MD Whistleblower

With some regularity, a patient will contact my office and demand a prompt call back. While the patient may be understandably preoccupied with the issue at hand, in most cases there is no medical urgency present.  I take my customer service responsibility seriously.  In fact, with rare exceptions, before the end of every work day, I or my staff have contacted every patient who has reached out to us.  The system works best when all parties are being reasonable and considerate.   Patients have told me over the years of rude treatment they have received from staff as well as medical professionals.   I believe that this does happen and it is inexcusable.   Medical professionals and staff must maintain decorum and high standards even when challenged.   When patients relate these anecdotes, I do not challenge them but I am aware that there may be competing versions of what transpired. Patients also have a responsibility to tend the doctor-patient relatio...

Gastroenterologists see patients for chest pain regularly.  This is because the esophagus is a potential origin of various chest symptoms.  We all know that heartburn and belching, for example, can be manifestations of gastroesophageal reflux disease, or GERD.   But the esophagus is not always the culprit responsible for chest distress! When I am seeing a patient with chest pain, my highest professional obligation is to consider if there might be a cardiac explanation.   If I am at all suspicious, then I will direct the patient to an appropriate practitioner, which may be the primary physician.   Years ago, I sent a patient with chest pain directly to the emergency room.   From there, he was sent for cardiac catheterization when a stent was placed..   Nearly every doctor could relate a similar anecdote. Oftentimes, chest pain patients are sent to me by cardiologists so I can be secure that a cardiac explanation has been excluded,   On oth...

An important part of the human experience is the connections we forge and cultivate with others.  We all have our own universe populated with a cast of characters who play roles in our personal and professional lives.  You might recall the words of a rather well known playwright who began a monologue with, All the world’s a stage, and all the men and women merely players… Familiarity breeds comfort.   Comfort creates satisfaction.   Change triggers anxiety. The three maxims above are not incontrovertible, but they are often true.   Indeed, we have all experienced them throughout our lives. As of this writing, my mother is 90-years-old.   She is managing reasonably well in her own apartment in New Jersey, in the same town where I was first raised over 60 years ago. During one of my recent visits to her, when she was of the tender age of 89, she prepared an amazing and unforgettable surprise for me.   She made me her special meatloaf, the same one ...

 E pluribus unum has been regarded as our national motto since 1776.  This motto has remained the same but I wonder if we have remained true to its meaning. This Latin phrase in English means, out of many, one.   This certainly encapsulated the dream of the Thirteen Colonies who aspired to join together to form one nation.   Coincidence that the motto has 13 letters? This motto appears on the Great Seal of the United States and on our currency.  I just pulled out a $1 bill and verified this.  If you wish confirm this yourself, then I suggest having a magnifying glass in hand! For the purists among you, our official national motto, In God We Trust , was established in 1956 by an act of Congress. It seems that the forces of division in our country have gained strength and momentum, particularly over the past decade.  Our legislature and the populace are sharply polarized.  Politics does not seem to be a forum for a respectful exchange of views...

“I have a food allergy.” “I have a parasite.” “I have ‘leaky gut’.” “I have esophageal spasm.” These are examples of speculative diagnoses offered to me by patients.   It is natural in the era of the internet, with artificial intelligence (AI) looming, that patients will search for explanatory diagnoses for their symptoms. Who knows?    In time, and sooner than we think, AI’s performance may exceed that of human physicians, as well as other human endeavors.   At that time, AI may be preparing my weekly blog posts as it interferes and takes over the rest of my life. I won’t succumb willingly to this omnipresent and overpowering force, but I acknowledge that it will not be a fair fight. Most often, patient offered diagnoses are wrong, even though an internet search seems to have nailed the diagnosis precisely.   I have fever, fatigue, muscle aches, headaches and digestive issues.   Google let me straight to malaria!   How did my doctor miss thi...

I was recently queried on a product called Deplin, which claims to have anti-depressant effects when added to a conventional anti-depressant.   Not surprisingly, as a gastroenterologist, I have never prescribed this, although a psychiatrist I contacted has never prescribed it either. Although a prescription is required, Deplin is not classified as a drug by the Food and Drug Administration (FDA).   It is labeled as a medical food, an important distinction that the public should be aware of. Years ago, a medical food product, EnteraGam, was introduced as a ‘treatment for diarrhea.   This is when I first became acquainted with the medical food designation. Let me offer readers some 'medical food' for thought. The FDA does not assess medical foods as they do for conventional drugs and medical devices.   The prescription drugs that you are taking have passed through years of intense testing under the scrutiny of the FDA, whose approvals means the medicines are bo...

I recall when urgent care offices proliferated and were often housed within pharmacy chains.  This latter arrangement was symbiotic in that the pharmacy provided a convenient venue for patients who then purchased their new prescriptions in the pharmacy.  And a patient entering the pharmacy for a medical visit is likely to make unrelated purchases while strolling the aisles. These sites are generally staffed by nurse practitioners (NPs).   I have worked with these excellent professionals for many years now,.  Beyond urgent care settings, NPs also work in hospitals and many other venues caring for patients with complex medical issues. When the urgent care option came onto the scene, there was stiff pushback from doctors who railed that the quality of care would be below par.   “Nurse practitioners are not doctors,” they warned.     My suspicion then was that doctors had unspoken concerns unrelated to medical quality.   The reason that NP-directe...