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Showing posts from January, 2016

Can Physicians Take Vacation?

Years ago, I was having dinner with 2 members of The Cleveland Orchestra, one of the finest orchestras in the world.  I asked them, with my kids present, how much time they devoted to their craft.  As many parents know, getting kids to commit to practicing a musical instrument is about as easy as splitting the atom.  The musicians told us how much time they practiced, which was mind boggling.  Any artist or athlete or Green Beret or similar professional, has to demonstrate extraordinary commitment to maintain a superlative level of excellence and preparedness. every day. I asked one of the musicians, the violinist, how long he could stay away from playing his instrument before he noted some professional slippage.  Guess your answer.   At the end of this post, I will relate his reply. How long can you be away from your job before your performance ebbs? For most of us, we can take weeks or longer on holiday and return back to our positions seamlessly.  A few examples.

Free WiFi in the Doctor's Office?

I am always always been irked when a hotel charges me for Wi-Fi use. This pick-pocketing is resented by hotel guests across the fruited plain.   This money grab is taken right out of the airlines’ playbook, who now charge us for carry-on bags, an aisle seat, a candy bar, a working flotation device ‘in the unlikely event of a water landing’ or a functioning oxygen mask.   Need to change your reservation?  Easily done for $150.  On what basis can this fee be deemed reasonable?  It constitutes consumer abuse of the first order.  Although airline profits are soaring, and fuel costs have tanked, there has been no trickle-down effect to travelers, who are left with little recourse except to pen cranky blog posts.  Airlines Heading Back to No Frills Hotels know that Wi-Fi is like oxygen.  Since we can’t live without it, why not extort a few dollars for it.  A paradox in this exploitative practice is that cheap hotels give their guests free Wi-Fi, while top tier hotels might charge $1

Should Patients Consult Dr. Google?

You see your gastroenterologist with long standing stomach pain.  You have undergone a reasonable evaluation and all the endoscopic bodily invasions and imaging studies of your abdomen have been normal.  Repeated lab work provides no clue explaining your distress.   You have been twice to the emergency room and were sent home with  prescriptions that didn’t work.  You are frustrated and so is your gastro guy.  You are convinced that there is a diagnosis that has been missed and you have the Google search to prove it. Every physician has had patients who come into the office with reams of paper from an internet search.  Usually, this approach uses a net that is just slightly over-sized for the task at hand.  It would be like using a butterfly net to catch a paramecium. Paramecia - Use a Small Net to Catch these Critters! Plug a few symptoms into a search engine, and then be prepared to take a year or so to review the results.  Pick a symptom, any symptom. Whistleblow

Why My Patient Left the Office

A patient came to the office and refused to see me, although I was quite willing to see him.  I’ll present the scenario followed by the patient’s reason he took an abrupt U-turn.   Then, if you are inclined, you may offer your own advice and comment. I performed a colonoscopy on this patient and found a large polyp in the upper part of the large intestine, or colon.  The upper part of the colon, or right side of the colon, has been receiving a lot of press in gastroenterology in recent years.  Medical studies have observed that cancers in this region are more easily missed for reasons that don’t need to be explained here.  For this reason, gastroenterologists are particularly vigilant when examining this region. The polyp was large and somewhat hidden behind a fold of tissue.  I suspected that this was a benign lesion.  I removed the polyp using one of the gadgets in our bag of tricks, but knew at the time that I had left some polyp tissue behind.  I was unable to remove the e

Whistleblower Looks Ahead to 2016

At the end of every year, the airwaves compete for our attention on programming that ‘looks back’ at the past year.  People we’ve lost in 2015. The 10 biggest news stories of 2015. The greatest gaffes of the past year. Stories that made us cry in 2015. Year-end magazine issues follow the same playbook. Whistleblower doesn’t look back.   Whistleblower Eschews Rear-view Mirror I suppose there is a public appetite for retrospectovision since, as we all know, the media’s mission is to serve up what we demand.  The newspaper adage, ‘if it bleeds, it leads’, is more a comment on us than it is on the journalism profession.  We are vampires who look to media for our next blood meal. Looking ahead is tougher since it’s quite a bit easier to chronicle known facts than it is to predict and guess.  But, isn’t this a more worthy task?  How do these story proposals grab you? People we’ll lose in 2016.  (Not serious, just want to assure you’re paying attention.)