MD Whistleblower

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. When a medical misadventure or new symptoms develop, physicians will often consider if the event is a side effect of a medication.  This can be very difficult to establish.  For example, if a patient is given medication to treat colitis and the diarrhea worsens, is this a side effect of the medicine or a worsening of the colitis?   Physicians face these dilemmas all the time.   If a patient develops a symptom, and a side effect is being considered as an explanation, the doctor either knows or researches if there is medical evidence supporting a side effect event in this specific circumstance.   If a patient develops headaches after a new medicine is prescrib...

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. I believe that health care is a human right.  This does not mean that every person must have precisely the same level of health care coverage.  This is not how our society works.  Wealthy individuals can afford higher-level medical care, just as they enjoy higher-level housing, vacations, legal and financial advice, education, automobiles, and clothing.  This list could be longer, of course.  But every American, in my view, is entitled to decent medical care to prevent and treat disease. We have millions of individuals in the country who are not citizens, many of whom have no medical insurance.  In a perfect world, I would like them to have access to medical c...

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. The medical profession in this country delivers excellent care in this country, although the quality is uneven.  Sadly and unfairly, the quality of medical care often depends upon one’s zip code.  Many Americans are underinsured and there are still many folks – including working people – who do not have medical insurance.   As I feel that health care is a right, employment should not be a prerequisite for insurance eligibility.  One should not be forced to remain at a job from fear of losing medical benefits. Racial disparities in medicine have been well documented.  And while medical professionals are plentiful in urban areas, residents who liv...

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. One of the gripes I hear from patients with some regularity is that they are not thrilled with their current physician.  How do I know this?  No, I’m not a mind reader.   I query every patient on our first meeting if they are pleased with their primary care professional (PCP).  Surprisingly, many offer lackluster or even negative commentary on their PCPs whom they have been seeing for years.  Why would patients who are unsatisfied not seek care elsewhere?  Puzzling! Typical complaints include waiting times in the office, rushed appointments, missed diagnoses, unreturned phone calls or portal messages, refusal to order diagnostic tests and tepid bedside ...

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. I see many patients referred to me after an emergency room (ER) visit for abdominal pain. ER medical professionals are generally very thorough in evaluating these patients.   These doctors see more patients with acute abdominal pain than gastroenterologists do, since patients with severe stomach pain often proceed to the ER as they are ill and understandably seek urgent attention.    In contrast, gastroenterology specialists see more chronic abdominal pain than do other medical specialists.   Many of t hese patients have had stomach distress for years and we gastroenterologists do our best to help them manage with their condition. Many patients who are evaluated in ...

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. Why is the medical history – the patient’s narrative – so critical?  I have opined in this blog repeatedly that the medical history is paramount, much more valuable than the physical examination or the laboratory and other data.  Of course, there are instances when a finding on the exam or abnormal data cracks the case, but in general, the patient’s own story is most significant most of the time. Indeed, medical professionals, if we are not being careful, can permit abnormal data results to lead us to a trap door which will take us far away from where we should be.   Consider this to be a medical ‘wag the dog’ phenomenon.   Our focus should be squarely on the patient ...