Author's posts
Before undergoing a test, ask whether it will make a difference in your care
Recently, a physician asked my opinion if a patient needed a colonoscopy. My partner was already on the case and I was covering over the weekend. The facts suggested that a colonoscopy was warranted. The patient had a low blood count and had received b…
The nuance behind an insurance company denial
I just read of a a jury award in excess of $25 million against an insurance company who denied a recommended cancer treatment to a patient who ultimately died. I do not wish to review here the particulars of this case, and admit that my knowledge is l…
When diagnosing colon cancer isn’t in a patient’s best interest
So much of life depends upon timing. Sure, we plan, but we know how much of our life’s events are unplanned and unexpected. So often, our jobs and our mates — two of our most defining accomplishments — are the result of a chance encounter or a random act. Life does not reliably proceed in […]
Do opioid contracts harm the doctor-patient relationship?
A contract is an agreement stipulating the rights and obligations of the signatories. In most cases, a contract is consulted when a dispute arises. When all is proceeding swimmingly, the contract remains dormant in a file drawer or in a digital file. In general, decent people resolve differences in the old-fashioned way utilizing the twin […]
Will artificial intelligence ever replace doctors?
Increasingly, we see functions executed by machines that were formerly performed by living breathing human beings. Examples range from the mundane to the preternatural. Order food and drink from an iPad. No server needed. Driverless auto travel. This may lead to a resurgence in prayer. Pilotless air travel. Hard times ahead for the Airline Pilots […]
Why this gastroenterologist decided to treat hepatitis C patients
In a prior post, I shared my heretofore reluctance to prescribe medications for my hepatitis C (HCV) patients. In summary, after consideration of the risks and benefits of the available options, I could not persuade myself — or my patients — to pull the trigger. These patients were made aware of my conservative philosophy of medical practice. […]
The misguided expectation of eliminating pain
I am against all forms of bodily pain, both foreign and domestic. I wish the world were pain-free. When I am suffering from even a routine headache, I want immediate relief just like everyone else. The medical approach to pain control has changed dramatically even during my own career. When I started practicing a few […]
A health insurer’s true motives
A patient came to see me with lower abdominal pain. Was she interested in my medical opinion? Not really. She was advised to see me by her gynecologist who had advised that the patient undergo a hysterectomy. Was this physician seeking my medical advice? Not really. Was this patient coming to see me as her […]
Which of these patients should get a liver transplant?
People with liver failure and cirrhosis die every year because there are not enough livers available. Who should receive the treasured life-saving organ? There is an organ allocation system in place, which has evolved over time, which ranks patients who need liver transplants. Without such a system, there would be confusion and chaos. How can […]
Restricting opioid prescribing: Some error has to be tolerated
I have written previously about the raging opioid epidemic in Ohio. Attacking and reversing this tidal wave will require many weapons, resources and time. Opioid addiction is a crafty and elusive adversary that will be difficult to vanquish. Our battle plan will have to be nimble and adjusted over time, much as military leaders must do in actual armed […]
