MD Whistleblower

Quite regularly, I am asked to comment on the care of folks who are not my patients.  Often, these are friends or their relatives who are suffering gastrointestinal (GI) distress.  “Would you be able to give her a call”?  On other occasions, a member of my own family wants me to connect with someone who has a GI issue. This is tricky terrain and I navigate it very cautiously.   Obviously, I am not the individual’s doctor and would never assume this role.   The individual shares with me only his version of the facts which may not represent the totality of the medical situation. I don’t have the data and have not performed my own examination..   It would be highly irresponsible and unethical for a physician from afar, who has no professional attachment to the individual, to dispense medical advice or to sow doubts about the quality of the medical care rendered.   Indeed, a physician who crosses a line here can cause confusion and doubt which can have deleterious health effects. Physici

 From time to time, I arrange diagnostic testing to ease patients’ minds.  “Could you scope my esophagus?   My boss was just diagnosed with esophageal cancer.”   “I know I’m not due for my colonoscopy for another 2 years.   But I’d like to do it now just to be on the safe side.   My wife is worried.” “No, the abdominal pain hasn’t changed since I had a CAT scan for it months ago, but maybe I should have another scan now just in case something new developed?” When these requests are offered, I do not automatically acquiesce.   I try to understand better the genesis of the anxiety.   Is it rationale?   Is it emotional?   Is there a true medical indication to justify a diagnostic test?   I interpret requests for tests as invitations for dialogue.   Very often, the ensuing conversation can settle the issue entirely obviating the patient’s testing request.   These patients don’t really want a test; they want to be reassured.   Physicians use these skills every day.   I can’t count h