MD Whistleblower

In medicine and beyond, folks just want stuff to be true.  Sometimes, we believe stuff that is unproven, but might be true.  We doctors recommend such treatments to patients every day.  On other occasions, a benefit of a drug or food item is extrapolated way beyond the data.  For example, if Nexium is known to be effective against stomach ulcers, then why not use it for patients with stomach aches who are ulcer-free?  There’s not a gastroenterologist on the planet that hasn’t engaged in this therapeutic mission creep.  More interestingly, folks often persist in beliefs that have been disproven.  The notion, for example, that certain vaccinations can cause autism has been thoroughly debunked by rigorous scientific study, yet there remain diehards who defy the science.  Curiously, many unproven or disproven practices have gained a fair measure of street cred in the Court of Political Correctness.  Keeping a gluten-free diet today is downri...

Profiling in this country is highly discouraged and is illegal in many circumstances.  Anti-profilers decry this technique which, they argue, unfairly targets innocent individuals violating their rights.  Our beloved Transportation Security Administration, or TSA, is charged not to use profiling as a screening tool.  Personally, I object to this prohibtion.  While an individual’s rights are important, it must be weighed against the rights of the community.  Our cherished rights to free speech and assembly are not absolute. I have flown on El Al airlines, whose personnel actively profile in an effort to keep its passengers safe.  Anyone who has been a passenger on this airline will likely agree with me that he has never felt safer on an airplane.  I have a right not be blown up, and if profiling further minimizes this risk, then call me a fan. Last year, my mother, who appears as threatening as a school librarian, was patted down twice when she t...

Patients are entitled to receive medical advice 24 hours a day.   If you call your doctor at 3 a.m., you will reach a physician who will advise you.   Of course, it may not be your own personal physician as this individual cannot be expected to be available 365 days a year until he retires.  Physicians partner with colleagues who share on-call responsibility for evenings, holidays and weekends.   For example, my gastroenterology group has 3 physicians who take turns during the off ours to be available for our patients. Here are some tips for patients who are seeking advice after hours from the on-call physician. When possible, call your doctor before sundown. I advise against calling the doctor after hours for a question that only your own physician can answer, unless an emergent situation is suspected.   For example, the on-call physician will not know what the next step will be if next week’s colonoscopy is negative. If you...

It’s the birthday of the nation, the Fourth of July.  John Adams proclaimed in a letter to his dearest wife Abigail that this day “will be celebrated by succeeding Generations, as the great anniversary Festival…with Pomp and Parade, with Shews, Games, Sports, Guns, Bells, Bonfires and Illuminations from one End of this Continent to the other from this Time forward forever more.” Years later, in an amazing twist of historical fate, John Adams and Thomas Jefferson would each ascend to heaven on the very same Fourth of July. 'Illuminations' These days, many of our historical figures and symbols are under review, judged in the context of current mores and sensibilities, always a process to be undertaken with care.  The Confederate flag is being banished from government property, as it should be.  During an earlier part of my life, I was sensitive to the argument that this flag properly honored the heritage of Confederate forefathers.  A little wiser now, ...

Bariatric surgery, including gastric bypass surgery, has become a popular remedy for obesity in this country.  Hospitals have weighed in on this issue and are marketing this service directly to the public who are ever willing customers of this slenderizing surgery.  I have many patients who have undergone the procedure and the results have been variable.   It’s too dismissive for me to refer to gastrointestinal bypass (GIB) as a ‘procedure’ as it is major surgery with major potential complications.  There are several types of bariatric surgery available today, but GIB is the standard surgery performed. It profoundly reroutes the guts and changes every day of your life.  This is not like undergoing a heart bypass surgery when after a period of recovery you resume your normal life.  After GIB, there is no normal life afterwards.  Your life is irrevocably altered.  Meals are such a significant and personal part of our lives.  Think of a...

The Deflategate investigation has concluded that it was more probable than not that Tom Brady had general awareness of the mysterious shrinking footballs.  Now the fun started.  Although t he investigator, Ted Wells, is highly regarded for his probity and objectivity, he was attacked by Brady supporters for what they argue were his tendentious findings.  As is so true today in our political world, when allegations are true and damaging, attack the messenger.  Physicists from prestigious universities brought us back to high school science class with theories suggesting how the squishy pigskins could have been the result of natural phenomena.  I think the science was a little squishy here.   It was, however, sentimental for me to relive the tender memories from high school physics about the exciting relationships between pressure and volume.  There’s nothing like a discussion of the ideal gas law to liven up a dull evening.  Would ...

Every week, I am asked by patients if their heartburn medicine causes osteoporosis.  The most effective heartburn medicines are called proton pump inhibitors, or PPIs.  If you watch more than an hour of TV per week, then you have seen ads for some of them.   Nexium, Prilosec and Protonix are 3 examples of these medicines. Many of them are now available over-the-counter at reduced dosages.  Patients today are incredibly informed, and sometimes misinformed, about their medical conditions and their treatments.  Most of their information is from the internet, and it’s easy for patients to become unwittingly trapped in the world wide web. The information dangling in cyberspace is entirely unregulated.  Information can be made to appear authoritative and objective when it actually is a paid advertisement.  Many blogs may appear to function to inform the public, when their true purpose is to serve the corporation that sponsors it.  If y...