MD Whistleblower

This blog is about freedom and personal responsibility.  I have opined that cigarette smokers should not be permitted to transfer total responsibility for the consequences of their choices to the tobacco companies, even if this industry has committed legal and ethical improprieties.  I do not support the politically correct beverage ban in New York City, sure to spread elsewhere, where the government decides the content and dimensions of beverages that the public desires to purchase.  With regard to Obamacare, don’t get me started or I’ll never get to the intended subject of this post. First, let me refute a point in advance that is sure to be leveled against me by the pro-breast crowd.   I am zealously pro-breast and want all breasts foreign and domestic to remain free of disease. I am against breast cancer and support the goal of striving for early detection of this disease and medical research to prevent it.  Indeed, I am against all cancer an...

Triceratops Photo Credit A theme woven throughout the Whistleblower blog is skepticism.  I endorse and rely upon this in my medical practice and in my life. I admit that there were times that I argued a point that was not truly my own at the dinner table simply to stimulate the minds of my progeny.  As the kids are not readers of this blog, I trust that actual readers will be protective of this knowledge that if released could sow a storm of familial strife. I am reluctant to incorporate new medical breakthroughs into my practice until enough time has passed to convince me that these medicines or treatments are truly safe and effective.  Often, the test of time exposes the vulnerabilities and hazards of new remedies for old maladies.  This is to be expected.  Once a new medicine is released into the marketplace, its true risks may not be known until thousands of patients have taken it.  On other occasions, new science retires old treatments....

One cannot escape the issue of rising obesity rates in the United States. A current statistic predicts that by the year 2030, 42% of us will be obese. The ramifications of this ponderous eventuality could indeed weigh down and sink the nation. Some of the consequences include: Zillions of health care dollars spent treating obesity directly. Gazillions of health care dollars treating medical consequences of obesity. Loss of economic productivity from a bloated workforce. Diminished economic activity from corpulent citizens who limit travel and recreational activities. Loss of quality of life for those who have expanded far beyond their desired BMI. Phasing out of Whoppers and Big Macs, two national gastronomical treasures. Of course, the percentage of us who are deemed to be obese depends upon how we define the condition. Look what the medical experts have done with blood cholesterol levels, with the assistance of Big Pharma. As the threshold for a normal cholesterol value h...

Medical ethics is woven into the Whistleblower blog. I have presented vignettes exposing ethical controversies in the medical profession. I have pointed out scenarios when patients test the steeliness of our ethical scaffolding. I have admitted when my own ethics can be fairly challenged. Indeed, this blog does not take a ‘holier than thou’ posture, though at times I have been accused of this. I have directed as much criticism at myself as I do elsewhere. Recently, I received a request to assist someone whom I was told was in dire need of a physician’s assistance. While I am a physician who has taken an oath to heal and comfort, in this case I turned away from a person in need. I present the anecdote not because it will stimulate a discussion of the competing ethical angles of the case. Indeed, the case has no angles and no reader will challenge my decision. I present it as an example of an outrageous and improper request that was made to a doctor. Indeed, while I have received nume...

It was recently discovered that Fareed Zakaria committed plagiarism in an essay he wrote for Time Magazine on gun control.  He confessed and apologized.  I think he could have been fired for this as plagiarism, aka theft, is a cardinal offense for a journalist and a news magazine where trust is a central pillar.  This was not a matter of an indiscretion in his private life or an offense that doesn’t threaten his profession’s central mission. This was dishonesty in a job that should demand honesty in every syllable.  Zakaria is a Harvard graduate and a Yale trustee.  How would these institutions have ruled on a student who admitted committing plagiarism?  CNN and Time ‘suspended’ him.  Was Zakaria too big to fail? I’ve devoted several posts in this blog to professional integrity and personal ethics.  Medical plagiarism is a serious ethical wound in the medical world and all of us must hold our academic colleagues, medical students and practi...

In American society, packaging trumps contents. Look at both the Democratic and the Republican presidential nominating conventions we all just endured. In the old days, these conventions had a purpose – to select nominees. Now, they are scripted, grandiose infomercials that insult our intelligence more than they inform us. They are coronations. I heard great oratory, decent rhetoric and pabulum. The spectacles wasted tons of money that could have been devoted to charity or some other worthy cause. As marketing and political folks understand well, packaging sells products. Think of this the next time you are choosing a bottle of shampoo off the shelf. Are you really buying the sleek bottle? Are you voting for the sleeker and more likable candidate? Except for Mitt Romney, it seemed that every other speaker was raised in a log cabin. Lincoln would have no advantage if he were running today. There’s plenty of packaging and fluff in the medical universe also. Complementary and altern...

The day before this writing, a patient who was minutes away from his colonoscopy, asked me how many colonoscopies I had performed. Before I could answer, he quickly followed-up asking if any of my patients developed perforation of the colon after the procedure. I satisfied his initial inquiry when I informed him that I have intruded into at least 20,000 colons in the past 2 decades. With regard to his second and more ‘penetrating’ question, I told him, yes, there have been a few perforations. I continued the dialogue in order to place the issue in context for him and his wife so he wouldn’t be spooked before his procedure. We didn’t want a panicked patient leaping off the gurney and high-tailing through our waiting room in a flapping opened-back gown to the parking lot. Fortunately, our discussion accomplished its purpose and his procedure proceeded calmly and uneventfully. Sure, complications matter, but numbers can deceive. Our most highly experienced physicians have likely had m...