MD Whistleblower

For a few decades, I have assisted tens of thousands of patients in making medical decisions.   While the stakes may be higher in making a medical decision, the process is the same as would be used in making any decision.    Gather the facts.   Weigh the options.   Consider the respective risks and benefits.   If applicable, consider additional issues that may tilt the decision, such as cost, family or professional impact, personal priorities or cultural norms.   Obviously, two individuals may share identical medical facts but decide differently – and both decisions may be sound and correct. Our politicians and government officials should use the same process when faced with a political decision or a vote.   But, they don’t.    Sure, they engage in a risk-benefit analysis, but in a rather twisted manner. Politician contemplating a vote:   “What is the risk to me if I vote for or against?” Same politician contemplating a vote:   “What is the benefit to me if I vote for

I am against all forms of bodily pain, both foreign and domestic.  I wish the world were pain free.  When I am suffering from even a routine headache, I want immediate relief just like everyone else.  The medical approach to pain control has changed dramatically even during my own career.  When I started practicing a few decades ago, the strategy was pain reduction.  We gave narcotics for very few indications such as kidney stones, heart attacks and severe abdominal pain after a surgeon evaluated the patient.  (The reason for this was so the surgeon could obtain an accurate assessment of the patient’s belly before pain medicine masked the findings.)  The new goal is pain elimination which I believe is one factor that has fueled the overconsumption of opioids, although there are other factors present.  I admit that I am opining on this as an individual who is blessed to be pain free.  I do not pretend or suggest that if I were afflicted with a painful condition, that I would not wa

We live in frustrating and angry times here in America.   If you are not aware of this reality, then you are: a newborn a plant or an invertebrate in heaven comatose on a deserted island sans electronic devices or wifi living outside of the Milky Way Peruse the front page of any newspaper or turn on any cable news channel.    You will read and hear about conflicts, outrage, investigations, accusations, threats and denials because this is what we desire and demand.   If we rejected such partisan and inflammatory reportage, the media would modify their content.    I do not accept that the media simply reports what is truly newsworthy; they produce their product to appeal to market forces.  Is Stormy Daniel's news value proportionate to the coverage she has received?   The reason that rags like the National Enquirer are successful is because we read them. Beyond our collective appetite for darker and salacious content, we are also participants in the various tribal

A patient came to see me with lower abdominal pain.  Was she interested in my medical opinion?  Not really.  She was advised to see me by her gynecologist who had advised that the patient undergo a hysterectomy.  Was this physician seeking my medical advice?  Not really.   Was this patient coming to see me as her day was boring and she was bored and needed an activity?  Not really. After the visit with me, was the patient planning to return for further discussion of her medical status?  Not really. So, what was going on here.  What had occurred that day was the result of an insurance company practice that I had thought had been properly interred years ago.  The Insurance Reform Hammer - Locked and Loaded. The woman had pelvic pain and consulted with her gynecologist.  An ultrasound found a lesion within her uterus.  A hysterectomy was advised.  The insurance company directed that a 2 nd opinion be solicited.  A second gynecologist concurred with the first specialist. 

Let's pause for a few moments, amidst the chaos and cacophony of a society tearing at each other, when we shout more than we listen, when we foment more than we forgive and when we hate more than we heal to recall the promise of a nation that was founded with noble ideals as it journeys to form a more perfect union.  The Whistleblower   ”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.” John Adams

Readers know of my hostility toward overdiagnosis and overtreatment.  I maintain that there is probably twice enough money as needed to reform the health care system if unnecessary medical care could be eliminated.  (Yes, I am including colonoscopies in this category!)   The challenge, of course, is that one person’s unnecessary medical care is another person’s income.   One institution that is routinely demonized are medical insurance companies.  They are described as Houses of Greed who put profits ahead of patients by design.  Every physician who is breathing can relate tales of woe describing frustrating obstacles that insurance companies place before us and our patients.  When one of my patients receives a ‘denial of service’ notification, I am always prepared to discuss the patient’s case with a physician at the insurance company, as this provides an opportunity for me to explain the nuances of the case to a colleague.  Take the following quiz now. Which of the follo

I have written previously about the raging opioid epidemic here in Ohio.   Attacking and reversing this tidal wave will require many weapons, resources and time.   Opioid addiction is a crafty and elusive adversary that will be difficult to vanquish.   Our battle plan will have to be nimble and adjusted over time, much as military leaders must do in actual armed conflict. Here in Ohio and elsewhere, physicians must abide by new prescribing restrictions.   Prior to prescribing a controlled pain medicine, doctors are required to check the patients OARRS report on line, which catalogues the patient’s prescription history.   This would alert us if the patient was receiving controlled medicines from various pharmacies that the patient might not disclose to us.   Physicians and the public are encouraged to seek non-narcotic alternatives for pain relief.   If opioids are prescribed for acute pain, there is now a limit on the length of opioid treatment that is permitted.   There are exc