MD Whistleblower

Medical students, please read no further. I am going to challenge one of the bedrock beliefs in medical training – the value of the physical examination.   Indeed, I was taught of the primacy of the physical exam as a young pup during my 4 years of medical education in New York City.   I believed it and did my best to acquire these skills from master diagnosticians.   Indeed, this was one of the thrills of being a medical student – learning what those clicks and clacks meant when we listened to hearts with our stethoscopes, seeing changes of diabetes and other diseases when we peered into your eyes with an ophthalmoscope or palpating a pulsating aneurysm that was lurking in your abdomen. An Ophthalmoscope and Otoscope The Eyes and Ears of Medicine I was in awe of these seasoned physicians who could make a diagnosis just by watching a patient walk across the room. While I still think the physical examination is useful, I have found over the years that it is less valuab

It is easy to opine on issues that don’t personally affect us.  We’ve all seen folks on television or in our own lives who righteously stake out positions when they are far beyond the reach of their effects.  Conversely, we’ve seen the irony and the hypocrisy of individuals who ‘evolve’ almost instantly when a controversial issue becomes relevant to their personal circumstances.  Senator Rob Portman of my state of Ohio, for example, was against same sex marriage until he wasn’t.  Readers are encouraged to look up what led to a reversal in Senator Portman’s view. Charles Darwin didn't realize that politicians can evolve. The pandemic has also exposed much public (and private) pontification from individuals, businesses, organizations, government agencies – all of whom may have agendas that extend beyond any actual public health concerns.   One issue that has created raw fissures among us is the concept of mandating vaccines.   There are spirited arguments on various sides of this i

  This has been a tough year for America and the world.  For many folks and families, it may be challenging to find reasons to feel thankful.  But we must try.  When you’re in a dark room, you might not see a way to let the light in.  Try to find a window that you can crack open.  Or, one of us will do our best to open it from the outside. Wishing blessings, contentment and peace to all. Hoping for a lot more light in the year to come.

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

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

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