MD Whistleblower

Usually, we doctors give you advice.   In this case, I’d like readers to offer an opinion on an issue that patients and I face regularly. First, let’s acknowledge the huge reservoir of frustration and anger directed against insurance companies concerning their coverage decisions.   I have willingly entered this arena to wage battles for patients.   Despite my vigorous prosecutions of these contests, the outcomes have been variable.   Indeed, these competitions are not for the causal physician combatant.   The doctor must have the mettle, determination, skill and endurance of a Navy SEAL if there is to be any prospect of success. Some of my prior duels against Big Pharma and Big Insurance are chronicled in the Pharmaceutical Quality category on this blog.   Considering many insurance company coverage actions and decisions, it is understandable that patients do not believe that these companies prioritize the health of their members.   Althou...

Let me test my readers to gauge how skillful you have become in choosing wisely in the Byzantine medical universe.  You develop abdominal pain and, although you are not a trained medical professional, you fear that you have appendicitis.  There are two surgeons available and you want to engage in due diligence to ascertain which physician should be granted access to your abdomen.   A quick internet search uncovers the following data. Surgeon A:  Twenty patients had proven appendicitis.  This surgeon operated on all of the patients.  No case of appendicitis was missed.  Surgeon B: Twenty patients had proven appendicitis.  This surgeon chose to operate on 18 patients.  Two cases of appendicitis were missed.   Before reading on, think to yourself which surgeon would you choose? While this is not a trick question, I wonder how many readers were entrapped to select Surgeon A.  Who wouldn’t choose a surgeon with...

Advertisers are masters at knowing how certain words and phrases will affect us.  Consider some of the seemingly innocent words and phrases below and how they have an emotional impact. IRS Big Tech Police officers Corporate profits Millennials Congress The Nursing Profession. Over time we have been conditioned to experience emotional responses to various phrases and labels.   For instance, there is nothing intrinsically evil in businesses earning money since this is an expected and desirable outcome.   Yet, ask us to react to the term corporate profits and I suspect that most of our reactions would trend negatively.   It’s unlikely that a political candidate would proclaim in an ad or a speech that he or she wants to be a Champion of Corporate Profits! Private Equity certainly merits inclusion in the above list.   Most folks have an unfavorable opinion of PE even if they don’t fully understand this business model.   And some of the action...

As a gastroenterologist (GI), I am regarded by primary care physicians and other medical professional as having special expertise in digestive diseases.  Indeed, I have highly specialized training in digestive maladies and function.  I regard myself as a GI generalist, that is a practitioner who treats the full array of digestive conditions.  Over the past decades, I have treated patients with diseases of the small and large bowel, stomach, and esophagus issues and pancreatic liver and gallbladder disorders.  And I have had a full endoscopy practice – the tools of the GI trade.  One of the appeals of being a GI Gen is that I see a wide and diverse span of medical conditions.  In a single week, I may address heartburn and ulcers. Crohn’s disease, hepatitis, bowel changes, internal bleeding, nausea and vomiting, abdominal pain, and hemorrhoids.  I enjoy the variety.   GI Generalists Cover a Lot of Ground! During most of my career, I seldom referre...