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Medical Overdiagnosis and Overtreatment - Do Physicians Want Cost Control?

Truth is more absurd than fiction.  Mayor Michael Bloomberg’s wacky ban on certain sizes of sugary beverages, a scheme which was riddled with inconsistencies and exceptions, was properly squashed by a New York judge.  The mayor’s next play was to order all establishments that sell cigarettes to hide them from patrons.  I hope that this policy is examined in the same courtroom that ruled that the leaky soda ban was illegal.  Is this guy a mayor or an emperor?  Who can legitimately defend the government dictating to private businesses how they can display legal products to its customers?  Where would candy, potato chips and other poisonous snack foods be sequestered?  Speaking of sequestration, which the president warned would crush the country, the earth still rotates, the sun rises in the morning and congress has a 15% approval rating.  In other words, not much has changed.  We learned that there was not enough cash to fund White Hou...

Sequestration Closes the White House

Fortunately, the sequester did not incinerate Caribou Coffee, where I suck down several hot chocolates each week.  Luckily, Cleveland hasn’t passed a Big Government Big Edict against Big Beverages, as Mayor Michael Bloomberg rammed through last year in New York City.  Recently, a New York state judge refused to drink the mayor’s Kool Aid and ruled against the absurd, loophole-ridden government intrusion.   Sorry, Mike.  I suggest that you console yourself with a beer, which apparently is much safer than soda since no restrictions were placed on sizes of alcoholic beverages that may be sold.      I will try to crank out at a blog post now, but my heart is ponderous as I contemplate the plight of our nation’s children.   The barricades have been erected at 1600 Pennsylvania Ave.  White House tours have been cancelled, yet another apocalyptic consequence of sequestration.  It’s not clear to me who was responsible f...

Metatstatic Medical Regulations and Health Care Reform - Job Security for Bureaucrats

This week I promised you specific examples of dumb rules that we doctors must comply with. Here are just a few.  There are enough ridiculous regulations to fill multiple blogs devoted only to this issue posting hourly around the clock.  Yeah, I sound a mite cranky now.  The truth is that I still enjoy the work of doctoring.  I love my time with my patients.  There is, however, an increasing burden of stuff thrust upon us that takes time, energy and money away from our healing mission.   Perhaps, these regs are solving someone’s problem somewhere.  I suppose that this should comfort me knowing that somewhere in a government cubicle, a bureaucrat is smiling. Floor Plan of Cubicles Where Health Care is Reformed          We are required to ask patients their ethnicity.   Of course, many of them including myself are uncertain how to respond to this accurately.   I’m sure that our staff conveys an impression...

Medical Regulations Run Amok!

This post is a two-parter.  Readers, forgive me.  When I completed it in one of Cleveland’s finest culinary establishments, a building adorned with two arches, the word count approached 1000, and I couldn’t subject readers to a post of this length.  This is not a sneaky device to lure you back next week for the stunning conclusion, reminiscent of the old Batman TV show where we would have to wait for the 2 nd episode to witness Adam West and Burt Ward save themselves from a seemingly fatal fate.  Using Sonar to Detect Gotham City Villains I don’t love rules and regulations, though I’m hardly a lawless renegade.  I was an obedient youngster who reliably colored inside of the lines.  I went through adolescence with barely a squeak of rebellion and earned a college diploma without plagiarizing.  In my personal and professional life, I try to maintain a comfortable distance separating my conduct from looser behavior that would still be consi...

Obama or the Whistleblower - Which One Has Hubris?

I love words.  Call me a logophile as well as a blogophile.  When I write, I never resort to a thesaurus.  I enjoy the struggle of trying to find the right word.  There’s not a day that passes that I am not in the dictionary looking up a new word, or more likely, looking up the definition of a word for the 3 rd or 4 th time whose meaning I cannot retain.  I find that until I use the word, the definition is dangling out of reach.   There are many words that I think I use correctly, yet when I verify the actual definition, I find that I have been using the word more creatively than, perhaps, I should.  Indeed, recently I engaged in some verbal sparring over the word responsive .  I had thought that this word could be used to describe a response to an inquiry that was on point, not evasive and forthrightly addressed the matter at hand, yet I did not find this meaning included in the definition of standard dictionaries. Here’s how I h...

Do Probiotics Work? Marketing Mania Tramples Science

My kids know that I enjoy a spirited argument.   During the days when the dinner table was our public forum, I tried hard to offer a responsible voice of dissent on the issues before us.  I admit now that the view I espoused was not always my own, but one that I felt merited inclusion in the discussion.  I still do this with them and to others in my life who are willing to succumb to probing of the mind.   I willingly subject my own mind to the same process.  Because I am a gastroenterologist, folks assume that I have special expertise in nutrition.  I should, but I don’t.  Perhaps, medical education has evolved since I was in medical training, but in my day, a soft subject like nutrition was bypassed.   I am hopeful that I can remedy this knowledge vacuum in the years ahead. These days, nutrition is part of the burgeoning tsunami of wellness medicine, a discipline that races beyond known science as it seeps into the m...

Are Medical Bloggers Smug?

I love words.  When I write, I never resort to a thesaurus.  I enjoy the struggle of trying to find the right word.  There’s not a day that passes that I am not in the dictionary looking up a new word, or more likely, looking up the definition of a word for the 3 rd or 4 th time whose meaning I cannot recall.  I find that until I use the word, the definition is dangling out of reach.   There are many words that I think I use correctly, yet when I verify the actual definition, I find that I have been using the word more creatively than, perhaps, I should.  Indeed, recently I engaged in some verbal sparring over the word responsive.  I had thought that this word could be used to describe a response to an inquiry that was on point, not evasive and forthrightly addressed the matter at hand, yet I did not find this meaning included in the definition of standard dictionaries. Here’s how I have used the word. “Have you read the latest Whi...