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Showing posts from February, 2023

What Doctors Can Learn from Hotel Resort Fees

I recently booked a hotel in New York City where I hope to spend several delightful days this coming June.  During the booking process, the hotel’s representative read off a dizzyingly list of taxes and fees that I would be paying.  I don’t think I’ve ever been saddled with so many surcharges on any transaction in my entire life, except for the last time I booked a NYC hotel. I felt that I needed to call my accountant for guidance. Many hotels have become green with envy  (or should I say greed with envy?) over state and local taxing authorities who fleece hotel guests.  Why should hotels, who are highly trained fleecers, be left out? Fortunately for me, I won’t have a car.   Anyone familiar with NYC knows the insanity of bringing a car there.   Beyond the expense involved, and the seemingly impossibility of finding a parking space, there’s the sheer joy of taking a drive through midterm crawling through gridlock with horns bleating while receiving lovely gestures from fellow motoris

Hospital Discharge Planning - Is the Hospital Sending You Home Too Soon?

In 1990, Desert Storm was initiated by President George H.W. Bush, along with coalition partners to reverse Saddam Hussein’s aggression with respect to Kuwait.   As American and allied forces moved into Iraq, many hawks wanted these forces to advance to Baghdad, and drive out Saddam Hussein.   As we all know, President Bush pulled us out as he did not feel this objective was part of the mission.   He knew when to get out. Now, physicians are not military strategists, but there are parallels between military strategy and patient care, particularly when a patient is hospitalized.   Consider the following schema.   The Conflict:   A patient arrives in the emergency room with a cough and a fever.   The Mission: Disease eradication The Tactics:   Hospitalization Exit Strategy:   Getting the patient out. Physicians, just like the generals in the Situation Room in the White House, need a sound battle plan.   The plan must be flexible enough to adapt to changing contingencies an

Is My Doctor Too Old?

I am regularly asked by patients and others at what age should colonoscopies end.  Some patients inquire hoping that they are one year beyond the limit! Other physicians face similar inquiries with regard to Pap smears, mammograms and other routine preventive tests.   Turning the tables, I have even read opinion pieces asking if there should be a retirement age for physicians.   Commercial pilots have an upper age limit of age 65.   Should an octogenarian surgeon be allowed to operate on patients?   Federal judges have lifetime appointments.   Is the public well served by this?    There are at least two sides to this lifetime appointment policy. Some argue for aging out folks in order to rejuvenate the ranks.   This makes sense.   Others argue that any individual who is competent should be permitted to continue working regardless of age.   Why should we jettison folks with decades of valuable experience just because a certain age has been reached?   The issue becomes sticky whe

When Should I Get a Second Opinion?

Some time ago, I saw a woman who traveled across state lines to see me to receive yet another GI opinion. She had been having daily gastrointestinal symptoms for a decade despite an exhaustive and repeated series of tests arranged by multiple different gastroenterologists.  Her symptoms remained unexplained and I suspected that they were unexplainable. I have seen many patients like this who suffer from chronic abdominal pain, nausea, bloating, bowel issues and other digestive complaints who have been evaluated by prior competent gastrointestinal specialists.   It is terribly frustrating when there is no explanatory diagnosis to explain the misery.   Sometimes these patients ask, ‘Am I crazy’?   Of course, they are quite sane.   Many common digestive symptoms simply don’t light up on our diagnostic tests.   Bloating and nausea, for example, are unlikely to be explained by a scope exam or a CAT scan or other studies. So, what should these suffering individuals do? So, what did I t