MD Whistleblower

While medical careers at all levels are suffering from burnout, this post will focus on nurses, particularly those who work in hospitals.  Ask any of these nurses about the burnout phenomenon and make sure you have an hour or two available to hear a sober soliloquy on the subject. What brought this plague upon them?  Is there an antidote? For nearly my entire career, I rounded daily at local hospitals attending to my patients.  I worked very closely with hospital nursing staff for nearly 3 decades.  They are selfless professionals who give their patients and their colleagues all they have.  Indeed, the public tends to trust them more than they do doctors, and I understand why.  Nurses always have their patients’ backs, but who has theirs?  Are they overworked?  Yes.  Are they underpaid?  Yes.  Do they feel appreciated by their employers?  Take a guess.  The Covid-19 pandemic has introduced a new crisis in hospital nursing ...

Physicians have great responsibility to protect the health of their patients.   But the practice of medicine is a shared responsibility.   Patients – the major stakeholders – obviously have responsibility for their own health.   In my view, they are charged with questioning and understanding the rationale of proposed medical advice.   I do my best to explain my advice clearly.   If there are reasonable alternatives, then I present them.   But if the patient before me remains unclear on the situation, then he needs to ask me to repeat and clarify.    Patients must exercise personal responsibility. If a surgeon enters an exam room and tells you that surgery is scheduled for the following morning, I would hope that you would be fully informed on what operation is planned and why it is necessary.   It sounds absurd that a patient would consent to an unspecified surgery.   "Ready for pot luck surgery tomorrow?" And yet, I reg...

A federal judge in Texas recently issued a ruling that would ban mifepristone by nullifying the Food and Drug Administration’s original approval of this medicine, which occurred 23 years ago. Mifepristone is one of two drugs that are used for medical abortions.  If this decision is ultimately upheld, it would ban this FDA approved drug throughout the country. Ironically, on the very same day, another federal judge in Washington state issued a contradictory ruling that would protect mifepristone’s status as an approved medicine.  An appellate court ruled a few days later that mifepristone's approved status remained valid, although prior restrictions on its use would be resumed.  This past Friday, the Supreme Court gave mifepristone a 5 day reprieve giving time for both sides to submit briefs days from now.   Will the Supreme Court deliver peace in the valley?   Not at all.   We have all painfully learned since the Roe v Wade decision of 1973 that a ...

I have been a conservative medical practitioner since my training days decades ago.  As readers of this blog have read (?endured) repeatedly, I am very hostile to over-diagnosis and overtreatment.  While I don’t have data, my strong sense is that I order fewer scans, offer fewer prescriptions and order fewer lab studies than my peers.  I am not suggesting that my approach is the optimal pathway to medical quality, only that it has always defined my medical comfort zone.  My philosophy can be summarized as less is more . Patients have their own medical philosophies and over time tend to link up with medical professionals who share their approach.  Some patients laud physicians who test them liberally regarding these doctors to be very thorough and conscientious.  “My doctor is so thorough, on my first visit he ordered blood work, a CAT scan and is sending me to 2 specialists!”  Patients who prefer a more measured and conservative approach seek likemi...

There is an epidemic of burnout in this country.  Many professions are targeted.  Ask a teacher, a police officer, a politician or even your mailman about the increasing burdens that have been foisted upon them, and be prepared to hear frustrating and demoralizing responses.  The burnout malady has hit the medical profession hard and is reaching down the age ladder toward younger medical professionals. While my generation didn’t create burnout by intention, it does seem that we have permitted and even facilitated its proliferation.   Why have we done this?   What are the consequences?   How can we push back? Using a medical analogy, it’s often much easier to diagnosis an affliction than it is to treat it.   For instance, physicians routinely and reliably diagnose degenerative arthritis, but we can’t cure it and often our treatments are inadequate.   So, it is with burnout, particularly once it has become firmly established in our occupational ...