MD Whistleblower

Do you think that physicians’ advice should be based on their patients’ best interests? How about lawyers?  Plumbers?  Financial brokers? An advisor who has what is termed a fiduciary duty is required to use the best interest standard with his client.  For example, an attorney is prohibited from recommending that his client proceed to trial, which would be beneficial financially  to the lawyer, if the attorney believes that a settlement serves his client’s interest better.   While it may not always work this way in the real world, this is how it is supposed to happen. "Toilet's clogged, ma'am.  Better replace the whole thing." Shockingly, investment brokers, unlike certified financial planners, have no fiduciary responsibility when advising clients on thei r personal investments.  They are free to make financial recommendations that are ‘suitable’  for a client , even if this would not be in the clien t’s best interest.  The b...

I love teachers.  And, I love the teaching profession.  I remember years ago teaching one class to middle-schoolers on a subject that I thought exuded fascination and drama – the Civil War.  It was a long 50 minutes.  Even my daughter was doing her best to feign interest.  While the fault here may have been with the guest instructor, the lesson for me, which I have not forgotten, is how tough the teaching trade is. Teaching - Leave it to the Professionals I don’t have the same affection for the teachers’ unions as I do for the profession.  Their unions are advocacy groups to protect the interests of its members.  There is nothing wrong with this.  Many professions and occupations, including mine, have similar societies to whom constituents pay money in  exchange for various job protections. My issue with these groups is when they torture the truth to disguise the real reason for their positions.  Of course, even the most d...

A female patient came to see me with some difficulty swallowing, a very routine issue for a gastroenterologist.  I performed an scope examination of her esophagus and confronted a huge cancer occupying the lower portion of her esophagus. Life changes in an instant. I expected a benign explanation for her swallowing issue.   She was relatively young and not particularly ill.  She had seen my partner years in the past for a similar complaint, which he effectively treated by stretching her esophagus.  I expected that I my procedure would be a re-run.  I was wrong. Prior to the procedure, we chatted and I learned that she had recently undergone a CAT scan of the chest ordered in response to some respiratory symptoms, which were not severe.  After I had completed my scope examination of her,  I was amazed that no mention of this tumor was related to the patient, who had told me that only a hiatal hernia was seen. I requested a fax o...

There’s nothing like discrimination – true or imagined – to keep our airwaves humming.  Earlier in the week, Indiana and then Arkansas were media fodder for laws that were proposed to protect religious freedom.   Yes, I know the other side of the argument, that these ‘religious freedom’ protections were veiled attempts to discriminate against the LGBT community.   Both states raced to revise their original laws, although the laws' backers deny any discriminatory intent or effect. It was likely that these governors feared an economic riposte from large companies who have expressed concern and disapproval over the perceived discriminatory effects of religious freedom laws.  I wonder how many of these companies do business with or remain silent about countries that use child labor, discriminate against women, have no freedom of speech or make homosexuality a crime.  Realize that the original RFRA proposals do not guarantee an outcome in any dispute, a...

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...