MD Whistleblower

I admit that I have a rudimentary knowledge of the business world, but I’m improving.  I now know, for example, that a C-suite does not refer to the procedure room where I do colonoscopies.  I am aware that executive coaching does not refer to advising top managers on their golf swing or tennis overhead.  I used to think that LLC stood for Long Live Colonoscopy, but now I know better.  CFO, Chief Flatulence Officer? While patients and physicians operate under oral agreements, business agreements are generally established in writing.  In these documents, terms are outlined including contingencies in the event that foreseeable obstacles or disputes develop.  Oftentimes, the two parties do not agree that a contractual term has been violated.  This is when the fun begins.   With a little luck, the legal profession enters the arena and can speedily resolve the disagreement in a matter of several years after impoverishing both sides. A co...

Many times over the years, I have witnessed the following scenario in my exam room.  Here’s the set up of this one act play. I’m seated at my desktop computer.  The patient is seated before me.  The patient’s daughter is seated next to her mother. Characters Elderly patient Attentive daughter The doctor Curtain's Up Scene I A patient comes to see me in the office with medical issues that strongly suggest that a colonoscopy should be performed.  As an aside, it is not my practice style to issue a colonoscopy edict, but rather to present the patient with available options, which should always include no testing as an alternative.  I may at that point strongly urge that the patient accept my colonoscopy recommendation, but at least the patient then knows the options with their respective advantages and drawbacks. [Reader aside: Examples of medical issues that lead most gastroenterologists and physicians to advise colonoscopy include: ...

                                                                                       Obamacare has promised to provide all of us with quality medical care that is affordable and accessible.  The very name of the law is the Affordable Care Act, which I have maintained will be short on both affordability and quality care.  Most of the country agrees with me.  The postponement for a year of the  corporate mandate to provide insurance in businesses with at least 50 full time employees was a great relief to these businesses and to Democrats ac...

I’ve never logged onto Angie’s List, but I might be on it.  Physicians are now routinely rated on various internet sites that the public can view before making appointments, or just as a parlor game.  You can look up doctors just as you would check ratings on toaster ovens, snow blowers, cars and restaurants. Are these sites truly useful? Can a grading site inform the public about a physician’s medical quality? Can a visitor to the site be confident that the view expressed is true and objective? I’m skeptical. Easier to rate a fridge than a doc I’ve thought deeply on the issue of medical quality since I was a medical intern in 1985.  Indeed, it was my preoccupation with this subject that led to the birth of this blog years ago.  Review the blog’s categories at the right of your screen and note how many labels include the term ‘quality’.   A recurrent theme here is how difficult it is to measure medical quality, even for medical in...