MD Whistleblower

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Lowering Cardiac Risk by 30% - Not So Fast!

The raison d’etre of MDWhistleblower is to give readers a peek ‘behind the medical curtain’. This post is true to this mission. I offer readers a lesson that I have shared with patients, friends and family over the years. I suspect that elements of my point have been covered in prior posts. As I have penned over 800 posts since 2009, I hope readers will forgive me of an example or two of repetition. There is a frequent technique that I’m about to share that misleads patients about the value of various medical tests or treatments. While these communications to the public are technically true, they are misleading. Let me explain. If you saw a product or medical test from reputable organizations that promised to cut your risk of a heart attack by 30%, would you be interested? Odds are that you would be very interested. Who wouldn’t want their risk of a heart attack to be cut by nearly a third? Medicine is riddled with similar promises of benefit for various conditions

Disadvantages of Electronic Medical Records - My EMR Ghosted Me

A few days before writing this, I had an ‘epic’ experience upon my arrival to work. I had 17 procedures scheduled that day and the first few of these lucky folks were arriving. After changing into scrubs, I sat before my computer and was prepared to swipe into the electronic medical record (EMR) system with my ID card. On prior occasions, when I have successfully performed this swiping exercise during office visits, I have joked with the patient, ‘looks like they haven’t revoked my credentials!’ But not today. After 3 swipes I had struck out. No entry. And my password wasn’t accepted. Twelve hours ago, my credentials were solid and I was a physician in good standing. Now it seemed I had become a physician non grata. My morning welcome from my EMR system! What happened? Was I being terminated without notice? Were foreign hackers at work? Was I to expect a ransom ware demand shortly? We use the electronic medical record system called Epic. Our first call to

Inpatient vs Outpatient Care;: Can Doctors Do Both?

Five years ago, I left hospital wards and emergency rooms behind and entered a new & improved medical practice model, at least for me. Since then, I only see patients for office consultations and procedures. Office medicine is a very different trade than hospital practice each having very distinct skill sets. If I were to return to the hospital now to see patients, it would be uncomfortable for me (and them) having not used these skills for years. Similarly, hospital-based doctors might find transitioning to an office practice to be clumsy and uncomfortable. While it might seem that a gastroenterologist or any medical specialist should be able to see patients in any location, this is not the case for most of us. Hospital medical issues are quite different from office medical complaints. Physicians, as in so many other occupations, need repetition in order to maintain high competency levels. There’s a reason, for example, that airline pilots need to maintain specified fl

Is Cologuard as Good as Colonoscopy?

I am regularly solicited for my opinion on the stool test Cologuard, a colon cancer screening option. These queries generally come from folks who are angling to avoid the joy of the colonoscopy experience. It’s hard to fathom why someone would want to avoid the pleasure of a supersized laxative followed by a day of fun on colonoscopy day! Scientific investigators are working hard on colon cancer screening blood test options, but as I have pointed out , these are not quite ready for prime time. Finding alternatives to screening colonoscopy is a very high priority for the medical profession. There are two driving forces. Colonoscopy, while effective, is a laborious process which is a 2-day experience, requires a driver, frequent time away from work, is expensive and has risk. If a stool or a blood test could achieve the same level of protection, it would be a game changer. The economic rewards for launching an effective stool or a blood colon cancer screening test would be a

Labor Day 2024

Tomorrow is Labor Day, which became a federal law in 1894 after President Grover Cleveland signed a congressional act into law. Originally, the holiday only applied to federal workers. Over time, all US states, territories and the District of Columbia observe the holiday. Similar to other national holidays, such as Independence Day, Memorial Day and Christmas, the original meaning of Labor Day is only dimly recalled or celebrated. The following one-question quiz will test your knowledge. The quiz is quite challenging and I wish competitors good luck. Remember, although responses may appear reasonable, you are charged to choose the best answer. Which of the following best describes the meaning of Labor Day? (a) It's the last weekend on the beach marking the end of summer. (b) It's an opportunity to to show off backyard grilling techniques with hot dogs, chicken and ribs. (c) It's a time to honor workers in the 19th century, and those who followed, who fought for safer an

Is My Doctor Any Good?

As readers know, the unifying theme of this blog is medical quality. Indeed, the role of a whistleblower should be to raise the performance level of a profession or organization. One need only scan this blog's category list for evidence of the blog's purpose. Feel free to sample a post or two. The medical procedure that is fundamental to the practice of gastroenterology is colonoscopy. I have performed north of 50,000 of these procedures on some very lucky inhabitants of northeast Ohio. This will be my professional legacy, not quite a true gift to humanity such as music, art or literature. I’ve been in practice long enough that there are patients whom I’ve performed more than 10 colonoscopies on. Patients prefer to remain with a doctor whom they are comfortable with. Long term relationships with patients is one of the joys of medicine. I also routinely perform colonoscopies on patients whom I have not met previously. They are referred for the procedure by their pri