MD Whistleblower

I have never worn the uniform.  My dad joined the Navy during World War II and served for 39 months.  He was never deployed beyond our borders.  One of his brothers signed up for the Army and the other brother joined the Marines.  They were all the children of immigrants.  They didn't expect any recognition for their service.  This is simply what everyone did.  While I do not advocate resuming the military draft, I would support every citizen performing some manner of compulsory service to the nation.  It would devote massive human energy to unmet needs. It would establish a culture of service that this country sorely needs.  It would bind us closer to each other and to the nation.  Imagine the experience of young citizens across racial, gender, religious and socioeconomic lines collaborating together on a worthy endeavor. Can you propose a legitimate argument against such a proposal? I'm so grateful to all who serve and have serve...

                                                             Exercising good judgement can mean the difference between life or death.  Life can be unforgiving of the choices me make.  As we all know, many life events are beyond our control and understanding.  But, there is much we can do to shape our personal paths to a brighter destination. Consider some of the choices listed below that many folks make every day.  Are any of them familiar to you? Texting while driving. Riding a motorcycle. Riding a motorcycle without a helmet. Lifting an object that we know is too heavy for us. Getting into a car when the driver has had one too many. Driving a car when we have had one too many. Giving your social security number to a caller who is promising you a tax refund. Responding to an email from Nigeria ...

This really happened.   The vignette I present now occurred 3 days before its posting on this site.   My good friend Bill invited me to a fundraising dinner to support a Jewish organization.   I declined the invitation, but told Bill that I would be pleased to make a donation to support a cause that was important to him.   I connected to the website which led visitors quickly to the Donate page.   Charitable enterprises want to make it as easy as possible for you express your generosity and separate you from your funds.   H aven’t you noticed that every museum visit leads to the gift shop?   I quickly filled in the credit card information and then scrolled down and typed $50 in the Customized Donation window.   This box allowed donors to designate their own amount, bypassing the default listed uber high dollar amounts that appeared higher up on the page.   The entire process expended about 3 minutes and ended when I clicked on the Donat...

I’ve delved into the issue of medical judgment more than once on this blog.  I have argued that sound judgment is more important than medical knowledge.  If one has a knowledge deficit, assuming he is aware of this, it is easily remedied.  A judgment deficiency, per contra, is more difficult to fix.   For example, if a physician cannot recall if generalized itchiness can be a sign of serious liver disease, he can look this up.  If, however, a doctor is deciding if surgery for a patient is necessary, and when the operation should occur, this is not as easily determined or taught.   Medical judgment is a murky issue and often creates controversies in patient care.  Competent physicians who are presented with the same set of medical facts may offer divergent recommendations because they judge the situation differently.  Each of their recommendations may be rationale and defensible, which can be bewildering for patients and their families...

Physicians and nurses deal with the deepest issues of the human condition – life and death.   Our profession brings new life into the world and does our best to bring comfort and peace at the journey’s end.   It is a profound and emotional experience for medical professionals to be with a patient and family when life ends. There are other professions who routinely confront loss of life.   Law enforcement personnel, paramedics, firefighters and soldiers all are exposed to events that most of us would never wish to experience. The medical profession and society is struggling to preserve our humanity in a 'cut & paste' world where one's worth is determined by the quantity of twitter followers.   Hugging a child.  There's no 'app' for this. On my very first day of medical internship in Pittsburgh, I was called by a nurse to pronounce a patient dead.    I had never seen the patient before.   The only deceased individual tha...

There is a confluence this weekend of holy days from two venerable monotheistic religions.   Today is Easter, which represents the anniversary of the resurrection of Jesus Christ, a foundational theological principle of Christianity.     Christians await the Second Coming, when they believe that Jesus will return to establish a world of peace and justice. Passover, which began on Friday evening, celebrates the iconic and gripping tale, chronicled in the Book of Exodus, of the emancipation and liberation of the Jews who were enslaved under a cruel Egyptian regime.   The yearning for freedom and resistance against tyranny carefully documented in the Torah, is truly a universal template that is relevant to this very day.   Jews Crossing the Red Sea Leaving Bondage Behind The religions are so deeply intertwined.   While I am neither a Christian nor a scholar, I have taken some effort to study the New Testament so that I might gain some understan...

Among the many tools that insurance companies wield to save money is a technique called ‘step therapy’.  This is a technique that exasperates patients and physicians.  Here’s how it works.  A patients comes to his doctor with a medical issue.  The doctor, who presumably has a decent measure of medical training, experience and judgment, decides to prescribe a medication, in an effort to ameliorate the patient’s distress.  Let us call this magic elixir Pill A.  The doctor zaps this prescription to the pharmacy at the speed of light using the ever trustworthy electronic medical record.  The satisfied patient leaves with the mistaken impression that his cure is just around the corner. Here’s where the fun begins.  Of course, the patient may receive the typical denial as Pill A is not on the formulary.  Keep in mind that an insurance company’s denial doesn’t mean the patient can’t fill the prescription.  Insurance companies would neve...