Freedom Is Not Free

I have enormous respect for the military who have suffered the highest costs of protecting the freedoms that we often take for granted. I have never served, but these men and women serve me and the rest of us every day.

The Whistleblower blog is not an anonymous samizdat, such as was present in the former USSR. I criticize the president openly under my own name. Those who challenge governments in other countries risk imprisonment or worse.

To those who protect our freedoms to write, speak, assemble, pray and criticize our leaders, please accept our collective endless gratitude, knowing that it will never be sufficient for what you have done and will do for us.

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Why Most Doctors Choose Employment

Increasingly, physicians today are employed and most of them willingly so. The advantages of this employment model, which I will highlight below, appeal to the current and emerging generations of physicians and medical professionals. In addition, the alternatives to direct employment are scarce, although they do exist. Private practice gastroenterology practices in Cleveland, for example, are increasingly rare sightings. Another practice model is gaining ground rapidly on the medical landscape. Private equity (PE) firms have been purchasing medical practices who are in need of capital and management oversight. PE can provide services efficiently as they may be serving multiple practices and have economies of scale. While these physicians technically have authority over all medical decisions, the PE partners can exert behavioral influences on physicians which can be ethically problematic. For example, if the PE folks reduce non-medical overhead, this may very directly affe

Why This Doctor Gave Up Telemedicine

During the pandemic, I engaged in telemedicine with my patients out of necessity. This platform was already destined to become part of the medical landscape even prior to the pandemic. COVID-19 accelerated the process. The appeal is obvious. Patients can have medical visits from their own homes without driving to the office, parking, checking in, finding their way to the office, biding time in the waiting room and then driving out afterwards. And patients could consult physicians from far distances, even across state lines. Most of the time invested in traditional office visits occurs before and after the actual visits. So much time wasted! Indeed, telemedicine has answered the prayers of time management enthusiasts. At first, I was also intoxicated treating patients via cyberspace, or telemedically, if I may invent a term. I could comfortably sink into my own couch in sweatpants as I guided patients through the heartbreak of hemorrhoids and the distress of diarrhea. Clear

Solutions for Medical Burnout

Over the past few months, I’ve written enough posts on Medical Burnout that I have created a new category to house them. Readers will find there posts detailing the causes and consequences of burnout in the medical profession. The profession has been long on the causes but short on solutions. What must be done to loosen the burnout shackles from medical professionals? It will be a huge undertaking for caregivers and society at large to turn this ocean liner around. And it will take time. The first step must be to obtain a commitment to the overall mission from as many constituents as possible. Support will be needed from medical professionals, hospital leadership and administrators, physician employers, insurance companies and the public. As with many reform efforts, many of the players must be willing to sacrifice some of their own interests in order to server the greater good – a worthy and rare event. Without adequate buy-in from stakeholders, the effort will never ge

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