MD Whistleblower

I was engaged in one of my pleasures, sitting in a coffee shop leafing through medical journals. Usually, I am perusing newspapers. I spend many hours each week combing through various newspapers and routinely forward items of interest to folks of interest. No newspapers today. I have a few gastroenterology journals to look through. My professional reading habits have evolved over my career. I am more interested in reading about medical ethics, health care policy and the art of medicine than in studying hard science or clinical research, which used to be my required reading years ago. I read an essay entitled, Irritable Bowel Syndrome (IBS) Patients’ Willingness to Take Risks with Medications published in the June 2012 issue of the American Journal of Gastroenterology. The article stated that IBS patients would accept a small chance of death if there were an overwhelming likelihood of cure. This caught my attention. Of course, IBS can be a debilitating illness. But, it is not cance...

Romney lost.  This update is for those who have just awakened from a deep coma.  I voted for him which will not surprise even the occasional reader of this blog.  While he was an imperfect candidate, I believe that a businessman whose successes have straddled the public and private worlds may have provided a pathway forward out of the abyss.  Sure, I recognize that campaigning is quite different from governing.  Had Romney prevailed then he would have been opposed by an obstructionist Senate that would have stiff-armed him in the way that I expect the House to do to the president.   The loser always faces a merciless post mortem where pundits and pontificators point out the series of fatal errors that the candidate committed.  “He dissed the Latinos.” “He didn’t reach out to women.” “He tacked too far to the right in order to gain the nomination.” “He made a $10,000 bet with Rick ‘Brain-Freeze’ Perry on national TV.” “He introduced us...

Which of the following events is most traumatic for a practicing physician? Your staff doesn’t show up because the roads are flooded, but the waiting room is full of patients. Medicare notifies you that coding discrepancies will result in an audit of 2 years of Medicare records. You receive an offer of employment by a corporate medical institution who will bury your practice if you do not sign. Your key expert witness defending you in your upcoming medical malpractice case is incarcerated. Your office electronic medical records (EMR) system suffers a cardiac arrest. Tough choices, I know. Our office lost complete access to EMR for 3 days, and it wasn’t pretty. I don’t grasp the technical (doubletalk) explanation for the temporary EMR coma, but we were reminded of how dependent we are on technology. Our IT gurus were working tirelessly, but their adversary was wily and formidable. Finally, they prevailed, but I wouldn’t regard this as a clean win for us. We were hobbling for 3 d...

One of the gripes that patients have about the medical profession is that we physicians don’t communicate sufficiently about our patients. In my view, this criticism is spot on. Patients we see in the office often have several physicians participating in their care. The level of communication among us is variable. While electronic medical records (EMR) has the potential to facilitate communication between physicians’ offices and hospitals, the promise has not yet been realized. The physicians in our community, for example, all have different EMR systems which simply can’t talk to each other. We can access hospital data banks from our office, but this is cumbersome and burns up time. Ideally, there should be a universal system, an Esperanto approach where all of us utilize the same EMR language. On the day I wrote this post, I participated in a direct conversation with the treating physician at the hospital bedside which vexed me. This scenario would seem to be ideal from the patien...

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...