MD Whistleblower

Each morning, as I read the newspapers in view of 3 birdfeeders, I send excerpts of news morsels to various individuals in an effort to stimulate a dialogue on issues of the day.  I am mindful how deluged we all are with a tsunami of unsolicited material.  I will not contribute to the cyber pile-on.  First, I’ll never forward an article that I have not read in full.  Secondly, I will send an item to an individual only if I have judged beyond a reasonable doubt that this person will feel that the time investment in the material will be judged to be time well spent.  I engage in an active colloquy with one of my good pals, who is among the millions of Whistleblower readers who ponder these posts each week.  To my knowledge, he has never left a comment on the blog, which is somewhat unexpected of this rather voluble individual.   As he has opted to remain anonymous, I will not ‘out’ him here, although perhaps this post may be the catalyst to morp...

Today's patients must adjust to seeing many physicians, many of whom are strangers.   If you need a doctor on the weekend, at night or just need a ‘same day appointment’, you may very well not be seen by your physician.  This is not your father’s medical practice.  The days of the physician house call have vanished.   There are many reasons responsible for this evolution (?devolution) in medical care.  Patients have by and large adjusted to this new reality. Housecall with some Old Fashioned Bloodletting We physicians have had to adjust as well.  Formerly, we took care of our patients exclusively, with rare exceptions when we were out of town.  If you went to the hospital, we were there.  Same day appointment needed?  We squeezed you in.   There was no nurse practitioner to pick up the slack.  While I’m not making a judgment on the mediical merits, physicians of yesteryear were more devoted to their patients ...

Everyone likes R & R.  In fact, I’m enjoying some R & R right now as I sit lounging on the backyard deck.  I have a full frontal of 3 birdfeeders who are all being attacked by avian assaulters.  It’s a microcosm of society – Lord of the Flyers, if you will.  The hummingbirds are working their wings off for a sip of nectar.  The finches politely share space on the feeder.  The male and female cardinals hang together – true love birds. The blue jays bully all the other birds away.  And, the lazy squirrels simply hang out below capturing seeds that the birds above spill to the ground. The Bully Senate Majority Leader Mitch McConnell is trying hard to get some R & R also.  Doesn’t he look like he needs it?  Poor guy.  The R & R on his agenda is not exactly like my backyard, bird gazing Rest and Relaxation.  The senator from Kentucky’s R &  R is R epeal and R eplace! The senator is a trained...

To this observer of the political scene, it does not quite seem that the Repeal & Replace effort has yet been clinched.  I have already opined on the House of Representative’s passage of their repeal legislation, which was passed for reasons unrelated to healthcare.  Remember, how smoothly that process went?  I wonder what ‘techniques’ were utilized to convince a few wavering House reps to choose wisely?  Hopefully, these methods do not constitute torture, at least as defined by the Army Field Manual. The world’s most deliberate body, The United States Senate, has not distinguished itself with the same task these past few weeks.  Majority Leader Mitch McConnell was attempting to defy gravity by promising passage, let alone a vote, on a horrendous bill that was rejected by factions within his own party.  Hence, he delayed the vote until after the July 4 th recess hoping that there will be a providential act in the coming days that will cause the l...

How's our sacred Honor doing? "And for the support of this Declaration,  with a firm reliance on the protection of Divine Providence, we mutually pledge to each other our Lives, our Fortunes, and our sacred Honor."

It may seem strange that a gastroenterologist like me does not prescribe pain medicines.  Let me rephrase that.  I don’t prescribe opioids or narcotics.   I write prescriptions for so few controlled substances that I do not even know my own DEA number.  You might think that a gastroenterologist who cares for thousands of patients with abdominal pains would have a heavy foot on the opioid accelerator.  But, I don’t.  Here’s why. I truly do not know my DEA number. I believe that one person on the health care team should manage the pain control.  In my view, this should be the attending hospital physician or the primary care physician in the out-patient setting.  There should not be several consultants who are prescribing pain medicines or changing doses of medicine prescribed by another physician.   With one physician in charge, the patient’s pain is more likely to be managed skillfully while the risk of fostering drug ...

Earlier this week, as I write this, our office lost a skirmish against technology.  It was my procedure day, where lucky patients file in awaiting the pleasures of scope examinations of their alimentary canals.  A few will swallow the scope (under anesthesia), but most will have back end work done.  We are a small private practice equipped with an outstanding staff.  We do our best every day to provide them with the close personal attention they deserve. The first patient of the day is on the table surrounded by the medical team.  The nurse anesthetist and I have already briefed the patient on what is about to transpire.  Propofol, the finest drug in the universe, is introduced into her circulatory system, and her mind drifts into another galaxy.  I pick up the colonoscope, which is locked & loaded for action, and the screen goes dark.  Our nurse goes through a few steps of messing around with plugs and doing a quick reboot, but we are st...