MD Whistleblower

I admit that I have a rudimentary knowledge of the business world, but I’m improving.  I now know, for example, that a C-suite does not refer to the procedure room where I do colonoscopies.  I am aware that executive coaching does not refer to advising top managers on their golf swing or tennis overhead.  I used to think that LLC stood for Long Live Colonoscopy, but now I know better.  CFO, Chief Flatulence Officer? While patients and physicians operate under oral agreements, business agreements are generally established in writing.  In these documents, terms are outlined including contingencies in the event that foreseeable obstacles or disputes develop.  Oftentimes, the two parties do not agree that a contractual term has been violated.  This is when the fun begins.   With a little luck, the legal profession enters the arena and can speedily resolve the disagreement in a matter of several years after impoverishing both sides. A co...

Many times over the years, I have witnessed the following scenario in my exam room.  Here’s the set up of this one act play. I’m seated at my desktop computer.  The patient is seated before me.  The patient’s daughter is seated next to her mother. Characters Elderly patient Attentive daughter The doctor Curtain's Up Scene I A patient comes to see me in the office with medical issues that strongly suggest that a colonoscopy should be performed.  As an aside, it is not my practice style to issue a colonoscopy edict, but rather to present the patient with available options, which should always include no testing as an alternative.  I may at that point strongly urge that the patient accept my colonoscopy recommendation, but at least the patient then knows the options with their respective advantages and drawbacks. [Reader aside: Examples of medical issues that lead most gastroenterologists and physicians to advise colonoscopy include: ...

                                                                                       Obamacare has promised to provide all of us with quality medical care that is affordable and accessible.  The very name of the law is the Affordable Care Act, which I have maintained will be short on both affordability and quality care.  Most of the country agrees with me.  The postponement for a year of the  corporate mandate to provide insurance in businesses with at least 50 full time employees was a great relief to these businesses and to Democrats ac...

I’ve never logged onto Angie’s List, but I might be on it.  Physicians are now routinely rated on various internet sites that the public can view before making appointments, or just as a parlor game.  You can look up doctors just as you would check ratings on toaster ovens, snow blowers, cars and restaurants. Are these sites truly useful? Can a grading site inform the public about a physician’s medical quality? Can a visitor to the site be confident that the view expressed is true and objective? I’m skeptical. Easier to rate a fridge than a doc I’ve thought deeply on the issue of medical quality since I was a medical intern in 1985.  Indeed, it was my preoccupation with this subject that led to the birth of this blog years ago.  Review the blog’s categories at the right of your screen and note how many labels include the term ‘quality’.   A recurrent theme here is how difficult it is to measure medical quality, even for medical in...

Everyone is familiar with the acronym HIPAA, which is the 1996 edict called the Health Insurance Portability and Accountability Act.  Isn’t that a smooth and melodious name? These are rules & regs that are designed to protect your confidential protected medical information.  I support the mission.  I don’t think that your medical records should be deliberately or inadvertently shared with those who are not lawfully permitted to view them.  Medical charts (remember when there were medical charts?) should not be left open on the counter. A physician should not yell to front desk personnel within earshot of others to give the patient a psychiatric referral. Elevators are not proper venues to have medical discussions about specific patients. Medical information should not be disclosed to inquiring friends and family without permission. I maintain that HIPAA has been OperationOVERKILL for many physicians and staff.  Keep in mind that doctors, at ...

Jingle bells, Jingle bells, Sebelius in her role, Oh what fun it is to see Her bringing us some coal. Obamacare, If you dare, The website has a glitch Fox News ratings - out of sight! While Dems are in the ditch. Here a tweak, there a tweak, Mad Obama fans, When he said a hundred times “You can keep your plan.” Here’s a clue, From me to you Just a little trick, To help survive Obamacare You’d better not get sick! Wishing you Joy and Peace

Whistleblower readers know that I have spewed some vitriol toward the airline industry, where customer service goes to die.  Indeed, in a prior post I contrasted their routine harassment of frequent fliers with the individualized stroking that Apple customers routinely receive.   For sarcastic scriveners like me, the airlines are the gift that keeps on giving.  The target is so large that one can hit it from miles away with a blindfold on at night. Fun, fun, fun... Some, but now all, sources of customer angst include: The convenience and rationality of the TSA process (“Out with those dentures, Granny!”) The sumptuous meals served aboard. (“Exact change for the pretzels is appreciated.”) The plush and spacious seats which easily accommodate those with BMIs < 18 On-time performance (Do we really know what time is?) Truthfulness with regard to the occasional flight delay  (Pinocchio would nasally impale customers if he worked as a gate agent...