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Showing posts from January, 2024

What do Medical Consultants Do?

I am a gastroenterologist.  Like most medical specialists, most of the patients I see are referred to me by other medical professionals.  In this role, I am serving as a consultant.  Similarly, when a specialist is asked to see a hospitalized patient by the attending physician, the requested doctor will be serving in a consultant role. Consultants are recruited when the medical team or an individual practitioner feels that additional knowledge and experience is necessary.   Consider three hypothetical scenarios. A patient has not responded to a standard course of antibiotics.   The attending physician asks an infectious disease physician to make recommendations. A primary care physician is uncertain if the abnormal chest x-ray is heart failure or pneumonia.   The doctor calls in a cardiologist to assist. A patient with colitis comes to an emergency room with worsening diarrhea after starting a new medicine.   The ER physician is uncertain if the patient’s diarrhea is a side-eff

Medical Marijauna Avoids FDA Scrutiny

Many of my patients are using medical or recreational marijuana to ease symptoms that do not respond well to conventional medical treatments. I understand this.  I have already opined on this blog that I believe that the medical evidence supporting the safety and efficacy of medical marijuana is rather thin, very different from the strict standards that the Food and Drug Administration (FDA) relies upon in assessing prescription drugs and medical devices.  Moreover, here in Ohio and elsewhere, our legislature is deeply involved in determining which medical conditions are eligible for medical marijuana treatment, a role that I believe should be handled exclusively by medical professionals and appropriate federal government agencies, such as the FDA.  Politicians should leave this to the professionals. How can you argue otherwise? I am employed by Cleveland’s largest health care organization which has national and international reach.   The organization will not permit any caregiver t

Demonizing Big Pharma - Good Politics but Bad Policy

When I was training to become a gastroenterologist decades ago, the heartburn drug Prilosec (omeprazole) was released in the United States.  I prescribed it then to patients who had been suffering from heartburn for most of their lives.  After just days of treatment, their heartburn disappeared.  These folks couldn’t even remember what it felt like to live without heartburn.  And suddenly, they were cured with one small pill daily.  Now I know that heartburn is not exactly cancer, but this experience very early in my career showed me the potential for a pharmaceutical agent to improve lives.   I still relay this vignette to patients. Pharma is not the enemy. Think of all of the institutions and professions that we and our politicians demonize -   lawyers, oil companies, congress, corporate America, Big Tech and the pharmaceutical industry.   Recently, Ivy League universities have been promoted to a top ten ranking on this coveted list.   On a granular level, even individuals routin

The Risks of Artificial Intelligence

One thing we have all learned about technology is that it cannot be restrained.  With the release of ChatGPT and various competitors, we are aware that an unfathomable technology will disrupt our lives in ways beyond our imagination.  In the coming years 2 nd and 3 rd generation AI will replace its forerunners. My guess is that this technology will dwarf the impact that the internet has had on all of us.  It will be able to create and cure and innovate and communicate and build and teach and protect and even drive your car.   As mentioned, future AI functions and capabilities are beyond the horizon and are out of view. Exciting?   What if your job would be an AI casualty?    It you drive a vehicle for a living, how will you and your family adapt when human drivers are no longer necessary?   Even jobs and occupations that we might believe are beyond AI’s grasp, may be in the crosshairs.   AI’s reach will be boundless.   It’s tentacles will reach through blue collar America and wil