MD Whistleblower

Even the most honest among us do not tell the truth all of the time.  We are flawed human beings.  We covet, we gossip, we steal, we lie and we stand idly by. You don’t think you steal?   Have you ever ‘borrowed’ someone else’s idea and represented it as your own? A few weeks before I penned this, I was presented with 2 opportunities to lie in order to save a patients a few bucks. The first patient wanted a refill for her heartburn medicine, which she takes once daily.  She asked if I would refill the medicine to take twice daily, so she could get double the supply for the same price.  The second patient asked me to write a note that he was at risk for Hepatitis B so that he could get the vaccine for free.   Writing the note would be easy, but claiming that he faced risk of Hepatitis B infection would require some prevarication.  I’ll assume that Whistleblower readers know how I responded to the above two issues.   However, many patients, and perhaps some physicians, who are

Medical marijuana is a smokin’ hot issue in Ohio.  Marijuana enthusiasts targeted our state constitution again this year with another amendment attempt, which failed.  Instead, our legislature passed House Bill 523, which will legalize medical marijuana use.  As a physician, with some training and experience in prescribing medicines to patients, these marijuana machinations are medical madness.  Is this how we want to bring new medicines to market? I think it is absurd that a specific medical treatment – or any medical treatment - should become a constitutional issue.  Do we want to establish a constitutional right to a specific medicine? Why stop at marijuana?  Why not start circulating petitions for constitutional amendments for screening colonoscopies, mammographies and MRI’s for back pain?  Patients with chronic lumbar disk issues have rights too!  The Ohio bill specifies an array of medical conditions that could be treated with marijuana, including AIDS, hepatitis C, i

Would you have elective surgery in the nearby major teaching institution on July 4 th ? Why not, you wonder? Prowling around the hospital wards every July are the fresh faced interns wearing starched white coats, with stethoscopes draped across their shoulders, with pockets stuffed with reflex hammers, K-Y jelly, and various cheat sheets to rescue ailing patients. These guys know nothing.  How do I know this?  I was one of them.  Luckily, I knew that I was clueless and never pretended that I could treat athlete’s foot or even a splinter. Imagine you are in a hospital bed in early summer complaining of chest discomfort.  Your nurse summons the intern who speeds into your room peppering you with questions.  Before you finish your answer to a question, another question erupts.  This physician is barely out of his shrink wrap and is understandably anxious that he is witnessing an impending cardiac catastrophe.   With his spanking new stethoscope, he establishes that there is a

Readers are not aware of my personal view on abortion, and they won’t be after this post.  While abortion seems on its face to be a complex biomedical issue, interestingly, those with firm views on either side do not describe it as a great moral quandary.  Those who ardently favor abortion rights, and those who oppose them in equal measure, often express that this is not a controversial issue.  For them, it is a clear issue of right and wrong, with each believing that the other side is entirely wrong and misguided.  This observation applies best to those who are toward the poles of the abortion question.  If you believe that an embryo and a fetus are human beings, than abortion is murder.  Not much room for debate here.  If you do not confer personhood on an embryo and a fetus, then a right to abortion is a woman’s right to freedom and autonomy.  Clear cut argument here also .  Of course, many thoughtful individual wrestle with this issue and do not grasp it in the black and white

”I am apt to believe that it will be celebrated, by succeeding Generations, as the great anniversary Festival. It ought to be commemorated, as the Day of Deliverance by solemn Acts of Devotion to God Almighty. It ought to be solemnized with Pomp and Parade, with   Shews , Games, Sports, Guns, Bells, Bonfires and Illuminations from one End of this Continent to the other from this Time forward forever more.” Who authored the above? Hint: His signature demonstrates excellent penmanship!

Medical ethical issues confront physicians daily.  Most of us contemplate ponderous ethical dilemmas, such as end-of-life care care, allocation of the limited supply of organs for transplant or our unequal access to health care.  Many ethical decision points are rather quotidian, not situations that would serve as content for bioethical conferences. Here are some examples of everyday ethical issues that physicians deal with. A patient asks his doctor to support a claim for disability that is not warranted. A patient asks his gastroenterologist to change his constipation diagnosis after the fact so that his colonoscopy is covered more fully by the insurance company.  An employee in a doctor’s office, whose own doctor is booked solid, requests an antibiotic prescription for a urinary tract infection from her physician boss. A physician falsely claims to an insurance company that he has tried certain medicines on a patient in order to gain approval of a desired medication. A

The value of anything becomes apparent when it is taken away from you.  Nothing profound here about one of life’s central truths.  It is an ongoing challenge not to take life’s gifts for granted.  I have never known hunger or lived without shelter. I have never been unemployed or suffered a serious illness. I pay my bills.  I have 5 children who enjoy excellent health and are forging pathways toward their dreams.  I love the people I work with.  I have found new love in the 6 th decade of life.  And, I have ice cream every day of my life. It would be shameful to have been bestowed so much and then to complain about some of life’s trivialities.  But, I am human. The Mother of All Gifts Consider the following list of events.  Has any of them ever dampened your mood, made you angry or resulted in an outburst of coarse language?  You find yourself in a traffic jam which delays your arrival to a meeting by 20 minutes. Your lengthy and detailed e-mail to a client suddenl