MD Whistleblower

I don’t advise patients to quit smoking. I don’t exhort alcoholics to stop drinking. I don’t preach to my obese clientele to slim down. And I don’t lecture patients to get the COVID-19 vaccine. This may be the point were some readers are wondering, “What kind of doctor are you?” For the record, I do not endorse or advise cigarette smoking, alcohol addiction, obesity or careless behavior during the pandemic.   I favor temperance in my own life.   I exercise.   I am attentive to my BMI. And I wear a mask and have received my COVID-19 injections with enthusiasm. But it has never been my style, either professionally or beyond the office, to tell people what to do.   Once folks reach a certain age, which for many are the teenage years, you just can’t make them do stuff.   Every parent understands this.  This does not mean that I don’t have influence over people who trust me.   I do and I use it.   However, i t’s a process issue.   How best can we help individuals make sound deci

Uncertainty makes everyone anxious, although each of us has a unique threshold for uncertainty tolerance.  In other words, different folks may react quite differently if they are confronted with the same set of facts.  Consider this hypothetical.   Two patients who are of similar age and enjoy excellent health undergo a CAT scan for a stomach ache.   By the time they follow-up with their physicians to review the results, their symptoms have resolved and they feel perfectly well.   A small spot is seen in the liver which the radiologist suspects is an innocent cyst, but he cannot state this definitively.   Each of the patient’s physicians explain that minor accidental findings like this are common and are very unlikely to pose any health threat. Patient #1:   “Ok, doc. I feel great and if you’re not worried, neither am I.” Patient #2:   “Are you sure it couldn’t be serious, like a cancer?   Should I have it cut out just to be safe?” First of all, let me give readers an inside ti

 There’s been lots of talk about lockdowns lately.  This issue, like masks, has become politically contaminated.  It’s been one of the fascinating lessons of the Pandemic of 2020 – the recognition that issues that would seem to be ‘immune’ to political interference became instead potent partisan weapons. Consider two rather distinct reactions to the recommendation to don a mask when frolicking about in public. Citizen #1:   Of course, I will mask up.   This will keep me and others safer.   In a small way, I feel I’m doing my part on the journey to the other side. Citizen #2:   Mask?  Hell no!  Just more encroachment by the government to rule our lives.   Similarly, locking down the economy, both here and abroad, has provoked bitter reactions from all sides. 'No mask for this patriot!' As I have written, I feel awful about the hundreds of thousands of businesses who have closed or are barely hanging on.   I also feel that their plight has not been given the attention

Millions of Americans are working remotely during the pandemic.  Many of them would have never believed that they could perform their jobs away from the office.  I’m one of them.  But we all now acknowledge that the basic structure and function of the workplace has been forever altered. This transformation was inevitable, but the pandemic was a potent catalyst to bring it about at, shall I say, ‘warp speed’? Did we really believe that in a world with remote robotic surgery, driverless cars, personalized genetic medicine, exploration of Mars, Alexa and the explosion of artificial intelligence, that we would continue to commute to brick-and-mortar offices each day?   It was only a matter of time before the physical workplace would be recalibrated.   The disruption has been monumental and to a great extent irrevocable.   While I do believe that there will be some backward adjustment after the pandemic has largely resolved, I do not expect a return to the status quo ante.   Do you think

I am writing this now, prior to the pandemic, from my new favorite coffee shop not far from where I live and work. It’s called Couchland and is located in Wickliffe, Ohio.   As the name suggests, every seat is comfortable.   The large space has several couches and plush armchairs that beckon customers to sink in and stay a while.   This is quite different from many of the other coffee shops I patronize, where upon entering, I scan the room like a seasoned detective to see if any of the few comfortable chairs that are present are still available. Otherwise, I must enjoy the discomfort of a hard wooden chair, a larger version of what I sat on in 3 rd grade.  It’s a cat and mouse game as customers compete for premium seating in an adult version of musical chairs.   And, there are rules of etiquette that at times require adjudication.   For example, is it permissible to plop your backpack on a favorable available seat before standing in line to order? When I stroll into Couchlan

I read recently that Kroger, who runs a grocery store chain, has joined with other retailers in paying employees who receive a COVID-19 vaccination.  The $100 payment should serve as an incentive for employees to roll up their sleeves. There is an ongoing debate whether employers can or should mandate COVID-19 vaccinations for their employees.   The state of play now is that employers are encouraging, but not requiring vaccines, as mandating vaccines creates legal exposure for employers.   For example, if you require that an employee is vaccinated against the worker’s wishes, and a complication occurs, is the employer responsible?   Can an employee be disciplined or terminated for failure to vaccinate if there are no vaccines available within a reasonable distance?   And mandating vaccinations may be complicated when workers are unionized. The right to refuse treatment is a bedrock medical ethical principle that I support.   For example, if I advise an individual with acute appendi

 There are many concepts and activities that we understand, but yet we have difficulty defining.  In 1964, Supreme Court Associate Justice Potter Stewart in an attempt to define pornography and obscenity stated that ‘…I know it when I see it.’    Indeed, this phrase has been embedded in pop culture and is used in circumstances far removed from it’s initial prurient reference. How would one define bipartisanship?   If a bill passes with the votes of 100% of one political party and captures only 1 or 2 votes of the opposition, can the outcome fairly be regarded as bipartisan?   How much support from the other side must exist before the ‘B-word’ can be invoked?   While I don’t have a precise threshold in my mind on this issue,   I don’t think that just a couple of votes is sufficient. Joe Biden was elected in part because of his promise to pursue unity and bipartisanship.   How many times have we all heard about his decades of reaching across the aisle?   He pledged to us during his