MD Whistleblower

 After the Civil War, which had more casualties than in any other American conflict, Decoration Day was established to honor the war dead.  Over time, this sacred commemoration transitioned to Memorial Day, which became a federal holiday in 1971.  This day honors all who have fallen in the service of the nation’s armed forces.  Although our debt to them can never be satisfied, we can at least pause and reflect on the inestimable sacrifice that they and their families have offered this nation.   We salute you all. Gettysburg National Cemetery on the 50th Anniversary of the Battle. As we all see at this very moment in eastern Europe, freedom is never guaranteed.   It must be protected and defended from those who fear it and aim to destroy it.   Threats may emerge both from without and within.   It’s easy and understandable that we take our freedoms for granted – the freedom to criticize the government, the right to equal justice under law...

Would a doctor ever order a diagnostic test that was not medically necessary?  I’ll give you a hint to this ‘yes or no’ question; the answer has 3 letters. Of course, in a perfect medical world, every medication would perform flawlessly with no adverse reactions.   All medical tests would be justifiable and painless.   Physicians’ diagnoses would always be accurate.   Drugs would be affordable.  All patients would recover from whatever ails them. And doctors would never be late for their appointments! Sound like the medical world you know?   I doubt it.   The medical universe that I inhabit is riddled with flaws and imperfections.   It is, after all, a human endeavor which guarantees variable outcomes. Sometimes, the patient just doesn’t get better. So why would doctors like me at times order medical tests that are not necessary?  Wouldn't this violate my professional oath and code of conduct? Years ago, when the plaintiff’s bar was o...

The day before writing this, I had two unusual experiences in the office.  I am not referring to the patient whom I had not seen in years who gifted me yesterday with a full size New York style cheesecake.  I now must decide how I will apportion those 15,000 calories.  Perhaps, if I have 1 teaspoonful a day for a year that my BMI won’t be unduly affected.  The newsworthy events had nothing do with my medical skills.   I did not nail down a rare diagnosis or provide a cure that evaded other practitioners.   In fact, the events that I will highlight below occurred prior to my entering the exam room. When I enter an exam room to greet patients, they are generally engaged in the same activity – they are on their phones.   They are watching videos or playing games.   They are checking their e-mails.   They are pecking at the keyboard as they are issuing forth text messages of monumental importance.   Where did this come from?   How...

Many physicians understandably pride themselves on special skills or knowledge that they have acquired.  This is true of so many professions.  A lawyer is admired for her skill in the trial arena.  A musician is lionized for his virtuosic technique.  An athlete inspires his peers and the rest of us with his record-breaking accomplishments. We have all heard of physicians who are renown for particular talents.    You need an operation on the pancreas?   Here’s the guy you should see.   Your Crohn’s disease is not responding? You should see my specialist who saved me from surgery! Your fibromyalgia is on fire?   Have you heard of this new doctor in town who runs a fibromyalgia clinic?   Obviously, a physician’s skill set is a critical asset in the practice of medicine.   Indeed, when a patient sees me, he comes with the belief that I have the training and experience to address his concerns. Usually I do, but not always.   It ...

My last blog post contrasted the experience of being an employed physician with being a private practice doctor. I expressed that at this stage of my career that I much preferred being employed to running a medical practice. (This means that I can now spend all of my time just being a doctor!) But there are desirable features of private practice medicine that simply do not exist in the medical megalopolis where I now work. Not surprisingly, the vibe is different in a gargantuan organization that employs tens of thousands of caregivers, staff and support personnel who serve millions of patients domestically and overseas.  It is simply not possible to recreate the intimacy that I enjoyed in my prior small practice with my patients and my own staff.   Here’s an example that will illustrate my point effectively. Here's how I found my doctor! For as long as I’ve been practicing medicine, I’ve queried every new patient who came to see on how they ended up with me.   Yes, th...

In my illustrious (or at least long) career, I have had 3 jobs.   After I finished all of my training, I was an employed physician for nearly 10 years.   Afterwards, I joined a small private practice group where I remained for 20 years.   Over time, as partners in the practice left or retired, I became the practice’s president by default.   I don’t really have an authority persona, which my staff was well aware and hopefully appreciated.   In nearly all cases when a decision could either favor the interests of our employees or the practice, I favored our staff. This earned a huge measure of staff loyalty, but no achievement award from the Chamber of Commerce. I am more than content to be regarded as a caring boss than a shrewd businessman.   Three years ago, I joined a rather large Cleveland medical enterprise where I now serve as a physician employee. Employment                         Indepe...

One of the most vexing issues for patients and their doctors is dealing with unexplained abdominal pain.  Indeed, over the course of my career, I have treated thousands of these patients.  Every day, one or two of them are on my office schedule. Many of them have had abdominal distress for decades.   Many have had several visits to emergency rooms and have seen multiple gastroenterologists and other doctors over the years.   Diagnostic tests are done and often repeated in the ongoing quest to find an explanation.   When I review a patient’s entire medical record, I am often astonished to learn how many CAT scans have been repeated to evaluate the same pain. These patients understandably are operating under the notion that the medical profession should be able to explain the cause of their pain. This is the primary reason that these individuals seek care.   This is, after all, the job of a doctor.   In addition, they also want decent pain control so...