MD Whistleblower

We are not, thank the Almighty, engaged in a civil war.  But it does seem that we are waging a war on civility.  Rage, anger, violence, division, hate and fear have crept into every corner.  Politics is increasingly regarded as a zero sum game.  Compromise and accommodation are considered by many to be signs of weakness.  If I can't get everything I want, then you will get nothing.  Should this be our modus operandi? And the country is in pain.  We are still suffering from the aftershocks of a horrendous pandemic.  Our kids lost a year of education.  Inflation is roaring ahead with no clear end in sight.  A recession with rising unemployment may be just around the corner.  Folks are scared.   A war in Europe reminds us that democracy is at risk. Political campaigns have taken on a coarse vulgarity that mirrors the erosion of etiquette and decorum at large.  The January 6th hearings, while necessary, are only further dividing a fractured nation.  And as all of this was boiling over,

Many patients are confused by the difference between a screening and a diagnostic colonoscopy.  While the actual procedure is the same, the distinction between the two depends on why the colonoscopy is being done.  While you might think that I am wading into a sea of nonsense and absurdity, I am offering you a glimpse of the rational and reasonable world of medical insurance!  Try to follow along. Here’s a primer. A screening exam means that you have no symptoms or relevant laboratory or x-ray abnormalities that justify a colonoscopy.   Consider this to be a simple check-up for your colon.   You are being screened to determine if you have a hidden abnormality or lesion.   Get it?   A diagnostic exam means that the doctor is investigating an existing or suspected abnormality. A medical condition is under consideration and a colonoscopy is advised to investigate.     For example, if you have bowel symptoms, weight loss, blood in the stool, a personal history of colon polyps

Many issues have clear and obvious solutions.  Consider some illustrative examples.  If a light bulb has burned out, then most of us would agree that popping in a new bulb should be the enlightened response.  If a flower bed is dry, then we reach for a hose.  If our car’s fuel gauge is nearing empty…   I think you get the point here. Here's a slightly more complex scenario.    Let’s say that your car has a rattle.   The mechanic may not know the cause or the solution, at least initially, but we can all agree that there is a specific malfunction that can be remediated with a targeted intervention.   As with the dead light bulb example above, there is a specific, reparable defect present.  Unlike in the automotive world, other disciplines operate with a loose, flexible and proprietary framework.   Consider the financial industry.   One need only read a newspaper’s business section for a week to appreciate the divergence of opinions on financial and investment matters.   Experts c

Stomach Pain and Mind-Body Relationship This is a delicate issue and must be approached by medical professionals with care.  Of course, it is an established fact that psychic distress can be responsible for physical ailments.  Did you ever get a headache after having an argument?  Were you one of those students who experienced diarrhea before final exams? This past week, I saw 3 new patients in my practice with abdominal distress all of whom volunteered that they felt that emotional stress and anxiety were the culprit, or at least a major contributor to their gastro issues.   Obviously, when the patient has this level of insight and expresses it to the physician, it paves the way for a fruitful conversation. But, this is not always the case. When I see new patients with long histories of unexplained abdominal complaints, I do not initially raise the possibility of a psychic connection.   I think this is arrogant and has the potential to communicate the wrong message to the patient,

When a judge hears a case, neither party is 100% correct.  Each litigant may have a meritorious claim, but one of them will be found to have the better argument. If the dispute could be easily and amicably resolved, or one party was clearly wrong, then the matter would be unlikely to have reached a courtroom.  One litigant may be found to be 'more right' than the other Which litigant's right will prevail? Medical ethics has a similar construct.  Rarely, is an issue clearly and easily decided.  For example, with limited financial resources, tough decisions must be made on how to ethically allocate these funds.  Those who will not receive any funds may still have an ethical right to receive them, yet other groups may have a stronger right.  If our society decides that it will not pay for dialysis in moribund individuals, it does not mean that these individuals have no right to this treatment. These complex decisions create winners and losers.  Those who are ru

 After the Civil War, which had more casualties than in any other American conflict, Decoration Day was established to honor the war dead.  Over time, this sacred commemoration transitioned to Memorial Day, which became a federal holiday in 1971.  This day honors all who have fallen in the service of the nation’s armed forces.  Although our debt to them can never be satisfied, we can at least pause and reflect on the inestimable sacrifice that they and their families have offered this nation.   We salute you all. Gettysburg National Cemetery on the 50th Anniversary of the Battle. As we all see at this very moment in eastern Europe, freedom is never guaranteed.   It must be protected and defended from those who fear it and aim to destroy it.   Threats may emerge both from without and within.   It’s easy and understandable that we take our freedoms for granted – the freedom to criticize the government, the right to equal justice under law, the right to peaceably protest, the right