shutterstock_173882891 Patients are entitled to receive medical advice 24 hours a day. If you call your doctor at 3 a.m., you will reach a physician who will advise you. Of course, it may not be your own personal physician as this individual cannot be expected to be available 365 days a year until he retires. Physicians partner with colleagues who share on-call responsibility ...

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Every week, I am asked by patients if their heartburn medicine causes osteoporosis. The most effective heartburn medicines are called proton pump inhibitors, or PPIs. If you watch more than an hour of TV per week, then you have seen ads for some of them. Nexium, Prilosec, and Protonix are three examples of these medicines. Many of them are now available over-the-counter at reduced dosages. Patients today are incredibly informed, and sometimes ...

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shutterstock_228969187 Racism and prejudice are endemic in America. Many of us reflexively answer, No, if we are asked if we are prejudiced. I don’t. I say yes. While I do my best to give everyone a fair shake, I grew up in a white suburban family in the latter decades of the last century. My friends, my parent’s friends and all those we ...

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shutterstock_93662965 I was asked to consult on a 43-year old female with abnormal liver blood test results.  It took but a few minutes to determine that she was an alcoholic, which was the likely explanation for her abnormal blood results.  She drank several beers daily over several years. My diagnosis was alcoholism, but did the patient concur? “Do you feel that you are drinking ...

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shutterstock_155822504 Readers know that I am a conservative practitioner.   I rail against overdiagnosis and overtreatment.  Less medicine results in more healing and protection.  In an example, I have explained previously why I advise patients not to undergo total body scans, despite the lure that they offer a cancerophobic public. I’ve never undergone a CXR in my life.   I’ve never entered medicine’s tunnel of ...

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While I consider myself to be an ethical practitioner, I am not perfect, and neither is the medical profession. I will present a recurrent ethical dilemma to my fair and balanced readers and await their judgment. Our gastroenterology practice, like all of our competitors, has an open access endoscopy option. This permits a physician to refer a patient to us for a colonoscopy, without the need for an initial office visit. Patients ...

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Practicing physicians like me rely on up scientific medical journals to keep us current on medical developments. We learn about new treatments for old diseases. New diagnostic tests are presented as alternatives to existing methods. Established treatments, which are regarded as dogma, may be shown to be less effective or less safe than originally believed. It’s a confusing intellectual morass to sort among complex and conflicting studies some of which ...

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shutterstock_100776622 Everyone likes to be recognized for a special achievement or accomplishment. Every career has special awards and commendations for everything. While there’s no reward that matches cold hard cash, many of these honorable mentions have no tangible value whatsoever. Pull into a fast food parking lot and you may see a parking space designated with a sign proclaiming, employee of the ...

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Do you think that physicians’ advice should be based on their patients’ best interests? How about lawyers? Plumbers? Financial brokers? An advisor who has what is termed a fiduciary duty is required to use the best interest standard with his client. For example, an attorney is prohibited from recommending that his client proceed to trial, which would be beneficial financially to the lawyer, if the attorney believes that a settlement serves ...

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A female patient came to see me with some difficulty swallowing, a very routine issue for a gastroenterologist.  I performed an scope examination of her esophagus and confronted a huge cancer occupying the lower portion of her esophagus. I expected a benign explanation for her swallowing issue.   She was relatively young and not particularly ill.  She had seen my partner years in the past for a similar complaint, which he ...

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