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Showing posts from May, 2010

Preparing for the MCAT – Not Your Father’s Exam

Remember the MCAT (Medical College Admission Test)?  This is the examination that determines if pre-med students will become actual physicians. This is an extensive examination covering an expansive amount of information that is not clearly related to the practice of medicine.   It reminds me of the government and insurance industry’s emerging quality initiatives.   Like the MCATs, these programs measure what is easy to count; but what really counts, can’t be easily measured.  If I were asked to submit MCAT questions, as a practicing physician, I would bring a real world flavor to the examination.  Whistleblower MCAT 2.0 Sample Questions! Test Your Knowledge! Amaze Your Friends! Let the Games Begin! Medical Knowledge Section You are in the hospital recovering from ankle surgery after a fracture. After pain medication is prescribed, you develop some constipation and abdominal discomfort. The orthopedist’s physician assistant orders a CAT scan of the abdomen to evaluate the new

Tort Reform and Frivolous Lawsuits: Show Me The Money!

Several months ago on this blog, I informed readers that I was a defendant in a medical malpractice case. I offered no specifics, as I didn’t want my attorney to fire me as a client, in case he discovered the post. Although the plaintiff was granted two 45 day extensions to troll for an Ohio physician to sign an affidavit of merit against my care, none could be found. My lawyer had reviewed every syllable of the medical record, and couldn’t divine an allegation against me. My lawyer and I were groping guests in a Chamber of the Absurd - trying to figure out what allegations the other side might concoct. After a few months, I was dropped from this case that should have never been filed in the first place. Years ago, as a younger and more idealistic gastroenterologist, I was kept dangling on a lawsuit for a few years. I endured the light hearted amusement of the discovery process, including expert witnesses outside of my specialty who claimed in their written reports that my care was

Why Do Dentists Prescribe Prophylactic Antibiotics So Often?

Because they can. Why am I dissing my dental colleagues? Because I can. Perhaps, this is a simple case of Dental Envy, since their profession remains within secure borders far beyond the health care reform line of fire. Consider these dental incidentals: • Not a syllable in the ~2000 page health care reform law that affects dentists. Every filling is still worth its weight in gold. • Dentists recover every dime they bill. If their fee is a gazillion dollars, and your generous dental insurance, covers fifty bucks, guess what? There will be a very large cavity in your bank account. • No middle of the night runs to the emergency room, a drill that we physicians endure • No hospital work, which for many physicians has become an inefficient hassle which became the root of a new medical specialty • Dentists don’t need an attorney on retainer , or caps on non-economic damages, as their malpractice situation is calm. • We still call them, ‘doctor’. Dentists prescribe prophyla

How Do Physicians Choose Consultants? Looking ‘Under the Radar’

Professional sports has never been a dominant personal interest, although I admit that I become more engaged if my town’s teams reach the post season. Here in Cleveland, folks assign a priority level to sports that is just a notch below breathing. I do make it a point to know enough of what is happening within the various stadiums and arenas so that I am not ostracized or placed in a stockade in the public square to serve as a deterrent. If the Cleveland Cavaliers do not emerge as national champions this year, then northeast Ohio will sink into the Sea of Melancholy There is an aspect of professional sports that I greatly admire. This transcends the athleticism and skill of the athletes, the work ethic, coaching expertise, teamwork and the thrill of the game. This is one of the only institutions that is a pure meritocracy. The philosophy is simple and not blurred by arguments for diversity or massaging the qualifications for admission to serve another agenda. Coaches, managers and ow

Sir Isaac Newton and Health Care Reform

Whistleblower readers know of my deep skepticism that the promises of Obamacare will be realized. As time goes on, my skepticism sinks deeper. The health care reform (HCR) legislation that was passed with reconciliation guarantees more taxes, more access to care for the uninsured and more government control of health care. But it fails in its promise to bend the cost curve, or does it? Perhaps, I’m being unfair and need to adopt a more literal approach to the president’s promise of cost control. President Obama’s program does bend the curve, but does so in the wrong direction. He wouldn’t be the first Democratic president in recent memory to engage in a public demonstration of linguistical gymnastics. If health care costs continue to rise, can we expect to hear the president lecture us in 2012 during his reelection compaign with his finger wagging “I kept my promise to bend the cost curve, and I did.” This past month, a national and respected health care organization reported that