MD Whistleblower

The intractable Israeli-Palestinian conflict has been raging and smoldering since I was born, over half a century ago. This suggests that it is an insoluble conundrum, yet all parties to the conflict and others admit that they know what the contours of the final peace would be. This reality heightens everyone’s frustration. The process is frozen within close view of the end zone. The Medicare crisis is analogous to Middle East peace process. The challenges are well known and the solutions are obvious. Yet, decades go by and politics have kept politicians, and those they serve, out of the end zone. They’ve been fumbling the ball for a generation. Now, it’s 4th down and they want to punt again. The problem is that the Medicare program is headed toward insolvency. The solution? Here’s three Mensa suggestions: Scale back benefits Spend more money Raise the age of eligibility Most folks support scaling back benefits, as long as it’s someone else’s benefits that will be adjusted. Si...

Recently, nine patients died in Alabama when they received intravenous nutrition that was contaminated with deadly bacteria. This type of nutrition is called total parenteral nutrition, or TPN, and is used to nourish patients by vein when their digestive systems are not functioning properly. It is a milestone achievement in medicine and saves and maintains lives every day. What went wrong? How did an instrument of healing become death by lethal injection? What is the lesson that can emerge from this unimaginable horror? This tragedy represents that most feared ‘never event’ that can ever occur – death by friendly fire. No survivors. Contrast this with many other medical ‘never events’ as defined by the Centers for Medicare and Medicaid Services, such as post-operative infections, development of bed sores in the hospital or wrong-site surgery. Under the ‘never events’ program, hospitals will be financially penalized if a listed event occurs. Many physicians and hospitals are concern...

Your humble Luddite Whistleblower has leapt across the sea to reach the Isle of Technology. I now own and operate an iPhone, which identifies me as groovy, hip and cool, three adjectives that none of our 5 kids ever use to describe their technophobic father. I’m told that my text messages are too long and too frequent. I am admonished that it is not necessary for me to photograph moments of high drama, such as a kid eating breakfast, and then to disseminate the image to my contact list. I am reminded often that I am slow to grasp the mechanical intricacies of the device, such as switching from ring to vibration mode. You may wonder how it was possible that I, who consider using an ATM to be a high level computer operation, could make the iPhone, my phone. I knew I couldn’t fail, despite my trepidation of all things cyber. I had a secret weapon, a ‘Plan B’. Actually, I had Plan Z, the most powerful asset that anyone in my situation could hope for. Z stands for Zachy. One sentence ...

Prototype 'BS' meter.  So many folks express views that are obviously self-serving, but they try to masquerade them as altruistic positions that benefit some other constituency. These attempts usually fool no one, but yet these performances are common and ongoing. They are potent fertilizer for cynicism. Teachers’ unions have been performing for us for decades. Their positions on charter schools, school vouchers, merit pay and the tenure system are clear examples of professional advocacy to protect teachers’ jobs and benefits; yet the stated reasons are to protect our kids. Yeah, right. While our kids are not receiving a top flight education, the public has gotten smart in a hurry on what’s really needed to reform our public educational system. This is why these unions are now retreating and regrouping, grudgingly ‘welcoming’ some reform proposals that have been on the table for decades. This was no epiphany on their part. They were exposed and vulnerable. They wisely sense...

Ohio made national news twice in one week, and the Cuyahoga River wasn’t even on fire. First, Obama and his entourage flew here to headline the conference, Winning the Future Forum for Small Business, when he addressed small business leaders. He referred to the ‘reinvention of Cleveland’, a term that suggests we are experiencing a renaissance here, an event that most of us are unaware of. In any event, when a president flies in, it offers an opportunity to think, particularly if you are held hostage on the highway awaiting the presidential motorcade. Then, you can ponder how late you will be for your destination. Education, one of my preferred issues, also made headlines. A Mount Vernon, Ohio teacher was accused of infecting his curriculum with creationism, among other allegations which readers can discover with a single click after a Google search. Ohioans follow the creationism issue closely and pride ourselves on being more enlightened than many spirited evangelists from the Sunf...

This is a family blog. At times, I have had to expunge comments for inappropriate content. My criteria for comment eradication include: Raw language Personal attacks Overt commercial objectives There was a time in my lifetime when breasts were considered an inappropriate topic in public discourse. You never saw Little Ricky suckling his mother’s milk on I Love Lucy. These days, of course, breast references and actual images are chic and ubiquitous. Relax, parents. The remainder of this post will remain family-friendly, so there is no need for you to consult your 14-year-old on how to implement parental controls on your computer. Here are 3 recent breaking breast developments that all inquiring minds will want to be abreast of. Landmark medical study concluding that many women with breast cancer do not need to undergo pain and expense of removing lymph nodes. They do just as well if their nodes are not disturbed. Why does this matter? See prior landmark Whistleblower post. U....

Recently, every newspaper in the country reported on a landmark development in breast cancer treatment. It is now clear that certain breast cancer women do not need to undergo removal of lymph nodes from the armpit as part of their treatment. This would spare them from the risk and discomfort of an unnecessary procedure. It is welcome news, particularly for those of us who argue that in medicine, less is more. This is an example of the benefit of comparative effectiveness research , a tool that can separate what patients truly need from what the medical profession believes they must have. Let’s hope that breast cancer breakthrough metastasizes across the medical profession. Here’s what it accomplished. It spares women from unnecessary surgery. It saves money. It demonstrates that physicians and medical professionals can serve the public interest. It gives hope that all medical specialties will critically evaluate and justify the tests and treatments that we recommend to our pati...