MD Whistleblower

Posts

Does Informed Consent Really Matter?

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 doctrine of informed consent is a bedrock medical ethical principle. Physicians’ obligation is to present the patient with reasonable diagnostic or therapeutic options with the respective risks and benefits. Decision-making authority resides with the patient. While this process sounds straightforward, it can be a bewildering process for patients and their families. For starters, physicians – as members of the human species - have opinions on the available medical options. These opinions may be on the basis of medical evidence or professional experience. Is it possible that a surgeon might prioritize an operative approach by virtue of training and ...

Can Anyone Perform an Appendectomy?

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. In the olden days, purchased products were accompanied by instruction manuals. I realize that this anachronistic item will be unknown to today’s technophiles who direct Alexa to turn up the heat or play Sinatra songs during dinner. Permit me, as a courtesy to them, to offer a working definition. Instruction Manual: A printed document that explains how to operate and maintain the new item. I realize this sounds quaint to the Gen XYZ crowd, but we antiquarians relied upon these instructions regularly. Yes, there was overkill. We likely didn’t need to be advised that to make toast, we should simply slide a slice of bread into either of the two designa...

Are Patient Autonomy and Shared Decision Making Overrated?

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. In the olden days, physicians practiced in a paternalistic fashion, simply informing patients of the next steps to be taken. This anachronistic practice falls well beyond today’s professional boundaries, although several decades ago, this was the norm. And the public did not object. They came to their doctors for advice and, in general, they accepted the recommendations that were offered. Both sides of the relationship believed that the system was functioning well. There was no preoccupation with autonomy or with shared decision making, the process whereby physicians and patients today collaborate as they tease through various options. While I conform t...

How to Avoid Medication Side Effects and Adverse Reactions

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...

Treating the Medically Uninsured

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 of advantages could be longer, of course. But every American, in my view, is entitled to decent medical care. We also 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 care, along with all other members ...

Why Isn't My Medication Covered by Insurance?

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...