MD Whistleblower

This is the only Thanksgiving holiday in my memory that I was not on call for hospital work.   Physicians, like many other folks, are not automatically off on holidays and weekends.  I’m not complaining here, but there are times that I am envious of individuals who are home on every weekend and holiday.  Americans need health care, law enforcement, and various emergency services even on days of national leisure.  When I am driving to the hospital on one of those days, I remind myself that the sick person I am headed to see has a much worse deal than I have. I have been bestowed with many blessings, and I am grateful for all of them.  Some of them, I may have earned, while others just fell my way.   Similarly, life’s travails can result from a bad decision or just bad luck.  Life isn’t fair. Spread Sunlight I admire folks who always spy a rainbow through a storm, and I want to be like them. Appreciating one’s lot in life, e...

We’ve all heard or used the phrase, ‘leave it to the professionals’.  It certainly applies to me as the only tools that I can use with competence are the scopes that I pass through either end of the digestive tunnel.  Yeah, I have a ‘toolbox’ at home, but it is stocked similar to the first-aid kit in your new car, which contains a few BandAids, adhesive tape and, hopefully, the phone number of local doctor.  My home tool box has an item that can practically fix anything – the phone number of a local handyman. Nothing for Hemorrhoids Here.      Photo credit It is essential to know one’s limitations, regardless of one’s profession.  Politicians shouldn’t speak authoritatively as if they are climatologists. Gastroenterologists should not prescribe chemotherapy, even though we are permitted to do so. Bloviating blowhards on cable news shows are likely not military experts. The guy who fixed your toilet might not be a top flight kitchen ...

A few days before I wrote this, a patient had a complication in my office.  I have discussed on this blog the distinction between a complication , which is a blameless event, and a negligent act.  In my experience, most lawsuits are initiated against complications or adverse medical outcomes, neither of which are the result of medical negligence.   This is the basis for my strong belief that the current medical malpractice system is unfair.  It ensnares the innocent much more often that it targets the negligent. I performed a scope examination through one of the two orifices that gastroenterologists routinely probe.  In this instance, the scope was destined to travel inside a patient’s esophagus on route to her stomach and into the first portion of the small intestine.  Sedation was expertly administered by our nurse anesthetist (CRNA).   The procedure was quickly and successfully performed.  The patient’s breathing became very impa...

The Ebola hysteria continues.  True, we might have a greater chance of being struck twice by lightning, but the press would have us think we need to purchase Hazmat suits for our families just to be prepared.  I’m surprised that an entrepreneur hasn’t at least constructed prototypes for Hazmat suies for newborns, popular dog breeds, pet rodents and heirloom tomatoes. Tomatoes? Yes, tomatoes.   I have not heard any authoritative official from either the NIH, the CDC the WHO or Medicins Sans Frontieres (Doctors Without Borders) who have stated unequivocally that you cannot contract Ebola from an heirloom tomato.  To me, the hypothesis is entirely plausible as the sneaky virus  can hide in the heirloom’s surface crevices just waiting and hoping to gain access into an unsuspecting mucous membrane.  Smooth Skin Tomatoes Probably Safe As of this writing, there are 159 contacts in Ohio who have had contact with an Ebola infected nurse who f...

Who says that bipartisanship is dead?  Just recently, Governors Cuomo and Christie – a Democrat and a Republican – were shoulder to shoulder as they announced a new and improved Ebola policy to protect their voters,  I mean citizens.  Now, every individual who was arriving at Newark and Kennedy International Airports from Liberia, Guinea and Sierra Leone who had direct contact with an Ebola patient, would face a mandatory 21 day quarantine.  This policy exceeds restrictions advocated by the Center for Disease Control and Doctors Without Borders, two organizations who presumably are better qualified in infection control than politicians are. Might this policy discourage our health experts from traveling to West Africa to help to control the Ebola epidemic as they would face a 3 week quarantine upon their return home? Might some folks who are returning home who don’t agree with this new policy lie about their Ebola contacts? What if travelers returning...

While I haven’t devoted significant space on this blog to the news media, it is not because I do not have strong opinions on the current state of journalism.  Indeed, I could write an entire blog on the subject, and many have. News acquisition and analysis have always been important facets of my adult life.  I spend many hours every week reading various newspapers and other materials to gain new perspectives on the issues of the day.  Nearly every morning, I send items of interest to a close circle of friends and family.  I read news and opinion, although sometimes it’s hard to tell one from the other.  I am always drawn to opinions that differ from my own. While there is excellent journalism today, the profession is deeply flawed by a blow-dried approach that appeals to our tabloid lust and their desire for increased ratings.  Just because it’s above the fold on Page 1, doesn’t mean it truly deserves this prime real estate.  Pick up your own ...

One catch phrase in health care reform is cost-effectiveness.  To paraphrase, this label means that a medical treatment is worth the price.  For example, influenza vaccine, or ‘flu shot’, is effective in reducing the risk of influenza infection.  If the price of each vaccine were $1,000, it would still be medically effective, but it would no longer be cost-effective considering that over 100 million Americans need the vaccine.  Society could not bear this cost as it would drain too many resources from other worthy health endeavors.  Economists argue as to which price point determines cost-effectiveness for specific medical treatments.  As you might expect, insurance companies and pharmaceutical companies might reach different conclusions when the each perform a cost-benefit analysis.  Remember, it’s not just cost we’re focusing on here, but also effectiveness.  If a medicine is dirt cheap, but it doesn’t work, it’s not cost-effective.  G...