Almost four years ago now, I left my practice as an emergency medicine physician to enter the business world.  However, the medical world isn’t easy to escape.   I just couldn’t seem to forget some of the problems I used to face in the emergency department.  So, when I had the chance to fix one of them, I took it. The most intractable problem for me was fraud, especially as it related ...

Read more...

Political correctness and sensitivity training are interfering with medicine and healthcare. In a recent article published in the journal, Pediatrics, a group of researchers published their findings regarding parental perceptions of the terminology that doctors use to describe childhood obesity (ages 2 to 18). The researchers found that it was undesirable to use the term "fat," "obese," or "morbidly obese" because they were stigmatizing, blaming, and the least motivating to ...

Read more...

Sonia struggled to express herself through broken English. Her lively facial expressions and exuberance betrayed by her inability to string the words together fluently. One hand gesticulated widely while the other rested gently on the elderly woman's hair. She somehow managed to coo quietly in her companions ear, calming her, as she continued the conversation with me. Sonia's eyes opened and closed in an exaggerated blinking manner as she questioned me ...

Read more...

I have a 5% chance of having a heart attack in the next 10 years.  That’s not so high, but it’s higher than I want it.  Most of that risk is due to my cholesterol and my age.  I can’t do anything about the latter, but the former is under my complete control.  Cholesterol medications can improve my cholesterol significantly.  So can proper diet and exercise.  That’s not true of ...

Read more...

"I’m sorry, Doctor, but we can’t have you give that talk; you have a conflict of interest since you’ve been paid to do research on that medicine." "Well, Senator, it’s a conflict of interest for a doctor to sell those crutches in his office." "It is the opinion of this newspaper that physicians should declare to each patient any ownership interest they might have in a surgery center so that the ...

Read more...

The notion that dying is a right seems nonsensical to argue:  death is given to all of us equally without the need of anyone’s sanction.  The right to die well, on the other hand—well, that’s another matter entirely.  A good death is, in many cases, something our fellow human beings have great power to grant or deny, and is therefore, sadly, a right for which we must indeed fight. The ...

Read more...

Spin Class. For the uninitiated, this involves a dark studio in a gym, rows of stationary bikes, and a pounding beat, heavy on the volume and bass. The instructor out at the front cajoles and drives you through spurts of speed and tests your endurance with simulated mountain climbs. Some instructors are better motivators than others. One, I remember, stretched belief a little in trying to make us feel we were ...

Read more...

"I'm not a doctor, but I play one on TV." It seems that everybody wants either to be a doctor or to play doctor. There are "doctoring" nurse practitioners who some derogatorily call noctors; there are RNs who get a PhD, and are thus Doctors of Philosophy; and then there are those new DNPs, Doctors of Nursing Practice. Of course, there are Doctors of Pharmacy, Doctors of Chiropractic, Doctors of Podiatry, ...

Read more...

Cancer is a dreadful disease. Just dreadful.  Make no mistake: I have tremendous respect for the awesome doctors who treat patients afflicted with it day after day. Still, paradoxically, I can’t help but notice that some of them have just as hard a time as do other doctors with caring for patients at the  end of their lives. I believe a large part of their difficulty stems from the ridiculously ...

Read more...

One of my most vivid memories of medical school was during my internal medicine rotation, when it had become apparent to me that, despite spending my pre-clinical years studying complex pathophysiology and pharmacology, and the fine art of history-taking and the physical exam, the actual clinical work seemed to be more like a numbers game.  I felt like I was always responding to a data point:  a blood pressure reading, ...

Read more...