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Do Doctors Wash Their Hands Properly?

There is no person unaffected by the coronavirus pandemic.   It does seem that the public and the government are responding belatedly in a manner commensurate with the threat.   I write this knowing that less than a week ago from the time I am composing this, Florida beaches were teeming with vacationers.   A memorable quote from one of these selfless and enlightened partiers was: “If I get corona, I get corona. At the end of the day, I’m not gonna let it stop me from partying.” This individual, from my own state of Ohio, did apologize for his remarks.   I would suggest that his mouth be mandated to take a 14 day quarantine from all speech.   Look, we’ve all said dumb stuff.   I know I have.   My advice?   If you sense some dumb words about to erupt, and there are cameras rolling, sprint in the opposite direction as if the coronavirus is on your tail and gaining ground. Right now, Ohio and many other states are in a ‘shelte...

Coronavirus or Coronoverse?

A worker was told of corona. Who's boss said, "You're on your own-a." "Leave the arena" "Begone! Quarantina!" "You mean I'm gonna be all alone-a?" Coronavirus - An Invisible Foe We will get to the other side.   Clearly, the path to a safe and secure future has not been a straight shot.  Both the government and the public have fallen short. The initial coronavirus testing launched here was a debacle, in contrast to other countries that knew how to aim straight.  We have seen price gouging for hand sanitizer and face masks.  As recently as this past Thursday, Florida beaches were teaming with folks who brazenly and selfishly risked contracting the virus and transmitting it to others. But, most of us have fallen into line.  And, so have our leaders. I feel more sanguine that we will prevail in the medical arena than we will on the economic front. Epidemics and pandemics will join the array of natural disasters ...

Doctor-Patient Relationship Needs John Adams

In 1770, in Boston, British soldiers fired into a crowd of colonists who were taunting the soldiers.  Several colonists died and several soldiers were arrested and charged with murder.  This event known as the Boston Massacre was a seminal historical episode that contributed to the colonists’ growing desire to separate from the British Crown. Boston was a cauldron of the independence movement.   Hatred against the British was prevalent.  Who would be willing to defend the accused soldiers at trial risking opprobrium or worse?  John Adams, our future second president, defended the soldiers believing that every accused deserves adequate representation.  To this day, America distinguishes itself with our belief and practice that an accused man is presumed innocent and is entitled to a competent legal defense.  As we all know, lawyers are often assigned or volunteer to defend unsavory individuals to protect their clients’ constitutional rights, e...

Has Coronavirus Infected our Politics?

Have you heard enough about Coronavirus yet?    If not, feel free to tune in to the Coronavirus News Network, also known as CNN. I have zero medical experience in virology and public health, so read no further if you are looking for a Whistleblower travel advisory or if it’s safe to pet Scruffy if he develops a fever. I’m also not here to gripe about our nation’s response to this incipient pandemic.     Although we have a first class team in place now, even they admit that they stumbled initially.  I'm more interested in making progress than in racking up debate points. My observation is that there is no issue or event that is immune to politicization, a reality that depresses me.   We all agree that prior to the virus’s emergence from China, we were already rabidly hyper-polarized and hyper-partisan in the zero sum game that now defines our political landscape.   I won’t add to this sentence so as not to waste readers’ time in reading wh...

Can Sherlock Holmes Teach Today's Doctors?

To Sherlock Holmes, she is always the woman.    Thus begins Conan Doyle’s, A Scandal in Bohemia published in 1891.   In this gripping tale, Holmes is bested by a woman who proves to be the detective’s equal in intelligence and deception.   For reasons I cannot explain, I restrict my exposure to Holmes and Dr. Watson to podcast listening when I am airborne.  Years ago, I did love watching the classic movies starring Basil Rathbone and Nigel Bruce who defined the roles for me.  Conan Doyle, a physician, was a superb story teller, who wove his tales with texture, plot and humanity.  I think he wields words with surgical precision.   I admire his skill. I wonder to what extent Conan Doyle’s medical training influenced his writing?  Certainly, the stories often discuss arcane medical conditions that provide the detective with important clues.  In The Adventure of the Blanched Soldier, Holmes suspects that the prota...

Can Doctors Help You Lose Weight?

As a gastroenterologist -a trained specialist in digestive issues - I should have expertise in obesity, nutrition and weight loss strategies.  I really don’t.  While I have knowledge on these issues that likely exceeds that of most of my patients, I received inadequate formal training on these subjects during my gastroenterology training.   It is inarguable that digestive doctors – and indeed all physicians – should bring a high level of expertise on these medical issues into their exam rooms.  The impact of obesity reaches nearly every medical specialty.   Obesity is linked to heart disease, stroke, cancer, arthritis, diabetes, sleep apnea, high blood pressure and many other illnesses.  Most of my overweight patients tend to remain so.  Many of them are simply resigned to a shape and size that they feel they cannot alter.   Some are not motivated to engage in the hard work and long journey that can lead to a leaner dimension....

The White Coat Wall of Silence

We’ve all heard about the blue wall of silence that describes a belief that law enforcement personnel will refrain from reporting misconduct of their colleagues to the proper authorities.  Physicians had similarly been accused of hiding behind a white coat wall of silence , as I have on this blog.   This describes the belief that physicians do not reliably turn in colleagues who are incompetent and impaired.  Personally, I have never knowingly participated in the care of a patient with an impaired colleague.   Competency is a murkier issue and is, of course, variable in the medical profession.  In addition, it’s not easy to define or to measure.  It is this very fact that has made me so hostile to the Pay-for-Performance schemes that claims to be a quality metric, but is truly used as a cost cutting tool. 'I Know Nothing' I am aware of physicians in my community who do not have a strong reputation of medical skill.  Yet, many of t...