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Showing posts from April, 2026

Should I Fire My Doctor?

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. One of the gripes I hear from patients with some regularity is that they are not thrilled with their current physician.  How do I know this?  No, I’m not a mind reader.   I query every patient on our first meeting if they are pleased with their primary care professional (PCP).  Surprisingly, many offer lackluster or even negative commentary on their PCPs whom they have been seeing for years.  Why would patients who are unsatisfied not seek care elsewhere?  Puzzling! Typical complaints include waiting times in the office, rushed appointments, missed diagnoses, unreturned phone calls or portal messages, refusal to order diagnostic tests and tepid bedside ...

What's Causing my Abdominal Pain?

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. I see many patients referred to me after an emergency room (ER) visit for abdominal pain. ER medical professionals are generally very thorough in evaluating these patients.   These doctors see more patients with acute abdominal pain than gastroenterologists do, since patients with severe stomach pain often proceed to the ER as they are ill and understandably seek urgent attention.    In contrast, gastroenterology specialists see more chronic abdominal pain than do other medical specialists.   Many of t hese patients have had stomach distress for years and we gastroenterologists do our best to help them manage with their condition. Many patients who are evaluated in ...

Should my Gallbladder be Removed?

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. Why is the medical history – the patient’s narrative – so critical?  I have opined in this blog repeatedly that the medical history is paramount, much more valuable than the physical examination or the laboratory and other data.  Of course, there are instances when a finding on the exam or abnormal data cracks the case, but in general, the patient’s own story is most significant most of the time. Indeed, medical professionals, if we are not being careful, can permit abnormal data results to lead us to a trap door which will take us far away from where we should be.   Consider this to be a medical ‘wag the dog’ phenomenon.   Our focus should be squarely on the patient ...

My Approach to Second Opinions

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. I have numerous posts within this blog cautioning against pursuing second medical opinions.  This can be a tough argument to make as most patients  believe that obtaining additional medical advice is all upside. What could go wrong?  They argue that a second opinion either confirms the existing medical advice or provides new & improved recommendations.  It's not that simple. If readers enter second opinion in the search function of this blog, you will find several posts that point out potential pitfalls of seeking medical advice from new doctors.  It's not all upside. How do I regard my role when offering a second opinion? I generally regard my second opin...