MD Whistleblower

 I think we’re headed in that direction.  There are various angles and positions to consider.  But, as in so many disputes, it’s not a matter of right and wrong but an issue of which side has the better argument. When a judge rules for one party in a dispute, this does not mean that the other side had no legitimate position.  If means that the judge concluded that an analysis of the facts and the law tilted toward one side. We must acknowledge that an individual has a right not to be forced to accept a vaccine or any medical treatment.   The doctrines of informed consent and patient autonomy are bedrock pillars in American medical care.   If, for example, I recommend a colonoscopy to a patient with symptoms highly suggestive of a serious colon condition, the patient is free to decline my advice.   While I may feel strongly that this decision – referred to as informed refusal – is unwise, no medical practitioner or ethicist would argue that I sho...

Readers of this blog, and those with whom I have shared my philosophy of medical practice, know that I am a conservative practitioner.   I rail against overdiagnosis and overtreatment.  Less medicine results in more healing and protection.  In an example, I have explained previously why I advise patients not to undergo total body scan s , despite the lure that they offer a cancerophobic public.  I’ve never undergone a CXR in my life.   I’ve never entered medicine’s Tunnel of Adventure, also known as a CAT scan.  My fear would be that the scan would show various internal imperfections of no meaning that would generate anxiety, expense and a cascade of medical tests to follow up on the ‘abnormalities’.  Any real patient reading this who has been around the block once or twice, will validate my scanophobia.   Not a week goes by in my practice, that I am not facing a worried patient who was found to have some trivial finding on a ...

This morning, as I wrote this some time ago, a patient came to my office for a colonoscopy.  I sent her packing.  Here’s what happened. In our Ambulatory Surgery Center (ASC), in my prior private practice, we introduce light into dark spaces every day.  This is where we perform colonoscopies and upper endoscopies.  We have a program in place where referring physicians can have their patients contact our ASC and schedule a procedure without seeing us first in the office for a consultation.  Obviously, we have to have a vigorous screening process in place  We do not want to meet a person for the first time for a colonoscopy and discover that he has complicated medical issues and is dragging an oxygen tank behind him. Our screening system works extremely well, but it is not perfect.  On occasion, it misfires  The patient arrived at our office at 7:00 a.m. after a 45 minute drive.   She had ingested the required purge, ...

  We have nearly emerged from the pandemic's abyss, but we have not yet reached the other side. The wily virus tries daily to morph into other variants to slide past our defenses. The politics of division and personal destruction have not yet been set aside. The surreal scenes of January 6th are seared onto our memories.   The recent horrors in Surfside, Florida leave us all gasping. We are still a divided nation. I want to believe that there is an ache and a hunger to come closer together. July 4th is upon us.  Might this be an occasion when we might begin the process? ”I am apt to believe that it will be celebrated, by succeeding Generations, as the great anniversary  Fes tival. It ought to be commemorated, as the Day of Deliverance by solemn Acts of Devotion to God Almighty. It ought to be solemnized 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 forwa...

 Over the past few weeks, several patients I saw faced a common challenge.  This is a situation I have confronted in the past, but what was unique recently is that multiple patients in a short period of time were in the same situation. This was not a medical issue.   In fact, many of the individuals were feeling perfectly well.   This was not a financial issue, such as the patients were in the dreaded ‘doughnut’ or their particular medications were not covered by their insurance companies.   This was not a second opinion request from patients who suspected that their gastroenterologist (GI) of record may have missed something. Here’s what happened.   A gastroenterology practice that had been in the community for decades closed down.   Suddenly, tens of thousands of patients with an array of digestive maladies were let loose to find a new digestive nest to occupy.   I’m sure that every GI within 20 miles of my office has been affected.   M...

How many actions do we take in our lives simply because this is how we and others have always done them?    In these instances, shouldn’t we at least pose the question if there might be a superior alternative?    I admire innovators who view the world through a prism that aims to shake up and disrupt the status quo.   You know who I mean; the folks who hear the music in between the notes.   Medicine is riddled with practices that have remained in place for decades and are, therefore, hard to change.   Acute appendicitis is treated with surgery.   Why aren’t antibiotics an option here as they are for other similar infections in the large intestine? Diverticulitis has been treated for decades with antibiotics?   Only recently, have experts wondered if this treatment should be reexamined. For a generation, children with red eardrums received antibiotics presuming that this was a bacterial infection.    Ultimately, a skep...

Here follows a true vignette from a few years ago.  After giving a patient the pleasure of a colonoscopy, I left the hospital and headed for my office.  As there was 45 minutes until my first office patient was due to arrive, I stopped at a coffee shop for my default hot beverage - café mocha.  I strongly prefer independent coffee shops and routinely will take a long drive to reach one.  I approached the counter and discovered that my phone, always holstered in the inside pocket of my sport jacket, was AWOL.  For many folks, especially physicians, their smart phones are beyond essential.  It serves as my pager, my appointment calendar and my communication nexus.  It is a portal to the medical site that we doctors consult for difficult cases – Wikipedia!  It is my lifeline to my offices and the hospitals I serve.  Sure, my brain may still be functioning even when I am phoneless, but the phone  supplies the fuel and power to make it al...