MD Whistleblower

I never served in the military.  My father served for 39 months during World War II, but was never in harm's way.  He was in the navy, stationed in California.   Had President Truman not ended the war in Auguts 1945, I think it is likely that he would have been sent to join in an invasion of Japan. Because I have not served, and no one in my close circle is in the military, it is difficult for me to grasp the full depth and meaning of Memorial Day - a day that the nation honors and remembers its sons and daughters who have served, been wounded and have fallen. Arlington National Cemetary I try to connect with the experience as best as I can.   I watch, I read and I listen.  I recently watched Ken Burn's monumental documentary, The Vietnam War, trying to absorb its lessons.  But, I realize that I am still a spectator who will never comprehend the experience as the actual participants and their loved ones appreciate. I have been honore...

The day before I wrote this, I read about a ‘research’ fiasco where 3 individual were blinded after receiving stem cell injections into their eyes.  This ‘research’ was done in a physician’s office and cost each patient $5,000.   What a tragic outcome.  At least two of these patients discovered that this treatment was available by clicking on ClinicalTrials.gov, a name that suggests government approval, which is not true.  Clearly, the name of this website is deceptive.  Neither the Food and Drug Administration (FDA) or the National Institutes of Health had any endorsement or sponsorship role here.  Moreover, press reporting indicates that these patients had scant medical evaluation prior to and following the medical procedure. Note to readers: Legitimate clinical trials generally do not charge patients for participation. Legitimate clinical trials have intensive evaluation to screen patients for eligibility.  Many or most patients may ...

People with liver failure and cirrhosis die every year because there are not enough livers available.  Who should receive the treasured life-saving organ?  There is an organ allocation system in place, which has evolved over time, which ranks patients who need liver transplants.  Without such a system, there would be confusion and chaos.  How can we fairly determine who should receive the next available liver?  What criteria should move a candidate toward the head of the line?  Age?  Medical diagnoses? Insurance coverage? Employment status?  Worth to society?  Criminal record? An artist's rendering of the liver from the 19th century. Consider the following 6 hypothetical examples of patients who need a liver transplant to survive.   How would you rank them?  Would those toward the bottom of your list agree with your determination? A 50-yr-old unemployed poet is an alcoholic.  He has been sober for 1 ye...

We are working hard to bend the curve of the opioid crisis here in Ohio.   The cause of the crisis is complex and so is the remedy.   Statistics examining the last several months have not yet been released, but the trend over the past several years is very troubling.   When I first learned that Ohio was the epicenter of opioidmania, I was quite shocked, as I wrongly thought that this plague would spare the heartland.   In contrast, it seems the heartland is ground zero.   While I have no specific expertise in addiction medicine or sociology, here are my speculations on some of the contributors to the current crisis. Aggressive marketing by pharmaceutical companies. Deceptive marketing by pharmaceutical companies claiming non-addictive potential of their products. Economic decline and hopelessness. Increasing expectation by the public of a pain free existence. Physicians prescribing opioids, rather than non-addictive alternatives, in response to a new pr...

‘I can’t stand the site of blood!’  We’ve all heard that adage.   Blood can provoke emotional reactions from even steely muscle-bound bodybuilders.  We gastroenterologists routinely receive fearful phone calls from patients who have observed even minor rectal bleeding.  Fortunately, in most of these cases, there is a benign explanation for the sanguinary seepage. If blood repels you, then gastroenterology should not be on your short, or even long list of professions under consideration.  We confront blood every day.  Of course, blood is the elixir of life as it courses into every remote recess of our bodies.  But, when blood loses its bearings, takes a wrong turn, and emerges errantly from our gastrointestinal tract, then gastroenterologists - or G-men -are called in.   Indeed, searching out the site of blood leakage in patients is one of our primary diagnostic tasks.  You might say that blood is our ‘bread & butter’. I rece...

Are you getting a little tired of being warned that all kinds of stuff you do is unsafe?   I wrote a post recently about Warning Fatigue with regard to our office’s Electronic Medical Record which I fear will emit a flashing Red Alert if I prescribe a patient an aspirin. Now, I start every morning with a steaming cup of coffee.   In fact, there is one beside me right now, as I peck about my Dell keyboard to create this post.   My inner circle of intimates and those with whom I share a high percentage of DNA, are aware that I add something to the java, which is a rather atypical additive.   Curious readers may inquire further, although I cannot pledge here that I will make a full disclosure.    Persuade me to disclose, and I will give your request due consideration.. Recently, a judge in California ruled that various coffee companies, including Starbucks, must issue a cancer warning regarding a component of coffee called acrylamide   Violato...

In a prior post , I shared my heretofore reluctance to prescribe medications to my Hepatitis C (HCV) patients.   In summary, after consideration of the risks and benefits of the available options, I could not persuade myself – or my patients – to pull the trigger.   These patients were made aware of my conservative philosophy of medical practice. I offered every one of them an opportunity to consult with another specialist who had a different view on the value of HCV treatment. I do believe that there is a medical industrial complex that is flowing across the country like hot steaming lava.   While I have evolved in many ways professionally over the years, I have remained steadfast that less medical care generally results in better outcomes.   A Scouting Patrol of the Medical Indutrial Complex There was an astonishing development in HCV treatment that caused me to reevaluate my calculus.   New treatment emerged that was extremely safe and amazin...