Skip to main content


Showing posts from April, 2021

Was the J & J Vaccine Pause Necessary?

 I am not a public health expert.  But I have learned this past year that one need not have any public health knowledge in order issue advice and opinions.  How ‘bout some hydroxychloroquine with a bleach chaser? I trust our public health experts and have largely hewed to their advice, although I’m not sure that they have hit the bullseye every time.    As expected, they have modified their advice over time in response to new knowledge.   This is not a flip-flop – this is how science works. And millions of folks have completely rejected their advice for all kinds of reasons.   We’ve all seen photos of patrons who were piled into bars or kids on spring break who were recklessly partying on.   Masks optional. Others, in contrast, were pushing back on the Center for Disease Control and Prevention (CDC) arguing that the rules were not strict enough.   We’ve seen the teachers’ unions refuse to return to classrooms despite CDC guidance assuring that it was safe to do so, as long as pro

Is My New Doctor Qualified?

When one applies for a job or a position, it is expected that the interviewer will assess if the applicant has the necessary skill set and experience. Doesn’t this make sense?  Consider these examples. A clarinetist applies for a position in a symphony orchestra.   While many criteria will be assessed, he will surely need to audition to demonstrate his musicianship.   Would he ever be hired without playing a note? A college student wants to join the swim team.   The applicant can expect to show off her speed and technique as she cuts across the pool.   Would any coach accept a new swim team member without watching her swim? A journalist for a town paper applies for a job at a large metropolitan newspaper.   The interviewing editor will surely review the applicant’s prior work product to gauge his competence and suitability for the new position.   Would an editor bring on a new reporter without ever reviewing his writings? A college graduates applies to the State Department as a

Overutilization of Colonoscopy - An Unusual Suspect

A week or so before writing this post, a patient came to my office requesting a colonoscopy.   Nothing newsworthy so far.   An individual wanted a service that our practice routinely provides.   Yet, I was reluctant to accede to her seemingly reasonable request.    She wanted a screening examination of her colon in search of a benefit that humans have pursued for as long as humans have existed – peace of mind.   I have found that ordinary folks are often confused by the meaning of the term screening.   Screening exams can be performed on various organs of the body.   When a physician uses the term screening, it means that the patient is not having any symptoms whatsoever.   For example, if I advise a colonoscopy on a patient who is having rectal bleeding or diarrhea, this is considered a diagnostic exam, not a screening test.     "You're paying the bill?  I'll have the steak!" Why does this matter?   Insurance companies often reimburse screening and

Are We Ready for the Next Pandemic?

 While most of us prefer order and routine, life can turn course unexpectedly and randomly.  Of course, we all know this.  For many of us, our occupation, our choice of mates or where we live are the result of some chance occurrence, not the product of diligent planning.   Indeed, this reality adds some excitement and wonder into our existences.  Would we really want to live according to a prescribed routine like a train schedule?   For me, I am most satisfied when my days include my daily routine pleasures seasoned with some spontaneity.  I suspect that this is true for most of us.  However, we differ in the ratio of random/routine that we prefer.   Some of us plan a trip, for example, with each day carefully planned while others prefer to simply land in their destination and explore untethered to a guidebook or a rigid schedule. And no force can set order aside more forcefully than nature.   Here is the scene from our window earlier this week.   Does this look like a typical spring