MD Whistleblower

Labor Day is a time to pause, reflect and to thank all those who keep this nation vibrant. You are the guts of the country. Labor has battled many adversaries over the decades.  It has sparred with management.  It has railed against 'right to work' legislation.  It has struggled to compete against low wage workers in foreign countries. But this year it has been sucker-punched by the most formidable adversary that has ever entered the arena. And Labor is still reeling.  And, so are the rest of us. An enemy like no other It will be a slow grind, but it will lumber forward.  Yes, we will reach the other side.  How will we get there?  Of course, we will need our medical and scientific community to put the virus in its place.  And everyone will have a role to play.  But, the grit, sweat and determination of Labor will be a major force leading us out of the abyss.

  I have seen many alcoholics during my gastroenterology career.   It is likely in the majority of cases that I was not aware of their abuse history.   Patients often deny or minimize their alcohol history when queried.   “Do you use alcohol regularly?” “Only socially.” At this point the physician and the patient engage in a linguistic tete-a-tete on the precise meaning of ‘socially’. Patients are more forthright about their habits when they have a medical condition that has a clear an obvious connection to alcohol, such as jaundice or liver injury.   And, if family members are present, they often serve as fact checkers and truth tellers. What is my approach to these patients?    Do I wave my arms and preach like an evangelist that they should throw their bottles away?   Do I tell them that they must quit or face medical damnation?  Do I threaten to sever them from my practice if they persist with their addiction?   I have adopted a rather different approach.   I do not advis