Whistleblower Wishes All a Happy Fourth of July 2017

How's our sacred Honor doing?

"And for the support of this Declaration,

with a firm reliance on the protection of Divine Providence,

we mutually pledge to each other our Lives, our Fortunes,

and our sacred Honor."

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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

Do Doctors Talk to Each Other?

I will share with readers a recent occurrence between me and another doctor that was both rare and refreshing. I was serving as the gastrointestinal consultant on one of the doctor’s patients. I performed a scope examination of the stomach and obtained some routine biopsy specimens. The pathology results were abnormal, but benign. No urgent action was needed, but a full airing of the significance of the results would require a conversation between me and the patient in an office visit. I notified the patient that there was no medical threat at all and we would unpack it all during his next visit. The referring physician wondered about this delay, which perhaps is a different style from other gastroenterologists (GI’s) who he works with. (My guess is that other GI’s may opt to handle the issue with the patient on the phone or via the portal. I think, however, that there’s too much complexity to fully address this issue in this manner.) So, here’s what the referring doctor did.

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