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Should Doctors Apologize to Patients?

I had thought that apologizing was a straightforward act, but I now realize that it is a nuanced art form.  We’ve all heard the ‘mistakes were made’ version, usually issued by politicians who attempt to insert a layer of passive voice insulation between themselves and their screw ups.  There is also the ever present conditional apology which by definition falls short of complete responsibility acceptance.  The template here is: “I’m sorry for my oversight which wouldn’t have happened if….” The Gettysburg Address - Silly Remarks? There have been several apologies in the news recently.  First President Obama offered a faux mea culpa with regard to his indisputable and repeated ‘misrepresentations’ on his broken promise that we could all keep our own doctors and health insurance plans.  Here’s what he said on November 7 th . “I am sorry that they are finding themselves in this situation based on assurance they got from me.” Finding themselves ?  Really?  I grade this as

Medical Overtreatment: Why Doctors Like to Slay Dragons

Saint George slaying the dragon. Bernat Mortorell, 15th century I’m sending a patient downtown to see a pancreatic expert.   He’s a young man who didn’t fully appreciate the health risks of a former alcohol addiction.  He’s been sober for well over a year, but alcohol toxicity can be unforgiving and permanent.   We don’t fully understand why some alcoholics develop cirrhosis and other complications while others seem to skate by without a scratch.  While I want folks who have the strength to conquer addictions to regain lost health and opportunities, many life choices lead to irreversible consequences.   Life is often an unfair mystery.  We witness this in medicine often.  Some smokers live well into their 80s, while others become tethered to oxygen tanks or contract cancer.   Trim athletes who eat seaweed salads seasoned with probiotics keel over while obese Whopper-swallowers wallow their way into old age.  My guy has chronic pancreatitis, a known consequence of alcohol ab

Why Won't President Obama Tell us the Truth about Keeping our Doctors?

Morality, truthfulness and personal integrity do not command the currency that they should or used to.  Truman’s phrase, ‘the buck stops here’ is of historical interest only.  Consider authors and journalists who admit to plagiarizing and then go on to resume their careers.  Resourceful students use modern technology to cheat on standardized tests.  Our government refuses to classify a military replacement of a government in Egypt as a coup d’etat.  Teachers strike for more money claiming that their only interest is their precious students.  Politicians deny that campaign contributions will confer any special influence by the donors. A parade of overachieving athletes over the years denies they have ingested any banned substances.  Our intelligence services are not spying on Americans.  Physicians order diagnostic tests claiming they are only for medical reasons. Sometimes, the dishonesty is stealth while on other occasions it is transparent.  I suggest that the phrase ‘it h

Has Your Health Insurance Policy Been Cancelled? Who Knew?

I feel bad for Jay Carney, the president’s spokesman.  Each day, he faces the Washington Press Corps -piranhas on the hunt – and he must dodge and obfuscate.  I am surprised that the velocity of his spinning hasn't resulted in him drilling himself a mile below the earth’s crust.  He is a human spinning tornado. Presumably, this role must be challenging for Carney, who formerly practiced as an actual journalist who was charged with ferreting out the truth.  Now, he is under orders to avoid the truth.  While I do not suggest that he openly prevaricates, withholding the truth qualifies as dishonesty, as I see it. Tornado or Jay Carney? Carney and all politicians leapfrog over the specific questions being asked.  Their non-responsive responses are exasperating to the questioner and to the public.  There are many rhetorical techniques that these professional double talkers use to change the subject.  Let me illustrate with a hypothetical interview. Interviewer:  “If the v

Should Michael Jackson's Doctor Practice Medicine Again?

Before Michael Jackson, most folks didn’t know what propofol was.  Now, patients are asking me for it by name.  It’s an awesome drug.  It provides a beautiful sedation, is extremely safe and rapidly clears after the procedure.  Under its effects, colonoscopy has become a sublime experience.  We administer it in a different manner than Conrad Murray did.  For those who may have just awakened from a 5 year coma, Conrad Murray was Michael Jackson’s personal physician who administered propofol to Jackson in his home to promote sleep.  Murray succeeded and received the modest salary of $150,000 per month for his medical services. Sleep Aid? Administering propofol in a patient’s home without necessary monitoring and training is an egregious breach of standard medical practice.  Those of us who use the drug properly were shocked to learn of this doctor’s reckless and indefensible care.   Here are a few hypothetical examples of similarly negligent care. A surgeon removing yo

Obamacare Health Insurance Exchanges Crash and Burn. Tweaks and Glitches

A few days ago, lawmakers sealed a deal to reopen the government and to relax the debt limit.  This was no O’Henry story with a surprise ending.  This was the outcome that all of us knew was forthcoming.  The GOP not only had no cards to play, but their empty hand was known to all.  It’s very hard to bluff when your cards are face up and you don’t even have a pair of deuces.   Obamacare was the GOP target that quickly became a phantom.  It disappeared.  Afterwards, there was nothing for them to shoot at except each other. GOP vs Dems A perusal of my posts nestled in the Health Care Reform Quality category will demonstrate my skepticism and hostility against Obamacare, which is an interim step toward something even worse.   But, the law was legally enacted, approved by voters in the last general election and was upheld by the U.S. Supreme Court.  That such a monumental program was passed in a unipartisan manner is wrong, but is not illegal.  The roll out of the exchanges ha

Ted Cruz Filibuster Misses the Mark

Even the most casual Whistleblower reader is aware of my hostility toward Obamacare, which appears destined for incremental implementation.  Ted Cruz’s paper mache weapons were no match for the Democrats' artillery brigade.   When the Chamber of Commerce, corporate America and organized labor are all on the same side of this issue, it suggests that healing this forerunner of socialized medicine will take more than a tweak or two to smooth it out.  Cruz Takes Aim There’s nothing unexpected or unfair here.  Romney campaigned hard against Obamacare.  The country had an opportunity to elect him, and declined to do so.   Did we expect that Obama would dismantle his signature legislative first term achievement in his second term?   When Romney lost, Obamacare won. The Affordable Care Act was legally enacted, albeit without a single Republican vote.  The Supreme Court determined that the law was constitutional.  Elections matter.  So, a flawed program, whose ultimate consequenc