MD Whistleblower

 Over the past few weeks, several patients I saw faced a common challenge.  This is a situation I have confronted in the past, but what was unique recently is that multiple patients in a short period of time were in the same situation. This was not a medical issue.   In fact, many of the individuals were feeling perfectly well.   This was not a financial issue, such as the patients were in the dreaded ‘doughnut’ or their particular medications were not covered by their insurance companies.   This was not a second opinion request from patients who suspected that their gastroenterologist (GI) of record may have missed something. Here’s what happened.   A gastroenterology practice that had been in the community for decades closed down.   Suddenly, tens of thousands of patients with an array of digestive maladies were let loose to find a new digestive nest to occupy.   I’m sure that every GI within 20 miles of my office has been affected.   M...

How many actions do we take in our lives simply because this is how we and others have always done them?    In these instances, shouldn’t we at least pose the question if there might be a superior alternative?    I admire innovators who view the world through a prism that aims to shake up and disrupt the status quo.   You know who I mean; the folks who hear the music in between the notes.   Medicine is riddled with practices that have remained in place for decades and are, therefore, hard to change.   Acute appendicitis is treated with surgery.   Why aren’t antibiotics an option here as they are for other similar infections in the large intestine? Diverticulitis has been treated for decades with antibiotics?   Only recently, have experts wondered if this treatment should be reexamined. For a generation, children with red eardrums received antibiotics presuming that this was a bacterial infection.    Ultimately, a skep...

Here follows a true vignette from a few years ago.  After giving a patient the pleasure of a colonoscopy, I left the hospital and headed for my office.  As there was 45 minutes until my first office patient was due to arrive, I stopped at a coffee shop for my default hot beverage - café mocha.  I strongly prefer independent coffee shops and routinely will take a long drive to reach one.  I approached the counter and discovered that my phone, always holstered in the inside pocket of my sport jacket, was AWOL.  For many folks, especially physicians, their smart phones are beyond essential.  It serves as my pager, my appointment calendar and my communication nexus.  It is a portal to the medical site that we doctors consult for difficult cases – Wikipedia!  It is my lifeline to my offices and the hospitals I serve.  Sure, my brain may still be functioning even when I am phoneless, but the phone  supplies the fuel and power to make it al...

One of the perennial patient gripes I confront is why on some occasions I refuse to refill a patient’s medication that I have previously prescribed.  Usually, but not always, when I offer my explanation for this roadblock, the patient understands why I advise a face-to-face meeting. Here is a sampling of patient feedback I’ve received over the years. Why do I need to come in?  I’ve been on the same prescription for years? Why should I have to pay a copay when all I need is a refill? I live 45 minutes away. The doctor doesn’t have an appointment for 2 months and I only have 4 pills left! I don’t drive anymore and I can’t get a ride. This doesn’t happen with any of my other doctors. Here’s how I see it.  Of course, I understand the sentiments expressed above from the patients’ perspective.  Certainly, when a patient I know whom I have been in regular contact with asks for a refill, I send it right through.  If, however, I feel that too much time ha...