MD Whistleblower

As of this writing, 5 air traffic controllers have been found asleep at the switch. By the time this piece is posted, several others may have joined the slumber party. Keep in mind, there’s a lot more snoozing in the towers than we’re aware of. We don’t know the denominator here. Our wise reactive government has recently issued orders that airport control towers must not be manned by only one individual. Somehow, prior to NappingGate, our bloated and inefficient government that is riddled with redundancy thought that one sole guy watching the radar at night was sufficient. There are some jobs where nodding off poses no risk. Let me test my readers’ acumen on this issue. Which of the following professions would not be at risk if an unscheduled siesta occurred? A race car driver A congressman A circus clown (not to be confused with above listing) A lawyer (not to be confused with the above listing) A school bus driver Let’s face it. Some folks on the job simply can’t safely snore...

I received a call recently from an emergency room (ER) physician about a patient who presented there with rectal bleeding. Does this sound blogworthy? Hardly. We gastro physicians get this call routinely. Here’s the twist. The emergency room physician presented the case and recommended that the patient be discharged home. He was calling me to verify that our office would provide this patient with an office appointment in the near term, which we would. We had an actual dialogue. This was a refreshing experience since the typical emergency room conversation of a rectal bleeder ends differently. Here’s what usually occurs. We are contacted and are notified that the patient has been admitted to the hospital and our in-patient consultative services are being requested. In other words, we are not called to discuss whether hospitalization is necessary, but are simply being informed that a decision that has already been made. There is a tension between emergency room physicians an...

In response to my prior post where I averred that cigarette companies were treated as scapegoats, I have had several cyber and actual conversations about personal responsibility. I believe that folks should realize the consequences and the benefits of freely made decisions. While we want American society to be compassionate, we do not want to punish success and reward failure. Our goal is to do all that we can to maximize everyone’s success. We should be ready to assist those who need and deserve our private and governmental assistance, but personal effort and responsibility are necessary elements of these interventions. When we see patients who are in financial difficulty, my physician partners and staff will do all that we can to help them. While it is not our policy to do colonoscopies for free, we will make whatever adjustments are necessary to make sure that the patient receives colon cancer screening. However, when patients who owe us money hang up on our calls, or express the...

At this writing, I am in Atlanta visiting our daughter at Emory University. This may be the only college campus in the nation where you can’t buy Pepsi. Coke is King here. If you don’t know this, do some due diligence before you or someone you love interviews here. I remember a few decades interviewing at the medical school here. There are only 2 medical school interviews that I recall after all these years. At N.Y.U. School of Medicine, the canny interviewer asked me what the death rate of Americans is. I correctly responded, “100%”. I suppose that untangling enigmatic questions was an N.Y.U. admission requirement, since they did accept me, and I did attend. The other medical school interview I still recall was at Emory, although it’s not the questions I remember. Their unique interview format made the experience memorable. Three medical school applicants were interviewed simultaneously as we faced a bank of questioners. This was reminiscent of the ancient and popular TV show, The D...

We have had many family conversations about education reform over the years. Whistleblower readers have seen some of this creeping through some prior posts. It’s an issue that affects every American and deserves the efforts of our most talented and innovative thinkers to elevate the system to a higher orbit. One of the mantras of traditional reformers is that smaller classes for students are optimal. Indeed, local school boards and teachers’ unions often warn of expanding or exploding class sizes if requested levies are not passed. They know that we parents believe that class size varies inversely with the quality of education. Ask parents if they would prefer a class of 20 or a class of 30 students for their youngsters and all will opt for the former. Are smaller classes really better, or do we just believe they are because our intuition instructs us that it is? Is something true because it seems self-evident to us? I found recent New York Times article on this issue very enlig...

Fast Food or Front for Evil? As Whistleblower readers know, I have a 6 day-a-week love affair with The New York Times. I love the paper’s reportage, but not its editorial policy. However, it’s important to seek out other views on the issues of the day. This is an opportunity to defend your beliefs by disarming the opposition’s argument, or to change your mind. The news these days is very dark. There’s an apocalyptic aura as we read about terror, war and natural disasters occurring all over the globe. And, since we all like reading about villains, the news media readily supplies us with demons to root against and to distract us from more serious challenges that hover over us. In this past week, there were four prime villains that the national media offered up for us to consume. Osama bin Laden Mouammar Khadafi Mahmoud Ahmadinejad Ronald McDonald Don’t let Ronald’s sunny visage fool you. Behind his painted smile and underneath his red hair is an evil mind who is devoting his li...

Photo Credit I barely escaped from an embarrassing situation recently in the hospital. I was consulted to place a feeding tube, called a PEG, in an ICU patient. We gastroenterologists are rarely consulted for our opinion on whether these tubes make sense, which they often don’t. We are recruited to these patients simply to perform the technical function of inserting the tubes, so that Granny, or Great-Granny, or Great-Great… , won’t starve. Multiple medical studies have demonstrated that providing this nutrition to individuals with advanced dementia doesn’t benefit them. In addition, while it may seem intuitive that artificial feeding provides comfort, this may not be the case. It may provide more comfort to the physicians and family than it does to the patient. The above paragraph is not a rigid presentation. Obviously, the decision to place and accept a feeding tube must be individualized. Regardless, it is inarguable that too many of these tubes are being placed for the wrong re...