"I can’t stand the site of blood!" We’ve all heard that adage. Blood can provoke emotional reactions from even steely muscle-bound bodybuilders. We gastroenterologists routinely receive fearful phone calls from patients who have observed even minor rectal bleeding. Fortunately, in most of these cases, there is a benign explanation for the sanguinary seepage. If blood repels you, then gastroenterology should not be on your short, or even long list of professions under ...

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Eons ago, there was a television show where a non-human character would yell out, "Warning, warning," when he sensed imminent danger. The series was called Lost in Space where we were entertained by a set of quirky characters on a cheesy set. We loved that stuff. It’s hard to imagine today’s millennials and younger folks being transfixed, as we were, with the deep television dramas of our day. Who could ...

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A few weeks ago, I saw a patient some gastro issues. So far, nothing newsworthy here since I am a gastroenterologist. I ordered a CT scan colonography, a special CT scan that is designed to view the colon in detail. It’s the CT scan version of a colonoscopy. Why didn’t I simply perform a colonoscopy, which, unlike a CT scan, would contribute to my retirement fund? That’s an easy one. ...

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I recently opined about a decision by Anthem to deny paying for emergency room (ER) care that it deemed to be non-emergent.  My point was that insurance companies should not be obligated to pay for routine, non-emergent care, recognizing that we need a fair and reasonable method to define a medical emergency.   In my view, payment should not be denied to a patient who reasonably believes he needs ER care, even ...

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We live in an era of demonization.  Political adversaries are not opponents; they are villains.  Commentary that contrasts with our views is labeled"fake news."   Presumption of innocence?  R.I.P.  Civil discourse has become a quaint memory.  Why would one debate respectfully when today’s tactic is to talk over and demean your adversary? On the morning that I prepared this post, I read an article reporting that one of Ohio’s largest insurance companies, Anthem, is denying payment for non-emergency ...

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Many of my readers do not know who Barry Goldwater was, let alone of the Goldwater Rule established by the American Psychiatric Association in 1973.  The rule advises against psychiatrists commenting on the mental health of public figures they have not examined.   Obviously, a psychiatrist or any physician who has treated a public figure is prohibited to offer any public comment unless he has been authorized by the patient to ...

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It used to be that doctors knew best. We told you what to do, and you obediently complied. The world has changed, and the paternalistic system of yore has given way to the shared decision model where patient autonomy is respected. The old way: “Well, I’ll be setting you up for surgery soon.” The new and improved way: “Let’s discuss all of the reasonable options with their respective advantages and drawbacks. Then, ...

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The computerized era has introduced all of us to a genre of errors that never existed during the archaic pen and paper era.   The paper medical chart I used during most of my career never "crashed."  Now, when our electronic medical records (EMR) freezes, malfunctions, or simply goes on strike, our office is paralyzed.  Although I appear to the patients as a breathing and willing medical practitioner, I might as ...

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There's a common affliction that's rampant in my practice, but it's not a gastrointestinal condition. It's called polypharmacy, and it refers to patients who are receiving a pile of prescription and other medications. I see this daily in the office and in the hospital. It's common enough to see patients who are receiving 10 or more medications, usually from 3 or 4 medical specialists. Of course, every doctor feels that he ...

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To accomplish certain tasks, we need a little help from our friends. No one can do it all, although many of us are more resourceful than others. Some folks are adventurous and dive into a new arena with excitement. They may be tinkerers who aren’t afraid to play with new gadgets. Sure, they might break some china, but they are apt to widen their skill set and enrich their lives. ...

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