MD Whistleblower

Physicians confront alcoholism regularly.    Indeed, nearly every day on my hospital rounds, I treat patients who are suffering the ravages of alcohol abuse.    While these patients may have a genetic predisposition toward alcohol abuse, or faced other personal pressures and demons, ultimately the disease is initiated by a person who made an unfortunate decision.   I do not judge these individuals as their doctor, any more than I do my hepatitis C patients who contracted the virus as a result of intravenous drug use.    But, when are examining the causes of these maladies, personal responsibility and accountability must be considered.   In fact, failure to do so will frustrate our efforts to prevent various injurious addictions.   Physicians and others have heard the vignette when an alcoholic denies his addiction despite that every other person in his life feels otherwise.    “They are all wrong,” he states emphatically. 'I can quit anytime.' There are many ex

I prescribe heartburn medicines every day.    There’s a gaggle of them now – Prilosec, Nexium, Prevacid, Protonix – to name a few.   As far as experts know, their primary effect is to reduce the production of stomach acid.   This is why they are so effective at putting out your heartburn fire.   In simple terms: no acid, no heartburn. I am quite sure that well-meaning physicians like myself do not understand or will ever know all of the unintended effects of tampering with a digestive process that took a few million years or so to evolve.   Are we so arrogant that we believe that these drugs only target gastric acid production?   They are absorbed into the blood stream and course through every organ of the body.   Is it not conceivable that certain tissues might be sensitive to these foreign invaders?   Might there be unintended consequences that occur far downstream well beyond our horizon similar to a butterfly effect.     Do we really think that gastric acid is present just

We are still recovering from the tragedies in Pittsburgh and Chicago.  Fires out west have roared over thousands of homes with more fatalities than have been yet accounted for.   Immigrants streaming toward our southern border in search of a better life are demonized and politicized.  Our nation's allies who have stood with us for a century are now reassessing their faith in our faithfulness.  Our free press, despite its lack of accountability and presence of bias, is under unfair attack.  Harvard's preferential admission policies have become exposed with other universities to follow.  Road rage had become the rage.  Facebook has exploited and deceived us. Truth has become an elastic concept.  Our political opponents are regarded as enemies.  I win if you fail.  The citizenry has deepened its disgust and cynicism.  An errant remark can lead to public vilification and loss of a job or reputation.  We have become an angry populace. What did you discuss at your Thanksgiving

Yesterday, a physician asked my opinion if a patient needed a colonoscopy.  My partner was already on the case and I was covering over the weekend.  The facts suggested that a colonoscopy was warranted.  The patient had a low blood count and had received blood transfusions.  Certainly, a bleeding site in the colon, such as a cancer, might be responsible.  We do colonoscopies to address similar circumstances on a regular basis.  Why did my partner and I demur in this case? We Placed this Sign on the Patient Because to us, our medical judgment trumped the medical facts.  First, the patient was elderly and extremely debilitated.  The challenge of having an individual in her state ingest the necessary laxatives is likely insurmountable.  If any readers have enjoyed the delight of guzzling down a colonoscopy prep, contemplate doing so as an elderly, ailing and bedbound individual. I asked the physician if the patient’s family would consent to surgery if a cancer was found.

I just read of a a jury award in excess of $25 million against an insurance company who denied a recommended cancer treatment to a patient who ultimately died.   I do not wish to review here the particulars of this case, and admit that my knowledge is limited by one news report that I read earlier today.   While I will not invoke the ubiquitous phrase FAKE NEWS, I always bring some measure of skepticism to various news sources, even those who enjoy excellent reputations.   The Olde Town Crier Always Told the Truth But this jury case raises an issue that physicians and patients wrestle with regularly. The physician prescribes a medication or recommends a treatment. The insurance company denies coverage for the recommendation. Sometimes, the reason for the denial is entirely reasonable.   For example, if an insurance policy restricts a patient to a network of physicians, the company will deny coverage if the patient wants to seek care out of the network.   It

The lights went out in Pittsburgh 8 days ago.    The shade from this moral eclipse reached far beyond the Pennsylvania border and, indeed, extended throughout the nation and onto foreign lands.   I know Squirrel Hill well, having performed medical training in Pittsburgh a few decades ago.   I’ve been to the Tree of Life synagogue in the prior era when none of us were afraid to engage in the routine activities of life.   I am saddened and horrified to witness yet another momentary triumph of evil.   I wondered how it is possible that a person who was born pure could over time morph into a seething cauldron of hate, completely unmoored from the moral guideposts that keep us civilized.    The man who stormed the innocents, wounded by selfless law enforcement professionals, was taken to the hospital to receive medical care.   Yes, we cared for his health and his life, despite that he massacred others who were in synagogue to pray and to celebrate a new life that had recently come