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How Many Tests Do Doctors Need to Make a Diagnosis?

History matters. I didn’t realize this as a kid, but I sure do now. I endured 2 years of U.S. history in high school, as New Jersey state law required. Can you say, soporific? Only years later, as an adult, did I realize that history is a potent intoxicant that lured me into a deep addiction. Along with my Dad and brother, we sojourned many times across the country to many of our nation’s historical treasures. Most of these were civil war sites, which we properly regarded as hallowed ground. Through happenstance nearly 2 decades ago, I learned of an aging physician in Saginaw, Michigan, Dr. Richard Mudd. I read that he had spent nearly his entire life trying to clear the name of his grandfather, Dr. Samuel Mudd, who was convicted as a participant in the conspiracy to assassinate Abraham Lincoln. My Dad and I drove up to Dr. Mudd’s home and listened to him tell his stories in in his parlor. The memory of this wonderful afternoon is vivid and indelible. This man, just 2 generations r

Frivolous Medical Malpractice Lawsuits Targeted by Medical Justice

Whistleblower readers know my views on the perverse and dysfunctional medical liability system. I have read numerous plaintiff lawyers’ blogs, and those of other tort reform opponents, to better understand the issue from other perspective. As a physician, I bring bias to the issue, as do all the players in the game. After 20 years of thought, and some legal brushfires, I am persuaded that the medical profession has the better argument. I also do not believe that we physicians are as strident and ideological as the other side is, but perhaps this is simply because this gastroenterologist has a jaundiced view of the issue. For example, most physicians readily admitted that our health care system, before Obama and the Democrats cured it, had serious deficiencies that demanded reform. In contrast, rarely do I hear or read plaintiffs’ attorneys remarking that the medical liability system needs some healing. What I read in their columns and postings is a spirited defense of the status quo. W

The Art of Medicine: A Pursuit of the Truth

I read this morning in our local newspaper that Tennessee is soon expected to have a law that would permit public school teachers to offer views on climate change and evolution that are counter to orthodox doctrine on these subjects. No, I don’t think that creationism is science and it should not be disguised as such. Climate change, however, is more nuanced. While it is inarguable that temperatures have been rising, it is not certain and to what extent human activities are responsible for this. Clearly, this issue has been contaminated by politically correct warriors and those who have an agenda against fossil fuel use. Science, like all scholarship, should be a pursuit of the truth. Just because something sounds true and logical, doesn’t make it so. In addition, repeating an opinion like a mantra isn’t sufficient to confer legitimacy on the view. Many sidestep around these inconvenient truths. In medicine also, much is presented as true, which is either false or unproven. Consi

The Supreme Court and Obamacare. And the Winner is...

I write now from the nation’s capital, one of my favorite destinations. For one who dwells on history and politics, this is the place to be and to return to. During these few days, I took a kid to Ford’s Theater and then to Mount Vernon. Today, I hope to amble throughout the National Mall where I will stand in awe before the great monuments that remind us of what we all need to be reminded of. We will see the monument to Martin Luther King, Jr., which has been in the news because objections have been raised to the inscription carved into the monument. Words matter. The Korean War Veterans Memorial, one of the most moving memorials I've ever seen, is introduced by stark words of enormous power and meaning:  Freedom is Not Free. Many Washington, D.C. license tags are adorned with the the words, Taxation Without Representation, a demonstration of citizen protest that is unthinkable in so many other world nations. I recall years ago, when a protest developed when the Smithsonian

Whistleblower Releases Top Ten News Stories: Nation Shocked!

My research staff at Whistleblower, which is me, scours the news each week so that I may deliver to my tens of thousands of readers, or at least a few dozen including family, pithy profundities. Here are some news items that were leaked to us by high level sources whose identities we will zealously protect for as long as their monthly payments to us continue. Here’s our top ten list. Let the whistle blow! Whistleblower Researcher  Obama admits he voted for George Bush in 2000. Residency training regulations modified at NYC hospital. House staff is now required to work a full 7 days without sleep to maximize continuity of care and to reduce hand off errors. American College of Radiology argues that CAT scanning is underused and that thousands of incidentalomas are being missed. Pay-for-Performance model will now be applied to elected officials. Physicians will design the quality metrics. Medicare will now cover the cost of any treatment that a patient believes is medically nec
Last July, McDonalds’ Happy Meals became a little less happy. Kids in pursuit of culinary happiness will have to be satisfied with fewer French fries and some added fruit. Surprisingly, the calorie count only decreased by 20%. McDonalds held firm on the request to discontinue toys in the Happy Meals, despite opponents’ arguments that these trinkets emit an encrypted electronic signal that lure kids to the golden arches.  The Enemy of Mankind An Indiana billboard offers this announcement along with a graphic photograph that depicts innocent hot dogs masquerading as cigarettes in a cigarette package. “WARNING: HOT DOGS CAN WRECK YOUR HEALTH.” This publicity effort was spearheaded by the carniphobic group Physicians Committee for Responsible Medicine (PCRM). This organization advocates that all of us restrict ourselves to the pleasure of an all plant diet. The billboard was a shrewd move. Beforehand, none of us had ever heard of these guys. Now, for a few hundred bucks, they ac

End of Life Care: The Feeding Tube Frenzy

Okay, readers, how many of you desire to have a feeding tube inserted into your belly one day? Some of you? A few of you? All of you? Not me, that’s for sure. So, if there comes a time when I cannot speak for myself, let this blog post serve as a statement of my philosophy that I do not wish to be subjected to everything that medicine may have to offer. If I am enjoying no meaningful life, and if I am not giving pleasure to others… I placed yet another feeding tube (PEG) in a patient this week. This is often an unsatisfying experience for me as I am not always serving the patient’s interest. Usually, the patient is not capable to express his own views and the decision is properly delegated to the family or to a designated medical power of attorney (POA). In this instance the tube was medically indicated and I reviewed the procedure and the alternatives with the 3 daughters in a conference room. The daughters were uncertain how to proceed. The ladies were clearly vexed. One of them w