MD Whistleblower

Even the most casual Whistleblower reader is aware of my hostility toward Obamacare, which appears destined for incremental implementation.  Ted Cruz’s paper mache weapons were no match for the Democrats' artillery brigade.   When the Chamber of Commerce, corporate America and organized labor are all on the same side of this issue, it suggests that healing this forerunner of socialized medicine will take more than a tweak or two to smooth it out.  Cruz Takes Aim There’s nothing unexpected or unfair here.  Romney campaigned hard against Obamacare.  The country had an opportunity to elect him, and declined to do so.   Did we expect that Obama would dismantle his signature legislative first term achievement in his second term?   When Romney lost, Obamacare won. The Affordable Care Act was legally enacted, albeit without a single Republican vote.  The Supreme Court determined that the law was constitutional.  Elections matter.  So, a flawed program, whose ultimate consequenc

I’m writing now in the wake of another tragic shooting here in the United States.  For most of us, we have never experienced the current pandemic of senseless violence that we read about and visualize every day.  I challenge you to find a newspaper tomorrow morning, or listen to a news broadcast, that will not report on dark and pernicious inclinations and accomplishments of evil practitioners.  If that challenge is not sufficient, then find an American over the age of 70 to attest that the world is better today than it was during his youth.   I listened to the every word that President Obama said at the ceremony honoring the fallen Navy Shipyard personnel.  He spoke well, and his reference to congressional inaction with regard to gun violence didn’t trouble me at all.   It was beyond shameful when craven congressman couldn’t pass any piece of legislation in the wake of the Newtown catastrophe.   This was a bipartisan failure that broke congress’s already abysmal performance l

Nearly every physician regards himself as an ethical practitioner.   Nearly none of us are, at least not fully.   There is no bright line that separates ethical from improper behavior.  Indeed, it is because the boundary is fuzzy that ethicists and the rest of us wrestle with contentious controversies.  It is, therefore, expected that ethicists are divided on many issues, much as the U.S. Supreme Court is often split in its decisions.  If the Court’s cases were easily decided, then most of its decisions would be unanimous. Finding the balance. While there are some bedrock ethical principles that should remain immutable, the field needs some breathing space to accommodate to societal changes and new research findings.  Analogously, the Constitution prohibits cruel and unusual punishment, but the definition of this evolves, so that today’s court may decide a punishment issue differently from its predecessors.  Similarly, it is possible that an issue deemed ethical today,

Outcomes matter.  One will forget a tortuous path if it leads to a sanguine outcome.  This is true in medicine and in life.  Look at the recent path of American foreign policy and where it has led us. Can You Choose the Right Path? The president announces that Assad has to go. The president lays down a red line for Syria with regard to chemical weapon use. The Syrians detonate a few chemical weapons, testers which we ignore. 100,000 Syrians are killed.  We ignore this as this is not a ‘ red line ’ violation. A death by sarin gas is more objectionable than a death by a grenade. There is a chemical weapon massacre in Syria which shocks the world. The president and the administration give daily public briefings on our intended limited military response. The administration assures that this "will not be a pinprick".  The Syrian regime watches CNN and FOX News so they can be apprised of the date and hour of our response. The Secretary of State makes a persuasive c

Some time ago, about 200 physicians met one evening for a conference. This is not newsworthy. Medical education is deeply engrained in our professional culture. Indeed, physicians are committed to lifelong learning and self-improvement. To stay current, we read several medical journals and professional communications, we attend lectures at our hospitals, we engage in on-line educational pursuits, we learn from colleagues and we travel to medical conferences. Conscientious physicians devote many hours to educational activities each week On this night, however, we were not learning about new treatments for heart disease or diabetes. We were not learning about emerging strategies to diagnose cancer at a curable stage. There was no talk about new techniques to reduce hospital infections or other preventable complications. We were not even learning about ‘soft’ subjects, such as medical ethics or doctor-patient communication issues. We were together at the strong urging of our medic

Though I have been accused by various commenters as protecting my own specialty when I point out excesses, flaws and conflicts of interest in the medical profession, this accusation would be handily dismantled after a fair reading of prior posts.  Indeed, my own specialty of gastroenterology and my own medical practice has felt the effects of the honed Whistleblower scalpel.   If an individual or an institution will not willingly engage in self-criticism, then it creates a credibility gap that may be impossible to bridge.  If you want a seat at the table, then arrive exposed and humble. My Preferred Instruments A study was published in the prestigious medical journal JAMA, the Journal of the American Medical Association in April 2013 publishing what we have known for decades: hospitals make more money when medical errors are committed.   As an aside, I have much more respect for JAMA than I do for the AMA , but I’ll resist the strong temptation to digress. Here’s how it