MD Whistleblower

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. In the olden days, purchased products were accompanied by instruction manuals. I realize that this anachronistic item will be unknown to today’s technophiles who direct Alexa to turn up the heat or play Sinatra songs during dinner.  Permit me, as a courtesy to them, to offer a working definition. Instruction Manual:    A printed document that explains how to operate and maintain the new item.   I realize this sounds quaint to the Gen XYZ crowd, but we antiquarians relied upon these instructions regularly.   Yes, there was overkill.   We likely didn’t need to be advised that to make toast, we should simply slide a slice of bread into either of the two designa...

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. In the olden days, physicians practiced in a paternalistic fashion, simply informing patients of the next steps to be taken.   This anachronistic practice falls well beyond today’s professional boundaries, although several decades ago, this was the norm.   And the public did not object.   They came to their doctors for advice and, in general, they accepted the recommendations that were offered.   Both sides of the relationship believed that the system was functioning well.   There was no preoccupation with autonomy or with shared decision making, the process whereby physicians and patients today collaborate as they tease through various options. While I conform t...

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. When a medical misadventure or new symptoms develop, physicians will often consider if the event is a side effect of a medication.  This can be very difficult to establish.  For example, if a patient is given medication to treat colitis and the diarrhea worsens, is this a side effect of the medicine or a worsening of the colitis?   Physicians face these dilemmas all the time.   If a patient develops a symptom, and a side effect is being considered as an explanation, the doctor either knows or researches if there is medical evidence supporting a side effect event in this specific circumstance.   If a patient develops headaches after a new medicine is prescrib...

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. I believe that health care is a human right.  This does not mean that every person must have precisely the same level of health care coverage.  This is not how our society works.  Wealthy individuals can afford higher-level medical care, just as they enjoy higher-level housing, vacations, legal and financial advice, education, automobiles, and clothing.  This list could be longer, of course.  But every American, in my view, is entitled to decent medical care to prevent and treat disease. We have millions of individuals in the country who are not citizens, many of whom have no medical insurance.  In a perfect world, I would like them to have access to medical c...

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. The medical profession in this country delivers excellent care in this country, although the quality is uneven.  Sadly and unfairly, the quality of medical care often depends upon one’s zip code.  Many Americans are underinsured and there are still many folks – including working people – who do not have medical insurance.   As I feel that health care is a right, employment should not be a prerequisite for insurance eligibility.  One should not be forced to remain at a job from fear of losing medical benefits. Racial disparities in medicine have been well documented.  And while medical professionals are plentiful in urban areas, residents who liv...

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. One of the gripes I hear from patients with some regularity is that they are not thrilled with their current physician.  How do I know this?  No, I’m not a mind reader.   I query every patient on our first meeting if they are pleased with their primary care professional (PCP).  Surprisingly, many offer lackluster or even negative commentary on their PCPs whom they have been seeing for years.  Why would patients who are unsatisfied not seek care elsewhere?  Puzzling! Typical complaints include waiting times in the office, rushed appointments, missed diagnoses, unreturned phone calls or portal messages, refusal to order diagnostic tests and tepid bedside ...

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. I see many patients referred to me after an emergency room (ER) visit for abdominal pain. ER medical professionals are generally very thorough in evaluating these patients.   These doctors see more patients with acute abdominal pain than gastroenterologists do, since patients with severe stomach pain often proceed to the ER as they are ill and understandably seek urgent attention.    In contrast, gastroenterology specialists see more chronic abdominal pain than do other medical specialists.   Many of t hese patients have had stomach distress for years and we gastroenterologists do our best to help them manage with their condition. Many patients who are evaluated in ...