to real people and families f

Before Justice Ruth Bader Ginsburg’s death certificate was signed, Judicial Warfare commenced. Both sides, of course, were prepared for this moment.   Justice Ginsburg, seemingly indefatigable, was well into her ninth decade and had numerous collisions with cancer.   It’s cruel, but entirely expected, that the nation was not given a proper opportunity to honor her legacy and accomplishments which should command admiration from all Americans.   One need not agree with her judicial philosophy or her opinions to admire the breadth of her accomplishments, her work ethic, her intellect, her vision and her humanity.   Indeed, her storied friendship with the late Justice Antonin Scalia shows a nation overflowing with anger what is possible. The efforts to recall her legacy were soon subsumed in partisan warfare.   The Democrats accused the GOP of monumental hypocrisy as they juxtapose their statements in 2016 when Judge Merrick Garland was nominated to their current proclamations that con

Perhaps, October 31 st will be an inflection point in the pandemic since more folks will be wearing masks on Halloween. I assume that the annual ritual of trick or treating will be suspended this year, as have so many of our performances, celebrations, concerts and athletic event spectating.    It has been my observation in Ohio that more folks are masking up, although there are exceptions everywhere.   Our governor has directed concern for some rising case numbers toward college youth, who astonishingly haven’t followed the rules.   Just because one is a college student doesn’t guarantee that his decisions will be graced with wisdom.   And, if there is to be any chance that college kids who are drawn toward campus parties like iron filings are attracted to a strong magnet, there will need to be sure and certain enforcement.   What if a college made students aware that violating public health rules would result in expulsion with no refund of monies spent?    Yes, I know this sounds

 The nation’s racial upheaval, particularly vis a vis law enforcement, has shown us the value of the skill of de-escalation.   A situation arises and several outcomes are possible, although some are clearly preferred.  The specific technique and approach utilized may determine the end result.  A range of options are often available.  What can make these situations so difficult to unravel afterwards is that an option that may lead to escalation may be deemed to be acceptable, according to the training protocol.  In other words, even the approach taken was acceptable, there may have been a better way. Obviously, we all endorse training and practices that has the highest probability of bringing calm to a potential combustible situation.    I expect law enforcement – the professionals – to pursue de-escalation as their default mode.   But, the citizenry can and should do its part to de-escalate.     If all parties share the desire for a calm denouement, then it is much more likely that t

Labor Day is a time to pause, reflect and to thank all those who keep this nation vibrant. You are the guts of the country. Labor has battled many adversaries over the decades.  It has sparred with management.  It has railed against 'right to work' legislation.  It has struggled to compete against low wage workers in foreign countries. But this year it has been sucker-punched by the most formidable adversary that has ever entered the arena. And Labor is still reeling.  And, so are the rest of us. An enemy like no other It will be a slow grind, but it will lumber forward.  Yes, we will reach the other side.  How will we get there?  Of course, we will need our medical and scientific community to put the virus in its place.  And everyone will have a role to play.  But, the grit, sweat and determination of Labor will be a major force leading us out of the abyss.

  I have seen many alcoholics during my gastroenterology career.   It is likely in the majority of cases that I was not aware of their abuse history.   Patients often deny or minimize their alcohol history when queried.   “Do you use alcohol regularly?” “Only socially.” At this point the physician and the patient engage in a linguistic tete-a-tete on the precise meaning of ‘socially’. Patients are more forthright about their habits when they have a medical condition that has a clear an obvious connection to alcohol, such as jaundice or liver injury.   And, if family members are present, they often serve as fact checkers and truth tellers. What is my approach to these patients?    Do I wave my arms and preach like an evangelist that they should throw their bottles away?   Do I tell them that they must quit or face medical damnation?  Do I threaten to sever them from my practice if they persist with their addiction?   I have adopted a rather different approach.   I do not advis