MD Whistleblower

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 actions committed by PE justify sus

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 referred patients to other gastroenterologists

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

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

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

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

Each work day, I enter the chamber of horrors also known as the electronic medical record (EMR).  I’ve endured several versions of this torture over the years, monstrosities that were designed more to appeal to the needs of billers and coders than physicians. Make sense? I will admit that my current EMR, called Epic, is more physician-friendly than prior competitors, but it remains a formidable adversary.  And it’s not a fair fight.  You might be a great chess player, but odds are that you will not vanquish a computer adversary armed with artificial intelligence. I have a competitive advantage over many other physician contestants in the battle of Man vs Machine.   I can type well and can do so while maintaining eye contact with the patient.   You must think I am a magician or a savant.   While this may be true, the birth of my advanced digital skills started decades ago.   (As an aside, digital competence is essential for gastroenterologists.) During college, I worked as a secretary