MD Whistleblower

One thing we have all learned about technology is that it cannot be restrained.  With the release of ChatGPT and various competitors, we are aware that an unfathomable technology will disrupt our lives in ways beyond our imagination.  In the coming years 2 nd and 3 rd generation AI will replace its forerunners. My guess is that this technology will dwarf the impact that the internet has had on all of us.  It will be able to create and cure and innovate and communicate and build and teach and protect and even drive your car.   As mentioned, future AI functions and capabilities are beyond the horizon and are out of view. Exciting?   What if your job would be an AI casualty?    It you drive a vehicle for a living, how will you and your family adapt when human drivers are no longer necessary?   Even jobs and occupations that we might believe are beyond AI’s grasp, may be in the crosshairs.   AI’s reach will be boundless.   It’s tentacles will reach through blue collar America and wil

Each work day, I enter the chamber of horrors also known as the electronic medical record (EMR).  I’ve endured several versions of this torture over the years, monstrosities that were designed more to appeal to the needs of billers and coders than physicians. Make sense? I will admit that my current EMR, called Epic, is more physician-friendly than prior competitors, but it remains a formidable adversary.  And it’s not a fair fight.  You might be a great chess player, but odds are that you will not vanquish a computer adversary armed with artificial intelligence. I have a competitive advantage over many other physician contestants in the battle of Man vs Machine.   I can type well and can do so while maintaining eye contact with the patient.   You must think I am a magician or a savant.   While this may be true, the birth of my advanced digital skills started decades ago.   (As an aside, digital competence is essential for gastroenterologists.) During college, I worked as a secretary

‘Twas the night before Christmas And all through the night, Biden's pet puppies Were ready to bite!   The Dems will run Biden GOP will have Trump While most of the nation Want both of them dumped!   Biden's their man. The race is but done, Yet most of his party Don’t want him to run. Biden is fit! His mind is so keen, Part of his charm? His gaffe-making machine!     Trump is in charge. His nomination can’t fail. But will he be running From a federal jail?     The country’s divided Will this be our fate? Who needs peace and love When we’re nourished by hate?   McCarthy was in. McCarthy was out. Santos was in. Now Santos is out!   With a few civil trials, And 91 counts Trump's polling goes up And his legal bills mount.   The best news for Trump That fits well with his style Was the political gift Of criminal trials!   GOP in the House In search of a speaker, Thumbs down on Jim Jordan

A fundamental skill that physicians rely on is calculating risk/benefit analyses when we advise patients.  My use of the word ‘calculating’ is a misnomer as there is no reliable scientific method to quantify risk and benefit.  Indeed, different physicians might ‘calculate’ such an analysis differently.  Similarly, different patients in the same medical circumstances might gauge the potential medical benefit differently.  This is not hard science.  Some folks might feel that a 5% risk of a major complication is acceptable, while others would balk at this statistic.   And on the benefit side, is it worth taking a medication that has some risk with the hope that it might shave 1 day off of a 7 day illness?   Despite that risk/benefit analyses are not easily quantified, physicians and patients must enter into a dialogue on this issue when a treatment or a test is being proposed.   The participants have to do their best to tease through the issues. If a 25-year-old athlete develops ac

Several times each month patients solicit my view on probiotics.   The tens of billions of dollars spent annually by Americans on these agents provides us with overwhelming evidence of an economic truth – marketing works.   Conversely, the evidence that probiotics actually deliver on their health claims ranges between thin and absent.   Why, then, are they so popular? While modern medicine has delivered much for the public, there are so many mysterious and chronic afflictions that remain out of reach.   Patients and physicians struggle over addressing bowel disorders, chronic arthritis, depression, fatigue, memory lapses, allergies, autoimmune diseases, skin rashes, sleep disorders, obesity and many other stubborn conditions.    When conventional medicine fails to deliver, many other treatments of questionable quality emerge.   This is undeniable.   Claiming benefit, however,  should not be sufficient.   Any new treatment should be subjected to the same rigorous vetting process that

Many professions can be easily identified by their uniforms or state of dress. Consider how easy it is for us to identify a policeman, a judge, a baseball player, a housekeeper, a chef, or a soldier.  There must be a reason why so many professions require a uniform.  Presumably, it is to create team spirit among colleagues and to communicate a message to the clientele.  It certainly doesn’t enhance professional performance.  For instance, do we think if a judge ditches the robe and is wearing jeans and a T-shirt, that he or she cannot issue sage rulings?  If members of a baseball team showed up dressed in comfortable street clothes, would they commit more errors or achieve fewer hits?  The medical profession for most of its existence has had its own uniform.   Male doctors donned a shirt and tie and all doctors wore the iconic white coat.   The stated reason was that this created an aura of professionalism that inspired confidence in patients and their families.   Indeed, even today

 I feel it is more challenging than ever to carve away the chaos and destruction so that we can focus on what we should be thankful for.   Yes, there is beauty in the world which we must seek out and cherish.   Yes, there is kindness and generosity in our midst which we must champion and promulgate. Yes, there is dialogue and open mindedness which we must resurrect and cultivate. Skimming national and international current events on any day reinforces the reality that the space to find gratitude is smaller that it used to be.  But it is there. Never doubt that a small group of thoughtful and committed citizens can change the world;  indeed it's the only thing that ever has.    Margaret Mead On this recent Thanksgiving, I hope that all of you had blessings to celebrate.  Perhaps the task will be easier for all of us next year.