MD Whistleblower

I practice gastroenterology in Cleveland in the dark shadow of a large medical institution whose name contains the name of our city.  They are a world class medical institution whose reputation is largely derived from its cardiovascular department.   Presumably, these practitioners, like all doctors, advise patients who smoke that cigarettes have deleterious health effects.    The entire campus is smoke-free, as are all hospitals today.   This is a relatively new development.  A few years ago, nurses and other hospital staff would huddle at the entrance puffing away.   No more.  Now, there is no smoking anywhere on the hospital property.  Hospital puffers now have to wait until quitting time, when they are behind the wheel and leaving the grounds before they light up.  I’m okay with all this.  The hospital should set an example to promote better health.  Patients and families who enter the hospital who ...

'Safety first' is a mantra of today's hovering parents.  It's the default explanation that a parent invokes when an edict has been issued that cannot be challenged or reversed. "Mommy, can I pleeeeeeze have a water pistol?" "I'm sorry, honey.  You know how Daddy and I feel about guns.  This is a safety issue.  Now go and practice your violin and afterwards help yourself to some kale chips." Caution! Water Pistol Zone Ahead The safety concept has crept into the medical arena.  In many cases, safety concerns about our patients are justified.  I see many of our elderly hospitalized patients approaching hospital discharge who face safety concerns at home with respect to falls, understanding complex and new medication lists and monitoring active medical issues.  Hospitals today have a staff of capable and compassionate professionals who do excellent work protecting patients poised for discharge.  This effort saves patients suffering and sav...

I just deposited a check into my bank account by photographing the check with my iPhone and zapping it through cyberspace.  I realize this is a yawn to the under 35 crowd.  Soon, there won’t be any paper checks as the entire transaction will occur electronically.  As a member of the over 35 crowd (plus 20 years), I am wowed by this process.  I remember being astonished when my kids told me how they performed this same process a year ago.   It’s the same amazement I experienced when I first read about a new piece of technology called a ‘fax machine’. "You mean you slide a document into a machine and an exact copy emerges elsewhere?" In my younger days, depositing a check into a bank account meant waiting in line with my bank book in hand waiting for a living, breathing human to count and record my allowance and snow shoveling earnings.   The bank that my kids use today has no physical offices.  It is entirely in the Twilight Zone. Me...

I have a good memory, which has often been a great asset for me. Medical school in the 1980’s required massive memorization of arcane facts, formulas and anatomical structures. The philosophy then was that it was better to spend hours memorizing stuff every night then it would be to simply look them up when the information is needed.  My tone here conveys my view of this approach. I can remember the phone number in the house I lived in until I was 8 years old.  Impressive? Perhaps.Useful? I doubt it. Some folks have long memories, which is not always a gift.  There are events and painful moments that while they will always be stitched within our personal tapestries, they may be better placed beyond easy reach. Nations also have long memories.  I am writing now from Manila on the other side of the globe. Yesterday, I was snorkeling and witnessed a shipwrecked Japanese warship sunk in WW II by the Americans.  The war in the Pacific theater between the Japane...

This is a Whistleblower Holiday.  A few weeks before this posting, we are setting off to the Philippines.  After about 10 days there, we're off to Japan, where we expect to savor the full potential of sushi and other delicacies.  This will be the biggest trip of my life. I leave with enhanced immunity having received the influenza vaccine, a belated tetanus booster and the oral typhoid vaccine - veritable germ armor! No Traveler's Diarrhea! Why the Philippines?  My daughter, Elana, is spending a year there teaching at an international school.  We are going because she is there.We all know the advantage of maintaining low expectations.  Here are some of mine. Pull an all-nighter the night before departure to reduce the expected jet lag.  Manila is 13 hours ahead of Cleveland time. Don't miss the initial 7 a.m. flight out of Cleveland. No one on any of the 3 flights sitting in front of me reclines. The airport WiFi actually works. Our ci...

It’s been amusing to watch Rand Paul, a doctor, trying to ‘clarify’ comments he made suggesting that vaccines for kids should be a matter of parental choice.  Conversely, Rick Perry some years ago had to walk back his aggressive pro-vaccine stance, when he championed mandating HPV vaccines for young girls.  This political clumsiness is not restricted to the GOP.  In 2008, both Barack Obama and Hillary Clinton argued that 'more research was needed on vaccines' potential side effects'. Presidential candidates, it seems, have not all been vaccinated against Panderitis.   Of course, I recognize an informed individual’s right to refuse treatment.  An adult with appendicitis has a right to refuse appendectomy, against the advice of the surgeon.  "You mean I didn't have to get sick?" Does a parent have a right to deny the measles vaccine for their kids?  I don’t think so.  Here’s why. Medical evidence provides overwhelming support for ...

Every doctor understands what the phrase, doctor aware’, means.  This is the phrase that hospital nurses record in their nurses notes when they have notified the doctor, usually by phone, on a patient’s issue.   Once the ‘doctor is aware’, the nurse is in the clear and has transferred responsibility for the issue to the physician. Here are some samples of doctor awareness. Phone Call Notification                                           Nursing Record Doctor, Mrs. Leadbelly just vomited.                        Doctor aware! Doctor, Mr. Wobbly is dizzy.                        ...