Gastroenterology

The shifting landscape of gastroenterology manpower and compensation

Physician
September 21, 2023

The field of gastroenterology in the United States has undergone a significant transformation over the past 5 to 10 years, driven by a confluence of historical changes in training programs, changing demographics among GI doctors due to the relatively new specialty of GI endoscopy, and a dwindling supply of gastroenterologists. These factors have culminated in a notable impact on gastroenterology physician salaries and have raised important questions about the future …

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Diabetes and liver disease: urgent screening needs highlighted by personal tragedy

Conditions
September 5, 2023

The American Diabetes Association recently released screening guidelines for liver disease in individuals with type 2 diabetes. Notably, 70 percent of people with type 2 diabetes have liver disease, and the most common form is non-alcoholic fatty liver disease. Ultimately, this can lead to cirrhosis and cancer. According to the American Cancer Society, the rates of liver cancer have tripled since 1980. Currently, one in 10 Americans has diabetes, …

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Chronic constipation treatment with pulsed irrigation evacuation [PODCAST]

Podcast
July 17, 2023
YouTube video

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In this episode, we delve into the serious consequences of fecal impaction and chronic constipation on patients’ well-being and health care costs. Our guest, Mahesh Moolani, an internal medicine physician and author of Tough Decisions In Care …

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The surprising truth behind virtual visits

Physician
July 14, 2023

We live in an era now when workers have leverage over their employers. Nearly every establishment is struggling to hire employees. It’s mysterious not only why so many folks have chosen not to return to work but also how they are paying their living expenses. Remote work, particularly for younger workers, has become a non-negotiable red line. If you are an employer who expects full-time in-person presence, then good luck …

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Ensuring medication safety: a shocking incident that exposed a dangerous flaw

Meds
June 28, 2023

At six-week intervals, I replenish my supply of omeprazole. Initially, I took it for symptomatic relief of GERD, becoming symptomatic again within a week or two during periodic self-directed suspensions. An esophagogastroduodenoscopy, done for another reason, disclosed Barrett’s esophagus, shifting that daily pill of personal comfort to a more essential intervention. It falls within several Gastroenterology Society recommendations as a component of later malignancy prevention. My weekly pill case, set …

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How one liver disease patient found hope and overcame adversity

Conditions
June 22, 2023

The first day I came to the liver service, I met Mr. S, who was struggling with complications of liver disease. In the long term, he required a TIPS procedure that would better distribute his abdominal pressure and eventually a liver transplant. He was at high risk for the procedure and was struggling to maintain the fluid restriction necessary to prepare him for it.

Mr. S was entirely despondent when I …

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The surprising risks of long-term proton pump inhibitor use

Meds
June 18, 2023

A lot of my patients take proton pump inhibitors (PPIs). They generally work pretty well for their intended use. By limiting the secretion of gastric acid from the stomach, they can effectively blunt uncomfortable symptoms of erosive gastritis, gastroesophageal reflux disease, H. pylori infection, and peptic ulcers. However, without further evaluation, these medications are not designed to be prescribed indefinitely, or for more than a two-month period. When patients experience …

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A unique method for managing chronic bowel conditions, treating fecal impaction, and preparing for colonoscopy procedures

Conditions
May 20, 2023

Fecal impaction and severe chronic constipation can have significant consequences on patients’ mortality, morbidity, psychosocial well-being, and health care costs. It is especially prevalent among the elderly and individuals with neurogenic bowel disorders. The condition can lead to life-threatening complications like bowel obstruction, intestinal perforation, fecal incontinence, and urinary retention.

Traditional treatments for fecal impaction and severe constipation include lifestyle changes, fiber supplementation, laxatives, suppositories, enemas, and digital stimulation. However, …

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How healthism and moralizing health are costing us too much [PODCAST]

Podcast
May 6, 2023
YouTube video

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In this episode, we will be joined by Kristen L. Cole, an assistant professor of communication studies. Kristen shares her personal journey with Crohn’s disease and how the pressure to control her health led her to accumulate …

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Why poor diets are contributing to a surge in colorectal cancer cases among young people

Conditions
April 26, 2023

An alarming trend has emerged in my medical practice in recent years: I’m seeing more and more young adults with colorectal cancer.

When I began practicing as a family physician 21 years ago, I never saw patients in their 40s and 50s with the disease, much less ones in their 30s. Now, I diagnose two to three people in those age groups every year.

On the heels of National Colorectal Cancer Awareness …

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Why skipping your colonoscopy could be a deadly mistake

Conditions
January 31, 2023

I have to respond to and correct the recent article and podcast about a doctor having his first colonoscopy in his late 60s without anesthesia. There were multiple factual errors and misstatements by the doctor author, which may well dissuade doctors and laypeople from colonoscopies in the future.

First, he notes the reason he’s thus far not had a colonoscopy: he has no family history, and he’s athletic and overall …

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A physician’s remedy for stress, anxiety, depression, and burnout [PODCAST]

Podcast
November 28, 2022
YouTube video

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“My own burnout episode forced me into some heavy-duty soul-searching and serious reflection. I got lost in the world of seeing as many patients as possible, battling for more operating room time, and keeping up procedure volumes, …

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How the mind-gut connection affects total health

Conditions
October 7, 2022

As a colorectal surgeon, I address complex intestinal issues with state-of-the-art interventions. Fortunately for most people, the key to a healthy digestive system isn’t that complicated. A proper diet, regular exercise, and stress reduction all help create a healthier and happier gut.

The “mind-gut connection” influences how you think and feel. Imagine a marathon runner nervous at the start of a race who runs to the bathroom first. Or how a …

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I’m a doctor who just had his first colonoscopy in my 60s — without anesthesia

Conditions
September 23, 2022

Well, I am that family physician and geriatrician who is now almost 70 years old. And I cannot believe it because, in some ways, I am still like 27 years old!

First of all, I’m very healthy, and I’m lucky that nobody in my family had colon cancer or any cancer. Most of my relatives lived into the late 80s, and my grandmother and my grand grandfather lived to the ripe …

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Drawing the line on unnecessary medical tests

Physician
September 2, 2022

How much medical uncertainty can you tolerate? Most patients have not given much thought to this consequential issue, but it hovers over them in their doctors’ offices. This is also an issue for medical professionals. Indeed, how both sides in the doctor-patient relationship navigate this will be instrumental in choosing the path forward.

Medicine is not mathematics. It’s a murky discipline with incomplete data and moving targets. Many of your symptoms …

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Why are women leaving medicine? Gaslighting.

Physician
July 22, 2022

Not a week goes by that I don’t have a conversation with an amazingly successful women physician who states: “I’m thinking of quitting.” They are succeeding in all their goals: leadership, family, practice improvement, the highest level of patient care, contributing meaningful research and/or teaching, and even getting some homemade muffins or a bottle of cherry wine from patients on occasion.

Why would someone in this situation feel so dissatisfied to …

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Are you guilty of anchoring bias?

Physician
June 30, 2022

As doctors, we have all been guilty of anchoring bias, which means we put too much weight on the first complaint. When a patient presents to the clinic with a complaint that sounds vaguely like a headache due to a sinus infection, we whip out the script pad and write a script for Augmentin. We tell them to return if they are not better in two days. That latter statement …

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The epidemic of work dread

Physician
June 17, 2022

Work dread.  Even if you didn’t know it had a name, you know the feeling.  It is that sensation in the pit of your stomach when you realize that the start of your workday or workweek is fast approaching, and you don’t want it to come.  Sometimes it begins on Sunday afternoon when you want to be enjoying time with your family.  Other times, you might find yourself sitting in …

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