MD Whistleblower

In a  prior post as a teaser, I promised to prove that the medical profession agreed with me that the physical examination is not a critical component of patient care.  In my medical training days, such a remark would have been considered heresy and the sinner would have found himself in a stockade in the public square.   Proof that the physical examination in many cases is superfluous is the explosion of telemedicine.  The volume of these virtual office visits is rising by the month.   If the physical examination was so critical and indispensable, then telemedicine could not operate successfully.  But it is and it threatens to make traditional doctors' offices like mine quaint, if not obsolete.   I anticipate that in the next 10 to 15 years that most patients will be seeing physicians or other medical professionals in digital arenas, not face to face in traditional offices.    By then, I may have gracefully exited the profession, but I will be an avid spectator.    The ce

Doctors make mistakes.  There, I’ve said it.  More than having said it, I wrote it.  This confession has now been memorialized in cyberspace, where no piece of data can ever be truly deleted.  We have all seen how seemingly erased data has been resurrected by forensic experts to the horror and dismay of the eraser wannabees. Doctors work on seriously ill patients.  They do their best to help heal them; or when this is not possible, to comfort them.  Some patients get worse under our care.  Some die.  This sober slice of the human condition impacts deeply on physicians and all health care professionals. I acknowledge that medical errors have worsened patients’ condition or have even contributed or caused their demise, a tragic but unavoidable result of a noble endeavor that is imperfect.  I remind readers that physicians are members of the human species and have all of the flaws and frailties that every other homo sapiens creature possesses.   Every aspect of the profession is

It can be a struggle in a turbulent and violent world to find space to give thanks, but we must try. I hope that we can commit ourselves to making the world better one day at a time accumulating a series of small acts of kindness.  While each individual action may seem insignificant, if enough of us step up, then the world can change.  A rainbow is the effect of millions of drops of water. Perhaps, next year there will be more to be thankful for. Wishing blessings to all.

I’ve never subscribed to the caveat to scrub politics and religion from my discourse.   Indeed, you will find these two subjects riddled throughout this blog.   I think we need more dialogue, not less.   I do agree, however, that dialoguing is a skill.   But it’s not brain surgery.   Any of us can become adept practitioners of this seemingly lost art, if we so desire.   It requires listening with an open mind.   It implies that your view on an issue might be modified in the face of a persuasive argument.   And your responses should respond to what has just been said to you indicating that the other side has been heard. So, now let’s talk some politics.   First, assess your political acumen by answering the following quiz question. Which of the following issues should not be handled by elected officials? (a) Tax policy (b) Zoning ordinances (c) Which chemotherapy regimen should be permitted for breast cancer patients (d) Parks and Recreation issues I realize that this is a

ROI (return on investment) is an investment principle.   If we contemplate an investment – whether money, time or training – we often speculate on what return on our investment we can expect.    What is the ideal ROI?   There is none.   One’s view of a financial ROI depends on the investor’s goals, risk tolerance, financial portfolio and stage of life.    For example, two experienced financial experts might completely disagree on the worth of a particular investment. What if I offered you an investment that costs nearly nothing but promised a huge yield?   Interested?  Am I sounding like a 2 a.m. telemarketer promising to make you rich on some 'no money down' scheme? If you follow my advice, you may surely become enriched, but don’t expect that you would enjoy any financial enhancement.   You can decide if it would be worthwhile to include these ‘investments’ in your life’s portfolio.   Here are some life investments that I think might make our lives better.    I’m ce

I am a parsimonious practitioner.  While I can’t cite statistics, I strongly suspect that I order fewer laboratory studies, prescribe fewer drugs and order fewer diagnostic tests than do my peers.  Medical minimalism has always been my medical world view.  This can feel a bit lonely at times in a profession that is rife with over-diagnosis and over-treatment.  I am not suggesting that my approach is the only reasonable medical approach, only that it’s the style that I’m most comfortable with.  All of us should consider the philosophy of the professionals we engage.   And the professionals need to gauge the goals and risk tolerance of those they serve.   These relationships may need to enter into negotiations from time to time in order to agree on which pathway to pursue. Physicians, judges, law enforcement professionals, teachers and others are not homogenous philosophically.   While folks may (hopefully) agree on the facts, the interpretations may differ. Consider two different

Life can be vexing.   Life is not a math problem that has one indisputable correct answer.   We are constantly weighing options as we make decisions.  How much risk would we tolerate in order to hope to capture a reward?  Does an NBA star go for the three pointer or drive to the rim?  Does a defense attorney put his client on the stand or leave him mute hoping that the prosecution hasn’t met the required burden of proof?   Does a surgeon recommend an operation today or should the patient wait another 24 hours to see if his condition improves without surgery? All of us struggle where to draw the line.   Look at the ongoing debates in the public square regarding national security.   While some government officials deny this, most of us acknowledge that there is a tension between guarding our civil liberties and protecting our security.  Civil libertarians claim that we can do both, but I believe that trimming civil liberties would provide our intelligence community with more tools to