MD Whistleblower

I have always felt that issues should be judged by the context of their times. For some issues, however, context provides no justification. Thankfully, the field of medical ethics has evolved into a robust discipline, and there is an enormous need for it. I have read defenses of prior ethical lapses, and even some recent ones, suggesting that context matters. If a 3 month placebo-controlled study is conducted in the developing world testing a medicine that was highly effective against a serious illness, are the ethical dimensions considered and respected? Were the pharm companies choosing this study locale as a cheap test run for their drug, which will ultimately be marketed in the west? Is it ethically problematic not to provide additional medications to ill subjects after the 3 month trial ends? Can we be assured that a rigorous informed consent process was followed? Sadly, outrageous practices have been reported in the very recent past. Our president and secretary of state recen

Photo Credit In response to my recent post where I averred that the cigarette companies were treated as scapegoats, I have had several cyber and actual conversations about personal responsibility. I believe that folks should realize the consequences and the benefits of freely made decisions. While we want American society to be compassionate, we do not want to punish success and reward failure. Our goal is to do all that we can to maximize everyone’s success. We should be ready to assist those who need and deserve our private and governmental assistance, but personal effort and responsibility are necessary elements of these interventions. In our gastrroenterology practice, when we see patients who are in financial difficulty, my physician partners and staff will do all that we can to help them. While it is not our policy to do colonoscopies for free, we will make whatever adjustments that are necessary to make sure that the patient receives necessary medical care. However, when pa

Several posts on this blog have been devoted to tort reform . More than any other subject, this topic generates more heat than light. Indeed, I describe these debates and commnets on this blog and elsewhere as duels, not discussions.  Many folks on various sides of this issue earnestly believe that they have the better argument. Other viewpoints are not purely held and are clearly contaminated by self-interest. I have written repeatedly that I believe that the current system is unfair and does not serve the public well. The public understands the issues and the controversies. In general, I don’t think most Americans believe that we have too few lawyers or lawsuits in this country. It is astonishing that people can defend a medical liability system that           Misses the vast majority of patients injured by medical negligence           Ensnares many more innocent physicians than negligent ones. Shouldn’t these two inarguable facts be sufficient to demand at least an examinat

Smokers of the world unite! It’s strange for a physician to be sympathizing with the tobacco companies, purveyors of the opium of the people. Am I a stealth nicotine addict, an apologist for Big Tobacco who supplies me with my daily fix? This scurrilous allegation can be vaporized in a one-question quiz. Identify which two of the three individuals listed below are cigarette smokers. John Boehner, newly elected Speaker of the House , 3rd in line to the presidency Barack Obama, Commander-in-Chief and leader of the free world Michael Kirsch, Hemorrhoid examiner I’ve never smoked and I detest the habit. It kills people and separates lower income Americans from money that could likely be devoted to more worthwhile endeavors. I remember caring for folks with end stage emphysema as a medical resident and thinking that this disease was worse than cancer. I haven’t changed my mind. Yet, I have felt for years that Big Tobacco is demonized by the press and the government as Big Scapegoa

Thank you, Obamacare. The GOP, demoralized and frustrated, as they endured the Obama liberal juggernaut that trampled across the country these past 2 years, has been resuscitated. It’s more fun to be in the majority, as Nancy Pelosi can recall. Democratic hubris and rising public disapproval provided not just a strong wind, but a tornado, behind the GOP’s backs. Obviously, there’s nothing revolutionary here, as midterm elections tend to favor the minority, with rare exceptions. What is noteworthy here is the depth of disapproval with the current administration’s policies, affecting every demographic. The gains that the Republicans achieved, particularly in the House, have left Democrats numb and glum. Whistleblower readers will not be shocked to learn that I did not vote for Obama in 2008, but I was inspired by him. I wanted to believe that he would be the transformational figure that his campaign promised and that the country desperately needed. In particular, I was moved by his s

I still marvel at the accomplishments of CAT scans and imaging studies.   These technologies have revolutionized the medical profession.   Imagine foretelling 50 years ago that a new technology would emerge that could perform ‘exploratory surgery’ without an incision.    This prediction would be greeted with disbelief, if not scoffing.   Of course, there would be similar reactions if decades ago other technological feats, such as fax machines, personal computers, emails and internet, were predicted. CAT scans save patients’ lives, prevent surgeries, make accurate diagnoses and refine treatment plans.   This is the good news.   However, as expressed repeatedly on this blog, there is a darker side of the story. Without doubt, too many CAT scans are performed. Accumulated medical radiation has health consequences. Resources expended on unnecessary CAT scans could be devoted to worthy health care endeavors Radiologists suffer from litigophobia and identify every tiny abnormality, whic