Skip to main content

Posts

Upgrading the Electronic Medical Record!

After 30 years or so, there is still much joy for me in the practice of medicine.   Electronic medical record (EMR) systems doesn’t make the list.   Chances are that if you asked your own doctor to assemble a Frustration List, that EMR issues would be among the top five entries.   Over the past 15 or 20 years, I have struggled through several of them.   At one point, I was using 4 distinct systems: 2 different hospital EMR systems, our office practice EMR and our endoscopy center’s software.   Does this sound like fun? Think of all the passwords I kept track of!   There is a recurrent EMR event in every system that brings doctors to our knees.   Here’s the simple phrase that transforms even a stoic doctor into a sweating and trembling practitioner: The EMR system will be upgraded overnight. Let me explain.   One might think that a computer upgrade would be a desirable event. For example, Merriam-Webster’s dictionary definition of upgrade is to replace something with a more us

Colonoscopy in the Elderly. How Old is too Old?

I am frequently asked what is the upper age limit for offering screening colonoscopy.   Patients today are often more informed on certain medical issues than their doctors are.   I support their empowerment.   Of course, we physicians, as actual medical professionals, presumably have more credibility in opining on the practice of medicine.   In my own life, I always give great weight to the folks I hire, whether they are tradesmen or professionals.   Why would I not give consideration and deference to one who has years of training and experience?   If I needed an attorney to litigate an issue, would I presume to advise on the optimal trial strategy?   ‘ He who represents himself has a fool for a client.’ Patients can acquire a great deal of medical knowledge, but they are not as easily able to exercise sound medical judgment.   This takes us professionals years to develop.   Consider this weighty maxim:   It takes 10 years to acquire 10 years of experience.     Indeed, I am still t

Whistleblower Holiday Cheer 2022!

  The Dems were all nervous Back in October. The Red Wave was coming! Would their blue reign be over? The tables had turned, After November, This midterm result Will be long remembered.   Deniers fell short, One by one, And the public ensured That democracy won.   With the House barely red, And the Senate still blue, Might we move beyond ‘I win so you lose’?   The last 2 guys standing Were Raphael and Herschel. We were finally spared Their endless commercials.   On his own time, Trump did announce, While a new special counsel Is ready to pounce.   Lurking in waiting, A stealth praying mantis, Eyeing his prey Is Ron DeSantis.   Biden is 80 Is he the Dem’s best shot? If he steps aside, Who else have they got?   Wishing you all, Good health and good cheer, And prayers to enjoy, A much better year.            

Was I Spreading Covid-19 Misinformation?

I presume that most of us are hostile to hate speech, misinformation and disinformation.  Politicians and others want social media to be scrubbed of all nefarious postings.  Twitter is most recently in the crosshairs on this issue after Elon Musk assumed ownership of the company.  They still haven’t settled on a moderation policy.  Social media and other information sources have been accused of radicalizing Americans, fostering hate, undermining our elections, providing a forum for bullies and predators, promoting division and coarsening our national discourse.  One man’s cleansing of disinformation is another man’s censorship. There is some speech that all reasonable people would agree should be banned, such as incitement to violence or prurient matter that children can access.   I challenge those who advocate against publishing hate speech, misinformation or disinformation to offer precise definitions of these categories.   Trust me, this is no easy endeavor.     And if you are

Telemedicine is Here to Stay! The Demise of the Doctor Visit?

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

Deaths From Medical Errors: Hell or Hype?

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