MD Whistleblower

 A few days before preparing this post, I greeted a patient who was about to undergo her 5 th colonoscopy.  I was the pilot for the 4 prior excursions.   “You should’ve signed up for the rewards program,” I quipped.  “This one would’ve been free!”  Our patients, with rare exceptions, enjoy our light atmosphere seasoned with some humor.  This does not detract from our seriousness of purpose and commitment to their welfare, and they know it.  Our endoscopy team is comprised of outstanding medical professionals. I care for many patients for whom I have performed all of their colonoscopies, which may exceed 10 procedures.   I recently performed an examination on one of my colitis patients who has unique findings which have remained stable for years.   I know his colon as well as I know his face!   Indeed, if I were shown a photo of his colon, I would immediately be able to name the individual.   So, when we gastroenterologists c...

Over the last decade, I’ve shared many vignettes about many gastroenterology medical conditions, diagnostic strategies and treatment options.  However, this is not a medical blog; it’s a medical commentary blog.  In other words, these posts are not a resource for readers who want understand how the pancreas works or how best to treat Crohn’s disease.  My angle would be more likely discussing why patient with Crohn’s might think twice before pursuing a second opinion.  I don’t present the diagnostic possibilities of abdominal pain that could serve as a primer for patients.  But I might point out why a CAT scan casually ordered on patient with stomach pain can tear open Pandora’s box. Pandora should have 'kept a lid on it!' So, in this spirit I’ve prepared a 3-question quiz for readers with the answers found at the foot of this post.   Regular Whistleblower readers will cut through all three of them like a buzz saw    Even t wo of correct answers ...

Many patients are aware of Cologuard as a colon cancer prevention option.  The appeal is obvious. One can submit a Cologuard stool test and forego the joys of colonoscopy.  Indeed, what motivates patients to select the easier option is not belief in the product but an opportunity to avoid a much less pleasant alternative.  This is analogous to how many of us vote in elections.  Rather than vote for a candidate we are often voting against another candidate.                                        Did you vote for or against a candidate? Cologuard is much more sophisticated and expensive than the conventional stool testing for occult blood which has been standard fare for decades.   Cologuard will also detect microscopic blood in the stool but will also pick up abnormal DNA which could indicate the presence of a large precancerous polyp or even a cancer.   Hen...

I am a casual viewer of professional football.  I have come to realize that sports for many who live in Cleveland is a religion.  Many of these religious zealots who have invested so much time and devotion to the Cleveland Browns have become apostates after what have been seasons of disappointment and failure.  Indeed, as of this writing I suspect that it is unlikely that the Browns will reach the Super Bowl this coming February 9 th , but one can always hope for divine intervention. But I am not writing to opine on the Browns’ performance.   For decades, I have been jarred by the violence of the game and the devastating injuries that routinely occur.   Indeed, one can expect players to be walked off or carted off the field in just about every game.   I treated a Cleveland Brown in his later years who had played for the team for 13 seasons in the 1950’s and 60’s.   I think every part of this body either hurt, didn’t work well or both.   He was a...

Readers of this blog are well aware of my frustrations and criticisms and even a soupcon of anger regarding the disappearance of customer service in our society.  This unfortunate reality is undeniable and is only going to worsen.  Corporations and businesses – with few exceptions – abuse their customers because they can, knowing that we have no recourse available.  Do you think the battle of Man vs Airline Industry, for example, which I fantasize over, will achieve a just outcome?  Two recent developments are relevant to this rant.   First, businesses are poised to start charging a fee to customers who are returning unwanted items.    And secondly, Amazon Prime will soon be showing commercials during their broadcasts.    Of course, for a surcharge, customers can still enjoy Amazon streaming without ads.   Let me distill this down using plain language.   We are going to further squeeze our already squeezed customers because we c...

Robert F. Kennedy, Jr. is Trump’s choice to lead the Department of Health and Human Services (HHS).   He will need to have his nomination confirmed by the Senate which I believe will occur.    He certainly fits in with Trump’s rather unconventional choices for various other cabinet leaders and government officials. To refer to RJK Jr. as controversial or eccentric are understatements.   We have all read about the worm in his brain, the dead bear that he deposited in Central Park in NYC and the whale head he attached to the top of his car on their way home, as related by his daughter. Is this a desired profile for HHS secretary who will be overseeing the NIH, CDC, FDA and Medicare and Medicaid?   If confirmed, he would yield enormous power to craft new health care policy in this country, particularly under a president who champions disruption. Kennedy is a known vaccine skeptic, has promoted unproven Covid-19 treatments, supports the consumption of raw milk, ...