MD Whistleblower

I have never served in the armed forces, but I have enormous respect for our veterans and for those  who serve now.  My father served for 39 months during World War II.  Fortunately, he was not placed in harm's way.  During that era, nearly every young male served joining together in an existential conflict between good and evil.  This experience bound the entire nation together in a shared purpose with shared sacrifice.   Our nation so desperately needs an experience that will transcend our divisions to unite us as Americans.  Is there a moonshot out there that we could all rally behind?   Is there a leader in sight who can bring us together?  What if we could agree on our country's top 3 goals and then join forces to achieve them? Hey wait, I have an idea.  What if a deadly pandemic swept across the nation that could have the potential of causing over a million fatalities?  Facing this common enemy, we would surely becom...

We all have taken lessons from the pandemic. There were many things we got right, particularly the development and administration of safe and effective vaccines.  There was also much we got wrong including inaccurate and contradictory information from government agencies and keeping kids out of school long after the data supported a return to in person learning.  And while I am not a public health expert, I still wonder about the wisdom of having imposed restrictions and mitigating measures on all of us rather than focus more narrowly on at risk folks.  I realize that this is a controversial issue as there was the fear that low-risk individuals could transmit the virus to a vulnerable recipient.  The mortality and morbidity in elderly infected people were quite different from that of younger and sturdier individuals.  Public health experts argued that we needed a broad brush to protect more people. Coronavirus Caused Illness, Death, Anger and Division Protect...

Sometimes, we read about a study result that is widely publicized, yet we are reluctant to accept its absurd conclusions.   I’m sure there are studies buried somewhere that conclude that seat belts and bicycle helmets are dangerous and that cigarettes prolong life.   If such studies do exist, they would face mountains of contrary scientific evidence.  In other examples, a medical study’s conclusions may be false or misleading because the data are improperly or inadequately interpreted.   Consider this hypothetical study.  One hundred patients with rheumatoid arthritis (RA) patients and 100 control patients are questioned about their exercise habits.  Ten percent of RA patients exercise regularly in comparison to 40% of the control group.   The authors than conclude that exercise might protect against the development of RA.  There are many scientific reasons why this conclusion is erroneous including the probability that RA pat...

For those who can’t stand the sight of blood, I would advise against pursuing a career in gastroenterology.   We confront blood more often and more directly than nearly every other medical practitioner.   One of the most common reasons we are called to see hospitalized patients is to evaluate internal bleeding that originates somewhere within the alimentary canal.   It is then our task to identify the exact site of leakage and to caulk the leak, if possible.   As even a casual TV watcher knows that blood thinning medications are ubiquitous.    In the olden days, there was Coumadin (aka warfarin), which is still in use today.   It is a rather clumsy drug that requires frequent monitoring and dosage adjustments.   At times, and for no apparent reason, a Coumadin user’s blood will become thinner than desired and internal bleeding may result.   More recently, new generations of blood thinners have emerged giving physicians many new ways to th...

While medical careers at all levels are suffering from burnout, this post will focus on nurses, particularly those who work in hospitals.  Ask any of these nurses about the burnout phenomenon and make sure you have an hour or two available to hear a sober soliloquy on the subject. What brought this plague upon them?  Is there an antidote? For nearly my entire career, I rounded daily at local hospitals attending to my patients.  I worked very closely with hospital nursing staff for nearly 3 decades.  They are selfless professionals who give their patients and their colleagues all they have.  Indeed, the public tends to trust them more than they do doctors, and I understand why.  Nurses always have their patients’ backs, but who has theirs?  Are they overworked?  Yes.  Are they underpaid?  Yes.  Do they feel appreciated by their employers?  Take a guess.  The Covid-19 pandemic has introduced a new crisis in hospital nursing ...

Physicians have great responsibility to protect the health of their patients.   But the practice of medicine is a shared responsibility.   Patients – the major stakeholders – obviously have responsibility for their own health.   In my view, they are charged with questioning and understanding the rationale of proposed medical advice.   I do my best to explain my advice clearly.   If there are reasonable alternatives, then I present them.   But if the patient before me remains unclear on the situation, then he needs to ask me to repeat and clarify.    Patients must exercise personal responsibility. If a surgeon enters an exam room and tells you that surgery is scheduled for the following morning, I would hope that you would be fully informed on what operation is planned and why it is necessary.   It sounds absurd that a patient would consent to an unspecified surgery.   "Ready for pot luck surgery tomorrow?" And yet, I reg...

A federal judge in Texas recently issued a ruling that would ban mifepristone by nullifying the Food and Drug Administration’s original approval of this medicine, which occurred 23 years ago. Mifepristone is one of two drugs that are used for medical abortions.  If this decision is ultimately upheld, it would ban this FDA approved drug throughout the country. Ironically, on the very same day, another federal judge in Washington state issued a contradictory ruling that would protect mifepristone’s status as an approved medicine.  An appellate court ruled a few days later that mifepristone's approved status remained valid, although prior restrictions on its use would be resumed.  This past Friday, the Supreme Court gave mifepristone a 5 day reprieve giving time for both sides to submit briefs days from now.   Will the Supreme Court deliver peace in the valley?   Not at all.   We have all painfully learned since the Roe v Wade decision of 1973 that a ...