MD Whistleblower

We are still recovering from the tragedies in Pittsburgh and Chicago.  Fires out west have roared over thousands of homes with more fatalities than have been yet accounted for.   Immigrants streaming toward our southern border in search of a better life are demonized and politicized.  Our nation's allies who have stood with us for a century are now reassessing their faith in our faithfulness.  Our free press, despite its lack of accountability and presence of bias, is under unfair attack.  Harvard's preferential admission policies have become exposed with other universities to follow.  Road rage had become the rage.  Facebook has exploited and deceived us. Truth has become an elastic concept.  Our political opponents are regarded as enemies.  I win if you fail.  The citizenry has deepened its disgust and cynicism.  An errant remark can lead to public vilification and loss of a job or reputation.  We have become an angry po...

Yesterday, a physician asked my opinion if a patient needed a colonoscopy.  My partner was already on the case and I was covering over the weekend.  The facts suggested that a colonoscopy was warranted.  The patient had a low blood count and had received blood transfusions.  Certainly, a bleeding site in the colon, such as a cancer, might be responsible.  We do colonoscopies to address similar circumstances on a regular basis.  Why did my partner and I demur in this case? We Placed this Sign on the Patient Because to us, our medical judgment trumped the medical facts.  First, the patient was elderly and extremely debilitated.  The challenge of having an individual in her state ingest the necessary laxatives is likely insurmountable.  If any readers have enjoyed the delight of guzzling down a colonoscopy prep, contemplate doing so as an elderly, ailing and bedbound individual. I asked the physician if the patient’s family wou...

I just read of a a jury award in excess of $25 million against an insurance company who denied a recommended cancer treatment to a patient who ultimately died.   I do not wish to review here the particulars of this case, and admit that my knowledge is limited by one news report that I read earlier today.   While I will not invoke the ubiquitous phrase FAKE NEWS, I always bring some measure of skepticism to various news sources, even those who enjoy excellent reputations.   The Olde Town Crier Always Told the Truth But this jury case raises an issue that physicians and patients wrestle with regularly. The physician prescribes a medication or recommends a treatment. The insurance company denies coverage for the recommendation. Sometimes, the reason for the denial is entirely reasonable.   For example, if an insurance policy restricts a patient to a network of physicians, the company will deny coverage if the patient wants to seek care o...

The lights went out in Pittsburgh 8 days ago.    The shade from this moral eclipse reached far beyond the Pennsylvania border and, indeed, extended throughout the nation and onto foreign lands.   I know Squirrel Hill well, having performed medical training in Pittsburgh a few decades ago.   I’ve been to the Tree of Life synagogue in the prior era when none of us were afraid to engage in the routine activities of life.   I am saddened and horrified to witness yet another momentary triumph of evil.   I wondered how it is possible that a person who was born pure could over time morph into a seething cauldron of hate, completely unmoored from the moral guideposts that keep us civilized.    The man who stormed the innocents, wounded by selfless law enforcement professionals, was taken to the hospital to receive medical care.   Yes, we cared for his health and his life, despite that he massacred others who were in synagogue to pray and to...

Here is a potpourri of medical vignettes.   All are real life scenarios that I have experienced in my practice.  The absurdities of life also permeate the medical profession.  An insider’s view of medicine, as in any profession or industry, may be less sanitized than its public face.  Here are some Scenes from Scopesville, Ohio. Act I, Scene I Patients are routinely told that they should not eat or drink on the day of their colonoscopy.   Recently, a patient decided that these instructions did not prevent him from eating a full breakfast.  This is where the phrase, ‘you prepped for nothing’, applies. A patient comes to see me on the advice of his primary care physician.  He has no idea why he has been sent.  Let the sleuthing begin! A patient asks for a work excuse for the entire week following his colonoscopy. I am asked to fill out disability papers for a patient I saw once a year ago. A patient complains to me and my staff a...

Health care costs in America are incinerating nearly 20% of the Gross National Product.    Can you say, non-sustainable?    Folks have been bloviating for decades about reforming the health care system with respect to quality, cost and access to care.   This is quite the quagmire.   If it were easily solved, then it would have been done during the Truman administration. He couldn't get it done.   Here are a few reasons why it has been so tough to crack this case. Cutting costs can threaten medical quality. I know of no player in the Medical Industrial Complex who is willing to sacrifice his own revenue to serve the greater good. Pharmaceutical companies receive federal research dollars but are not subject to reasonable governmental control on their opaque pricing schemes. The public expects every conceivable medical benefit, preferably for free. The fee-for-service model drives unnecessary medical care. Pharmacy Benefit Manager...

I prefer to do business with small, privately owned establishments rather than patronize the big box centers that have pushed smaller stores to the margins or off the grid.  Of course, I do spend money at the large centers for the same reasons that all of us do.  But, I miss the personal attention and interest that a single proprietor and the staff can provide.  South Orange, the small town, or actually village, where I was raised was full of these stores where we bought hardware items, sandwiches, clothing, medicine, shoes and ice cream cones.  I would periodically stop into the bank, with my passbook, to deposit my accumulated cash from my paltry weekly allowance. (As a third grader, I received 10 cents per week.)  When I would pop into to one of these places, the owners knew me and my family, not quite the experience in some retail stores today where one guard has to admit me into the store and another must scan my receipt before I can exit.  Villa...