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The Daraprim Debacle - The Smell Test Sniffs Out Price Gouging.

You don’t need to be an ear, nose & throat doctor to be conversant with the ‘smell test’.   We use this technique in everyday life.  This diagnostic test is used to determine if a situation is an egregious deviation from established norms.  The beauty of the smell test is that one need not be encumbered by facts and data.  It relies upon emotion and instinct, which greatly simplifies its use.  Let me illstrate. Situation When Smell Test Does Not Apply Grading the SAT Examination.  Sniffing and smelling just won’t work here. Situation When Smell Test Applies A city mayor hires his brother in a no-bid contract as a consultant.  Are you catching on here? The Mother of All Smell Testers I surmise that my erudite and insightful readers would sniff deeply through flared nostrils if they confronted the following situations. “A double dip ice cream cone, which yesterday cost $4.25 is now $57.85.  A severe shortage of sugar cones developed last night.”

Is More Gun Control the Right Prescription?

Guns are in the news again.  Here are some incontrovertible facts. Mass murders committed by young males have become a new phenomenon in American life. Individuals who should not be permitted to own a firearm can legally purchase one. Many other advanced nations have much lower incidences of mass killings. There is no political solution to this issue in sight. I remain skeptical  that restricting guns will make us safer.  I doubt that further legal restrictions against buying guns would apply to criminals who by definition are law breakers.  I concede that we should consider additional barriers to keeping guns away from those who are mentally unstable.  I challenge any reader here to offer a template on how we might accomplish this.  There are tens of millions of Americans with mental illness or a history of mental disease.  What about creepy people or folks who seem angrier than they should be?  Loners? Assuming we could identify these millions of citizens, how would we us

Make America and the Medical Profession Great Again

Even those who have but a passing interest in the American political know that Donald Trump is: Very Rich. Leading in every poll. Going to build a wall that Mexico will pay for. One of these 3 statements will remain true even if Trump’s campaign tanks.  He will still be rich.  I’ve heard some of his flailing critics who are claiming that he isn’t worth $10 billion, but only $5 billion.  Wow, that’s a really potent attack strategy.  I think that if his net worth is a mere $5 billion that he will manage to squeak by. The Hollywood Walk of Fame Because he is rich, he is self-funding his campaign.  He points out repeatedly that his adversaries are taking millions from lobbyists and other special interests who will expect something in return.  Of course, these candidates deny this, but we all know the truth here.  Remember, access is power.  If you donate a seven figure sum to support a candidate or a president, do you think it would be difficult to get your phone calls

Heroes Behind the Counter & In Other Places

The Marvelettes in 1963 Patients are cool.   I did a colonoscopy on a hospitalized man who was saddled with the ravages of obesity, diabetes, sleep apnea and respiratory disease.  My partner had performed the initial consultation, and it was my task to bring light into a dark place by performing a colonoscopy.  I engaged in some conversation prior to the procedure, not simply to acquire relevant medical facts, but also to establish some rapport with a man I hadn’t met before, who I was poised to violate.  I learned that he was a navy SEAL decades ago during the Vietnam war, and enjoyed some leisure time in Cambodia then.  He mentioned that he was waterboarded during his training repeatedly and described it as a routine exercise.  Yikes.  When I was his age, I was dissecting a cadaver in medical school.  The most risk I faced was crossing a New York City street. Fast food workers are cool.  I stop often in the morning at a McDonalds near one of the community hospitals we s

Is Your Hospital Crooked?

I read an interesting piece this morning about a medical renegade who turned his back on one of the most powerful health care systems in the world.  It’s not easy to push back against a leviathan.  If I give you an oar, I doubt that you could change the direction of a cruise ship.  But sometimes, a single person can make a wall fall down.  Remember, the brave Chinese man who faced down an approaching tank in Tiananmen Square, which was captured on an iconic video?  On a lesser scale, an orthopedist, formerly employed by The Cleveland Clinic Foundation, decided that his Clinic bosses were preventing him from offering his patient’s the best medical care possible.  He fired them. "Let's blow this joint!" The Clinic, in a cost cutting move, restricted orthopedists to using artificial joints from only two device companies.  The surgeon had been using artificial joints from another company for nearly 3 decades, and he reported excellent results.  This orthopedic surg

Is the Medical Profession a 'Special Interest'?

Don’t expect this humble blogger to explain Donald Trump’s broad and sustained GOP support, if our most seasoned political pundits are flummoxed.   Why is this man with no prior political or governmental experience trumping all of his competitors? Is he ahead because he is right on, or is he leading because the competitors are way off? Like most folks, the conventional politicians are by and large an uninspiring lot who offer scripted screeds that are canned and calculated.  Indeed, most political junkees like me can almost orate their stump speeches, since they vary little from speech to speech. Trump Appears to have no 'Special Interests' The conventional candidates often rail against ‘special interests’, a pejorative term that conjures up an evil group that is possessed by greed that tramples over the public good to serve themselves.  I challenge you to identify a candidate who has not spewed vitriol against these nefarious ‘special interests’.   When they

Labor Day Honors All

It’s Labor Day tomorrow when we pause to honor those whose labor has laid down the scaffolding of this nation.  Are we all in agreement who the honoree is on this federal holiday?  Labor Day - A Sad Day for Cows Originally, the holiday was to honor the labor unions, organizations that emerged over a century ago as a response to unfair and unsafe labor practices.  I certainly honor the working man for their contributions. There are carpenters and electricians who work for themselves, not for  labor unions.  Is the holiday for them also? What about the rest of us?  I’m a physician.  I work hard and hope that I am making some contribution toward the public good.  Is this holiday for me also? Business owners and management work long hours, often beyond traditional shifts, to maintain the success of their companies.  Is this holiday for them? Artists labor long hours coloring canvases or sculpting provocative creations.  Should they work tomorrow or are they ent