MD Whistleblower

Okay, readers, how many of you desire to have a feeding tube inserted into your belly one day? Some of you? A few of you? All of you? Not me, that’s for sure. So, if there comes a time when I cannot speak for myself, let this blog post serve as a statement of my philosophy that I do not wish to be subjected to everything that medicine may have to offer. If I am enjoying no meaningful life, and if I am not giving pleasure to others… I placed yet another feeding tube (PEG) in a patient this week. This is often an unsatisfying experience for me as I am not always serving the patient’s interest. Usually, the patient is not capable to express his own views and the decision is properly delegated to the family or to a designated medical power of attorney (POA). In this instance the tube was medically indicated and I reviewed the procedure and the alternatives with the 3 daughters in a conference room. The daughters were uncertain how to proceed. The ladies were clearly vexed. One of them w...

I see many patients with hepatitis C (HCV).  None of them are under treatment and they all feel quite well. Why don't I treat them?  After all, potential consequences of HCV include: Cirrhosis Hepatocellular carcinoma. or liver cancer End stage liver disease with all the trimmings Liver transplantation Death One would think that a portentous list like this would justify any treatment, even hazardous therapies.  But, I've never seen it this way, and my hepatitis C patients are all doing well under periodic observation. Yes, I know that the disease can be serious.  I recall one patient with advanced disease whom I referred for consideration of a liver transplant many years ago.  There may have been a few others along the way who received treatment for the disease also. The vast majority of hepatitis C patients I see in my community practice feel entirely well and the diagnosis is discovered by accident.  In other words, these patients did no...

Volcano - A Metaphor of Evil This past week, I awoke to read a chilling headline in tall black letters that announced that some innocents were shot by an assailant who himself was still a boy. We read these headlines and watch related images every day as the volcanoes of evil around the world never stop spewing out their merciless lava. Why this happens is a question that tests the most erudite theologians, who must try to comfort us and help us to understand what can never be explained. This wanton murder was not a suicide bombing in Baghdad or a Taliban ambush on NATO troops in Afghanistan. This shooting occurred in Chardon, Ohio, a small town less than half an hour from my home. I remember being there a few years ago for their maple syrup festival.  A 17-year-old kid allegedly came to Chardon High School and in a few moments changed the lives of many thousands of innocent people. As I write this, I am still plagued with deep sadness and sharp anger. I c...

Did Washington Chop Down the Cherry Tree? Courtesy of National Archives …resolve to be honest at all events; and if in your own judgment you cannot be an honest lawyer, resolve to be honest without being a lawyer. No need to identify the authorship of the above quotation, which should be known by all discerning readers, such as those who feast on the weekly Whistleblower offering. For those who have suffered a cognitive lapse, I will provide 4 identity clues. Take a guess after each clue. If after the 4th clue, you are still clueless, then politely request a 5th and 6th clue in the comments section, and they will be provided to you. (1) He had a high pitched voice. (2) He was prone to depression and melancholy. (3) He was an ambitious and successful attorney. (4) He was known as ‘the rail-splitter’. Honesty in medicine is a fundamental pillar of our profession. However, physicians and scientific investigators have the same moral failings as the rest of our species. While...

Inauguration Day Presidential election seasons are always exciting times for Americans. Read the newspaper any day for a reminder of how much we take for granted here. Every four years we have the opportunity to hire, rehire and fire a commander-in-chief. Of course, our system is not perfect, and is often downright maddening. But, most of us would not trade our system for another. The presidential election year is especially exciting when you can share it with your kids. I cannot calculate or even recall how many dinnertime discussions we had where all of us would debate the issues and evaluate the candidates. It was great fun to watch the kids engage in the electoral process. While I lean toward the political right, I tried to be a fair (and balanced) moderator during these dinnertime debates. My prediction is that 3 of the 5 will be Democrats, 1 will be a Republican (but doesn’t know it yet) and the 5th kid could go either way. As we know, one’s political affiliations tend to ch...

Leadership is convincing folks to follow a new and uncomfortable path. Folks have to believe that the new direction will ultimately serve their interests, even if it feels awkward and unsettling at first. This works when there exists a foundation of trust between leader and followers. Otherwise, there will be doubt as to the motives of the leader who will be suspected of serving his own parochial interests, and not the greater good.  Consider some examples. If your boss has always been stingy, it may be difficult for him to convince workers that the 'new and improved' health care plan is better for their families. If a presidential candidate receives $400 haircuts, can he convince the hoi polloi that he understands the common man and his travails? If a religious leader is discovered siphoning donations into his private accounts, will folks still call the ‘prayer line’ to offer a tithe? When trust in the leader is squandered, distrust lingers and will frustrate a...