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Calling Your Doctor's Office - Frustration #1

There are joys and satisfactions in the practice of medicine.   Indeed, they have sustained me for the past few decades.   I enjoy the work and I continue to be honored that my long-term patients as well as new ones place their trust in me.   Despite my best efforts to deliver perfect advice to every patient every time, I confess that I am a member of the imperfect human species.   I have reminded patients that while I try to offer sound medical advice, I am neither omniscient nor clairvoyant.    If I knew, for example, that the medicine I am prescribing wouldn’t work, or would cause you an unpleasant side effect, then I would not have prescribed it. If you become a ill a week after you have been discharged from the hospital, it does not mean that you were thrown out prematurely.     Excellent medical judgement doesn’t guarantee an excellent outcome.   Conversely, a favorable medical result may occur after mediocre medical care.   There are also frustrations in the everyday medical

Why I Oppose Medical Marijuana

I don't really oppose medical marijuana, only the process that has brought it to market. In general, I hew to the philosophy of  ‘leaving it to the professionals’.   Yes, I support all of us engaging in some measure of due diligence, but I try to select advisors and professionals whom I trust. If they have knowledge and experience that I lack, shouldn't their views carry more weight than mine? In my own life, and probably yours, there are many areas in which I simply am not capable of any due diligence. If a car mechanic, for example, recommends that an expensive part needs to be replaced, I can only hope that this is truly necessary.   If the folks we deal with are honest and experienced, then things will tend to fall into place as they should.   Obviously, for this to work out well, several assumptions need to be true. Many people today soundly reject the ‘leave it to the professionals’ philosophy.   For most of my life, the curricula in our public schools was dictated by

How to Treat Your Upset Stomach

There is a general fascination with the medical profession.  Consider how many television shows over past decades have had a medical motif.  And today’s patients are so über-informed and empowered, that at times they dabble with the practice of medicine themselves as an avocation.  When a patient, for example queries me about Barrett’s esophagus and dysplasia or if I intend to test them for H. pylori, a germ that resides in the stomach, then I know by their use of medical terminology that the office visit will be a  "peer to peer” experience. So, I’ll ask my erudite reader-practitioners to respond to the following medical inquiry.   A patient is suffering from a chronic upset stomach (called dyspepsia) nearly every day.   The cause of the condition cannot be ascertained, and the treatment options are wanting.   Assume that the medical professional has undertaken an appropriate evaluation and that no cause has been discovered.   Assume as well that there is no established treat

Was the Alec Baldwin Shooting Accidental?

Even casual followers of the news are aware that actor Alec Baldwin killed one associate and wounded another during a film rehearsal.  It was a horrible tragedy that captured the nation’s attention.  How could such a thing happen? This is the same question we ask when we learn that a surgeon has removed the wrong kidney.   I’ll leave aside how much attention this tragedy has received in comparison to the intentional killings that occur daily in cities throughout the country.   While all lives are equal, it does not seem that every life receives the same attention. Based on what is now known, it does not seem to me that this shooting was a mere accident that occurred from pure happenstance.   Of course, the shooting was not intentional, but it appears that there was a reckless disregard of established firearm safety protocols.   Investigators will surely discover how a live bullet ended up in Alec Baldwin’s gun.   More facts are emerging daily that indicate a laxity of gun safety an

Jeopardy Host Sidelined but Still Kept His Job?

When improper actions are followed by proportionate and predictable consequences, it serves as an incentive for us to behave better.  Let’s face it.  We are not hardwired to do the right thing. If we were, then there would be no need for thousands of laws, rules and regulations to guide our behavior.  We need laws against theft, insider trading and assault because we have accepted that our natural human inclinations often lead us astray. And, if we were moral creatures by design, parents, teachers and religious leaders would not have to devote so much effort to teaching us to do the right thing. When a consequence is hollow it threatens our confidence in the integrity of the system.   When a professional athlete has committed assault, the investigations and punishments have seemed to be a very different process than we would expect if an ordinary person, like me, were the accused.   We have all witnessed examples of this over the years. Some time ago, Mike Richards, who was anoin

Will We Be Wearing Face Masks Forever?

I don’t foresee them disappearing from the public landscape anytime soon. I think there will be a segment of the population that will continue to wear masks even after the pandemic has subsided.   Indeed, there are parts of the world where donning a face mask is routine. And as we have all seen, there is a vocal segment of the population that will refuse mask wearing regardless of the circumstances.   For example, sitting governors, with a keen eye for politics, have ordered that no mask mandates can be instituted in their states.   Score 1 for Politics and 0 for Science. Just as our country has not experienced its last hurricane or wildfire, there are other pandemics lurking over the horizon.   So, over time, mask wearing will rise periodically when nature’s germ warfare strikes us again. 'The Mask Stays!' I also suspect that many health care institutions will require their staffs to wear masks long after the public will have been advised that masking is no longer advi

Doctors Spreading COVID-19 Vaccine Misinformation

( As published recently in cleveland.com) Should a physician who spreads misinformation on coronavirus vaccines lose his medical license?  Would this violate the doctor’s right to free speech?  Shouldn’t physicians be able to offer their patients counsel and advice that differs from mainstream medical thought?  Every profession has ethical and legal requirements to maintain the integrity of the profession as well as the public trust. ·       If an attorney lies to a judge, then this lawyer can expect to be severely sanctioned.  ·       If a public-school teacher instructs science students that the world was created exactly as recorded in the Book of Genesis, then professional repercussions are expected. ·       If a police officer is discovered to have planted evidence to justify an arrest, then the officer will likely face criminal penalties. In the medical profession, there are also professional and ethical boundaries that practitioners must respect.  Consider these flagrant violatio