MD Whistleblower

 Over the past 15 years or so, I have endured several electronic medical record (EMR) systems. Indeed, there is an entire category, EMR Quality , on this blog where I share with readers the good, the bad and the ugly in the EMR space.  If you are suffering from insomnia, I invite you to review these posts nightly. When EMR was creeping onto the medical landscape, physician grunts like me were salivating over the prospect that one of our thorniest and frustrating challenges was about to be solved.   EMR promised that all of our patients’ records could be accessed with a couple of keystrokes in our own offices.   This made sense as we all knew that the digital world could create linkages that would permit access to all of a patient’s medical experiences.   Regrettably, this promise that was made to medical professionals and the public remains unfulfilled. Here’s why physicians were so ripe for the EMR seduction.   Consider this typical scenario in the pre...

 The world is watching as a maniacal dictator methodically levels a country, displaces millions of citizens and attacks civilian infrastructure and lives.  The Ukrainian response has been unexpected, effective and downright inspiring.  To paraphrase JFK’s iconic remark in a 1963 speech in West Berlin, ich bin ein Berliner , we are all Ukrainians today. By all accounts, the Russian military assault or war or invasion has stalled.   Their current ‘military’ strategy now appears to be that if you can’t occupy a Ukrainian city, then destroy it.   The ghastly footage is reminiscent of newsreel footage from London in 1941, when the city was bombed for months by another maniacal dictator.   The entire world, except one country, is aware of the deliberate targeting of maternity wards, schools, residential neighborhoods and civilians.   Of course, the Russians deny all of this and maintain that they are liberating Ukraine from genocide and other crimes. The...

On the day before writing this, I attended a seminar on medical professionalism.  The room was filled with physicians at all stages of our careers.  I enjoy opportunities to think about aspects of my profession that are beyond the digestive organs that I dally with daily.   At the seminar, a video clip was shown from the 1991 movie The Doctor.  The scene depicted an attending physician berating an intern in the presence of the medical team after he casually referred to the next patient to be seen as being ‘terminal’ without identifying him by name.  If fact, it became clear that the young doctor did not even know the patient’s name.  While the attending physician was correct to recognize that patients are living breathing human beings, not diseases or hospital room numbers, it was a breach of professionalism to humiliate an intern in public. After a few comments were offered by seminar attendees chastising the senior physician’s cruel approach to ...

Medical school, residency and specialty fellowship cannot prepare physicians for every eventuality.   Many important skills must be acquired on the job.   And, of course, physicians need to remain current with respect to cognitive and procedural advancements.   Here are just few critical subjects that I was not prepared for when I entered the healing profession. What happened to my phone medicine lectures? Phone medicine.   Treating a patient with abdominal pain at night on the phone requires different skills than when the patient is in my exam room. And, te phone call may be the first time I have ever spoken to this patient. Breaking bad news to patients and their families.  Wouldn’t you think that we would have received training for such a critical skill? Nutrition.  Patients are understandably amazed at my paucity of nutritional knowledge.  I suspect that most gastroenterologists can make the same claim.  Wouldn't you think that n...

 A doctor arrives just a few minutes late to his office and is warned by his staff that the patient slammed the exam room door and starting swearing.   A passenger on an airplane erupts in anger and has to be physically restrained.  Parents at school board meetings are foaming at the mouth objecting to revisions in the curriculum.  An angry mob storms the seat of our democracy attacking law enforcement professionals, an event that is later referred to as ‘legitimate political discourse’. So much anger. Where did all of this rage come from?   Is there a pathway back to civility? Anger today is more prevalent and intense than I have ever seen in my lifetime.   Moreover, it has spread over the landscape like hot flowing lava reaching regions that were heretofore anger-free zones.   Violence on an airplane?   Really?   In years past, there was a time and a place for anger.   Here are a few examples when anger was understandable. ...

I have been much less enthralled this year in the Beijing 2022 Winter Olympic Games.   And I’m not alone.   There are many reasons for this global Olympic ennui.   International publicity on China’s horrendous human rights record resulted in several nations, including ours, issuing diplomatic boycotts.   The Peng Shuai affair was also a turn off when this Chinese tennis athlete made an accusation of sexual harassment against a Chinese government official.   Then, she disappeared and issued a statement denying her allegation.   Sounds like she was being squeezed in a Chinese Olympic vice.   The shameless spinelessness of the International Olympic Committee is itself a reason to boycott watching the games.   And Americans and folks abroad have been absorbed with the ongoing pandemic and worsening economic realities.   Many are preoccupied with inflation or rising crime or an imminent war in Europe.   For them, watching the Olympics isn’t e...

During the pandemic, which has not yet ended, we’ve all heard lots of chatter about freedom.  Folks are figuratively burning their masks as a statement of their personal freedom.  We have seen patrons packed into bars and other venues, against the advice of medical professionals, claiming they have the freedom to congregate.  Political leaders in some states have banned mask mandates in schools arguing that parents have the freedom to make their own decisions regarding their kids. And the fundamental reason given by so many anti-vaxers and government skeptics is that they have the freedom to accept or reject any medical intervention.  These arguments are framed as pro-freedom positions in an effort to make it difficult for opponents to challenge them.   Who wants to be seen protesting against freedom?   Not surprisingly, and as I have posted previously on this blog, these issues are more complex.   Freedom is not absolute.   That’s why we have...