MD Whistleblower

It seems that there is an epidemic of obstructive sleep apnea (OSA) out there.  Snoring, a harbinger of OSA, seems to have captured the national attention, at least judging by the ubiquitous ads I am subjected to hourly on the radio.  Gastroenterologists routinely inquire about the presence of OSA in our patients as this may increase the risks of sedation and anesthesia.  Most patients with OSA are undiagnosed.  Many of them are not aware that the condition troubles them, but experts warn of potential long term consequences if the condition is not treated.  The diagnosis is classically made after an overnight sleep study when the patient is monitored.  I have equal confidence in the diagnostic skills of those who sleep in the same room as the individual at home.  For example, if a patient’s wife tells me that her husband regularly (and fortunately temporarily!) stops breathing during sleep, I think that the diagnosis has been securely made.  ...

Although I have confessed that I am not a seasoned expert in this field, here are some tips and pointers I’ve gleaned over the years. Slow and Steady Wins the Race! Avoid gimmicks.  We’ve all seen ads and telemarketing pitches that promise to melt off pounds by the hour.   These products are very effective for the companies, but not for you.  They don’t work.  Yes, you may enjoy some short term weight loss for as long (or short) as you can stay motivated, but the chance of keeping the weight off is vanishingly small.  You don’t have to be perfect.  Allow yourself some backsliding and seek continued motivation from these events.  The path to your successful destination may include some zigzagging. Weight loss medications don’t work well.  Of course, the notion of a pill solving any medical problem is seductive, but the history of weight loss medications includes an array of side effects and relatively modest results.  Ba...

Is there corruption in the medical profession?   Recall Captain Renault’s iconic rejoinder to Rick in Casablanca. “I’m shocked, shocked to find there is gambling going on in here!” In any enterprise with billions of dollars at stake, and when different players have competing interests which may not coincide with the public’s interests, there will be skullduggery.   How do you think our Defense Department and its relationships with vendors would look if we were able to shine a bright light on all its faces?   Do you think it’s possible that a weapons manufacturer might argue, through lobbyists and salesmen, that its weapons are essential to national security and superior to those of a competitor?    How about when a congressman argues for the continued purchase of military equipment manufactured in his district that military experts state is no longer needed?   And, there’s the quintessential and craven corruption of legislators refusing to clos...

A few weeks before writing this, two device salesmen came unannounced to our small private gastroenterology practice.  They were hawking a product that could quickly and non-invasively determine how much scar tissue had formed in a patient’s liver, a useful tool for assessing patients with hepatitis and many other liver conditions.  We are physicians, not entrepreneurs.  We do not regard the colonoscope as a capitalist tool.  Yet, these two salesmen were barraging us with facts and figures on how much money we could make off their product.  They knew the insurance reimbursement rates and could quickly calculate our practice’s return on investment depending upon our projected volume.  They recognized that the cost of their device would be beyond our reach and offered to sell us a ‘refurbished’ product at a huge discount. Liver Sales Reps Ignored the Liver! For a host of reasons, we were not interested in acquiring the device, which we could no...