MD Whistleblower

Remember the MCAT (Medical College Admission Test)?  This is the examination that determines if pre-med students will become actual physicians. This is an extensive examination covering an expansive amount of information that is not clearly related to the practice of medicine.   It reminds me of the government and insurance industry’s emerging quality initiatives.   Like the MCATs, these programs measure what is easy to count; but what really counts, can’t be easily measured.  If I were asked to submit MCAT questions, as a practicing physician, I would bring a real world flavor to the examination.  Whistleblower MCAT 2.0 Sample Questions! Test Your Knowledge! Amaze Your Friends! Let the Games Begin! Medical Knowledge Section You are in the hospital recovering from ankle surgery after a fracture. After pain medication is prescribed, you develop some constipation and abdominal discomfort. The orthopedist’s physician assistant orders a CAT ...

Several months ago on this blog, I informed readers that I was a defendant in a medical malpractice case. I offered no specifics, as I didn’t want my attorney to fire me as a client, in case he discovered the post. Although the plaintiff was granted two 45 day extensions to troll for an Ohio physician to sign an affidavit of merit against my care, none could be found. My lawyer had reviewed every syllable of the medical record, and couldn’t divine an allegation against me. My lawyer and I were groping guests in a Chamber of the Absurd - trying to figure out what allegations the other side might concoct. After a few months, I was dropped from this case that should have never been filed in the first place. Years ago, as a younger and more idealistic gastroenterologist, I was kept dangling on a lawsuit for a few years. I endured the light hearted amusement of the discovery process, including expert witnesses outside of my specialty who claimed in their written reports that my ...

Because they can. Why am I dissing my dental colleagues? Because I can. Perhaps, this is a simple case of Dental Envy, since their profession remains within secure borders far beyond the health care reform line of fire. Consider these dental incidentals: • Not a syllable in the ~2000 page health care reform law that affects dentists. Every filling is still worth its weight in gold. • Dentists recover every dime they bill. If their fee is a gazillion dollars, and your generous dental insurance, covers fifty bucks, guess what? There will be a very large cavity in your bank account. • No middle of the night runs to the emergency room, a drill that we physicians endure • No hospital work, which for many physicians has become an inefficient hassle which became the root of a new medical specialty • Dentists don’t need an attorney on retainer , or caps on non-economic damages, as their malpractice situation is calm. • We still call them, ‘doctor’. Dentists prescribe...

Professional sports has never been a dominant personal interest, although I admit that I become more engaged if my town’s teams reach the post season. Here in Cleveland, folks assign a priority level to sports that is just a notch below breathing. I do make it a point to know enough of what is happening within the various stadiums and arenas so that I am not ostracized or placed in a stockade in the public square to serve as a deterrent. If the Cleveland Cavaliers do not emerge as national champions this year, then northeast Ohio will sink into the Sea of Melancholy There is an aspect of professional sports that I greatly admire. This transcends the athleticism and skill of the athletes, the work ethic, coaching expertise, teamwork and the thrill of the game. This is one of the only institutions that is a pure meritocracy. The philosophy is simple and not blurred by arguments for diversity or massaging the qualifications for admission to serve another agenda. Coaches, managers and ow...

Whistleblower readers know of my deep skepticism that the promises of Obamacare will be realized. As time goes on, my skepticism sinks deeper. The health care reform (HCR) legislation that was passed with reconciliation guarantees more taxes, more access to care for the uninsured and more government control of health care. But it fails in its promise to bend the cost curve, or does it? Perhaps, I’m being unfair and need to adopt a more literal approach to the president’s promise of cost control. President Obama’s program does bend the curve, but does so in the wrong direction. He wouldn’t be the first Democratic president in recent memory to engage in a public demonstration of linguistical gymnastics. If health care costs continue to rise, can we expect to hear the president lecture us in 2012 during his reelection compaign with his finger wagging “I kept my promise to bend the cost curve, and I did.” This past month, a national and respected health care organization reported that ...

I never took a psychology course in my life. Perhaps, I should have. How was I to know, or even suspect, that years beyond college, I would be the father of 5 kids? In retrospect, I should have been a psych major, so that I could have developed essential parenting skills in negotiating techniques, behavior modification, unflappable self control, brinkmanship, verbal dueling and mind reading. Without a solid psychological foundation, I have been fenced in and cornered by teenagers who know very well that I am shooting blanks. This has not been a fair fight. Two weeks ago, my daughter and I traveled to the east coast to visit 3 institutions of higher learning. This is the 3rd child that I have done college visits with. By now, I could give these ‘info sessions’ myself. They are verbal versions of Mad Libs, where the speaker simply plugs in terms specific to his institution. For example: “What really makes __________ University so unique, is our ( insert superlative adjective ) profes...

My patients have the confidence of knowing that I am a board certified gastroenterologist (GI). I haven’t disclosed this to them personally, but somehow resourceful and curious patients can now find out facts about me that heretofore would have required a government warrant. (In fact, for my entire medical career, I have never displayed a diploma or any professional certificate in my office, which annoys my mom.) Now, with a few keystrokes, patients can read about my suspension from the fifth grade after making an unwelcome comment about another student. Being from the northeast, my initial reaction to this transgression was, “Will this be on my college record?” Assuming that I successfully recertify in gastroenterology in the coming year, I will enjoy this prestigious designation for another decade. I hope I that I am still practicing then, since the health care reformists have promised us a medical nirvana in in the coming years. It would be a shame if I retired just before the nirva...