MD Whistleblower

Here is a potpourri of medical vignettes.   All are real life scenarios that I have experienced in my practice.  The absurdities of life also permeate the medical profession.  An insider’s view of medicine, as in any profession or industry, may be less sanitized than its public face.  Here are some Scenes from Scopesville, Ohio. Act I, Scene I Patients are routinely told that they should not eat or drink on the day of their colonoscopy.   Recently, a patient decided that these instructions did not prevent him from eating a full breakfast.  This is where the phrase, ‘you prepped for nothing’, applies. A patient comes to see me on the advice of his primary care physician.  He has no idea why he has been sent.  Let the sleuthing begin! A patient asks for a work excuse for the entire week following his colonoscopy. I am asked to fill out disability papers for a patient I saw once a year ago. A patient complains to me and my staff about a $20 copay.  We have nothing to do wit

Health care costs in America are incinerating nearly 20% of the Gross National Product.    Can you say, non-sustainable?    Folks have been bloviating for decades about reforming the health care system with respect to quality, cost and access to care.   This is quite the quagmire.   If it were easily solved, then it would have been done during the Truman administration. He couldn't get it done.   Here are a few reasons why it has been so tough to crack this case. Cutting costs can threaten medical quality. I know of no player in the Medical Industrial Complex who is willing to sacrifice his own revenue to serve the greater good. Pharmaceutical companies receive federal research dollars but are not subject to reasonable governmental control on their opaque pricing schemes. The public expects every conceivable medical benefit, preferably for free. The fee-for-service model drives unnecessary medical care. Pharmacy Benefit Managers – huge middlemen – suck out

I prefer to do business with small, privately owned establishments rather than patronize the big box centers that have pushed smaller stores to the margins or off the grid.  Of course, I do spend money at the large centers for the same reasons that all of us do.  But, I miss the personal attention and interest that a single proprietor and the staff can provide.  South Orange, the small town, or actually village, where I was raised was full of these stores where we bought hardware items, sandwiches, clothing, medicine, shoes and ice cream cones.  I would periodically stop into the bank, with my passbook, to deposit my accumulated cash from my paltry weekly allowance. (As a third grader, I received 10 cents per week.)  When I would pop into to one of these places, the owners knew me and my family, not quite the experience in some retail stores today where one guard has to admit me into the store and another must scan my receipt before I can exit.  Village Hall in South Orange, NJ

So much of life depends upon timing.    Sure, we plan, but we know how much of our life’s events are unplanned and unexpected.   So often, our jobs and our mates – two of our most defining accomplishments – are the result of a chance encounter or a random act.   Life does not reliably proceed in an orderly manner. This is often true in the medical profession.    Here, physicians in our quest to seek out and squelch disease, often discover what would should have been left alone.   For example, is discovering prostate cancer in an older man a true benefit if the tumor would have remained silent throughout the man’s life?   Whenever possible, it is best to ask the question, ‘what will I do with the information?’, before recommending a diagnostic test to a patient.   There is a risk to disturbing the natural order of things. Are we really just shooting dice? Sometimes, medical events occur on their own without any prompting from a physician.   I was contacted by a physician

The nation was transfixed this past Thursday with the sequential testimonies of Christine Blasey Ford and Brett Kavanaugh.   It is rare that a judicial or quasi-judicial proceeding generates this stratospheric level of intensity and interest.   In my recollection, the O.J. Simpson murder trial and the Anita Hill hearing before the Senate Judiciary Committee both reached this level. I watched a good deal of the hearings and read about what I was unable to watch. Personally, I don’t think that minds were changed.     Nearly every U.S. senator’s mind was firmly decided at the moment that the judge was nominated months ago.   Many offered up their strident support or opposition within 24 hours of the announcement of the nomination, if not sooner.    I will let readers decide if such a response is the diligent and fair reaction that a nominee and the country deserve.   To me, it seems that this massive pre-judgement was offered up without necessary fact finding or standard due dil

For many people throughout the world, this past week provided an opportunity to reflect on one’s life and to invest in one’s soul.    While self-examination should be an ongoing task,   the Day of Atonement is a singular opportunity to meditate deeply on this process.   While this day culminates a 10 day period of intense reflection – or so it should – once again, this does not relieve us of our obligation to pursue this task on all other days. Atonement is a tough business and I admit that I am no expert.   Consider how challenging this process is. Personal reflection. Acknowledging personal flaws and transgressions. Approaching those whom we have wronged to make it right. Forgiving those who seek our pardon with grace. Committing not to repeat our offenses if placed in the same circumstance again. Sounds easy?    Hardly.   Changing our traits and actions are very difficult.   Why do you think so many of us have the same list of New Year’s resolutions every year?  

I read about artificial intelligence software that can rival high school juniors armed with #2 pencils.  The program attacked SAT math questions and performed at the level of a typical 11 th grader.  The study was too complex for me to grasp. I guess I should ask an 11th grader for assistance.  Artificial intelligence is well beyond conventional computational exercises. It can ‘think’. Man vs Machine Increasingly, we see functions executed by machines that were formerly performed by living breathing human beings.  Examples range from the mundane to the preternatural.  Order food and drink from an iPad.  No server needed. Driverless auto travel.   This may lead to a resurgence in prayer. Pilotless air travel.  Hard times ahead for the Airline Pilots Association.  Making precision tools – from 3D printers. Gourmet meals created with a voice activated command. Theater and film productions starring faux actors created on keyboards. Will artificial intelligence i