Michael Kirsch is a gastroenterologist.
My kids know that I enjoy a spirited argument. During the days when the dinner table was our public forum, I tried hard to offer a responsible voice of dissent on the issues before us. I admit now that the view I espoused was not always my own, but one that I felt merited inclusion in the discussion. I still do this with them and to others in my life …
I am a physician who writes and I think that more of my colleagues should do so. Not because, we are such skilled wordsmiths or understand plot and characterization. We don’t. But, we confront the human condition every day. We see pain and struggle and fear and rebirth. We have much to share.
Beyond my own profession, I think everyone should write, because everyone has something important to say and to …
Am I an apologist for the pharmaceutical companies? I don’t think so, but others may disagree based on some sympathetic Whistleblower posts that have appeared in this blog. It is without question that the drug companies have been demonized and portrayed as rapacious gangs of greed who seek profit over all. Haven’t you come across the pejorative term, Big Pharma? Linguistical note: …
Cleveland and northeast Ohio are not hospitable to private practice medicine. I should know. I’m one of them. Private practice is fading as health care reform suffocates it by design. When this occurs, the public will have lost physicians who, in my view, have practiced patient advocacy and service at a higher level than our employed counterparts.
Keep in mind that the first half of my professional career was spent as …
Sometimes, I feel like I belong in law enforcement. There was a time in my life that I seriously considered a career where I would haul in the bad guys and make society a better place. Of course, every American male youngster fantasized that he would one day drive the Aston Martin, get the girl, defuse the bomb, and sip on a …
I was engaged in one of my pleasures, sitting in a coffee shop leafing through medical journals. Usually, I am perusing newspapers. I spend many hours each week combing through various newspapers and routinely forward items of interest to folks of interest. No newspapers today. I have a few gastroenterology journals to look through. My professional reading habits have evolved over my career. I am more interested in reading about …
Which of the following events is most traumatic for a practicing physician?
One of the gripes that patients have about the medical profession is that we physicians don’t communicate sufficiently about our patients. In my view, this criticism is spot on.
Patients we see in the office often have several physicians participating in their care. The level of communication among us is variable. While electronic medical records (EMR) has the potential to facilitate communication between physicians’ offices and hospitals, the promise has not …
This blog is about freedom and personal responsibility. I have opined that cigarette smokers should not be permitted to transfer total responsibility for the consequences of their choices to the tobacco companies, even if this industry has committed legal and ethical improprieties. I do not support the politically correct beverage ban in New York City, sure to spread elsewhere, where the …
One cannot escape the issue of rising obesity rates in the United States. A current statistic predicts that by the year 2030, 42% of us will be obese. The ramifications of this ponderous eventuality could indeed weigh down and sink the nation. Some of the consequences include:
A patient who was minutes away from his colonoscopy, asked me how many colonoscopies I had performed. Before I could answer, he quickly followed-up asking if any of my patients developed perforation of the colon after the procedure.
I satisfied his initial inquiry when I informed him that I have intruded into at least 20,000 colons in the past 2 decades. With regard to his second and more ‘penetrating’ question, I …
One of the joys of being a physician is learning the patients’ histories. A joy, you say? Isn’t taking the history simply part of the doctoring routine? You’ve all been there.
When did the pain start?
What made it worse?
Did it move around or stay in one place?
I agree that inquiries like these are not intrinsically joyful, but this is not my meaning here. I refer to history here in the conventional …
All parents have heard their kids complain that but for 1 or 2 percentage points, they would have achieved a higher grade.
“This is so unfair! My average is 89.9999 and he is still giving me a B+!”
Every kid should receive an A, of course, since psychologists are now professing that every kid is a prodigy in some new measure of intelligence. Academic intelligence, the conventional and obsolescent notion, has been …
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“Your call is important to us. Please listen carefully because our options have changed.”
During your current or any prior lifetime, has any phone menu option ever changed?
I have more than once experienced an option not offered on the robotic phone menu option choices – a dead phone line after a 30 minute wait.
Have you tried this customer plea as I have? Could you pretty-please jot down my cell phone number in …
One would think that a physician who earns his living billing patients would be conversant with the prices of his services. Not this doctor. I am queried periodically by patients asking how much I charge for a colonoscopy.
Of course, every physician recognizes that this question is not phrased properly. It doesn’t matter what we charge; it’s what an insurance company determines we will be paid. I might believe that your …
With regard to antibiotics, physicians and the public have each been enablers of the other. Patients want them and we doctors supply them. There’s nothing evil about this arrangement. Antibiotics are one of medicine’s towering achievements and have saved millions of lives. Shouldn’t we prescribe them to patients who need them? Of course we should. But why do we prescribe them to patients who don’t?
Before you race to the comment …
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Would you rather your physician be an astute diagnostician or a compassionate and empathic practitioner? Of course, we want our physicians to be blends of these qualities. We want it all. We want them to be chimeras of Drs. House and Welby. But, is this possible?
I can’t say. I suspect that it is easier to cultivate soft bedside manners than it is to teach medical acumen, although the latter was …
During my college years, we loved the album Bat Out of Hell by Meat Loaf. We would wail along with Meat Loaf as he screamed out his passionate interpretation of Paradise by the Dashboard Lights. Another memorable song on that album was Two out of Three Ain’t Bad, which offers an important lesson to those of us interested in health care reform.
No, Meat Loaf was not a medical policy wonk …
When I see patients in the office, I try to guess their occupations from their demeanor and mannerisms. Salesmen are the easiest to ID. In general, they are gregarious males with manly handshakes. They laugh loudly and like to tell jokes. Teachers are more reserved and often give their narrative in a logical and chronological order, as would be expected. Another clue that the patient is an educator is that …
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President Obama enjoyed a towering victory that I feel leaves the GOP reeling, although they are spinning the Supreme Court’s validation of Obamacare as a great gust of wind at their backs. While I would not have expected a different response from them, I fear that there is a developing wind that may blow them away in November. I offer this analysis as a tepid Romney supporter who will be voting more …
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