Good Doctors vs Bad Doctors

In my experience growing up in a family that eats, sleeps and breathes healthcare and medicine (father owns several healthcare-related companies; mother is a primary care nurse practitioner and is also the owner of a Covington skin care spa; and a sister who is a MD (ENT, to be specific), I have a few thoughts about an article I came across at About.com about (no pun intended) how to distinguish good doctors from the not-so-good ones. I take exception to the title of the article, which is why I will refrain from using it here.

The article mentions a survey that was obviously conducted in such a way that doctors would appear to be dishonest creeps once the results were in. Not surprisingly, the survey was conducted by Massachusetts-based researchers, most affiliated with Harvard University.

I'd like to see the context and the way in which the questions were presented and phrased before taking any statistics from the study at face value. There surely must have been more information provided to the doctors surveyed than the minimal information reported in the 'Patients.About' article. No doctor would answer the questions supposedly asked without context. The author of the piece included a link to the abstract, but offered nothing by way of details in terms of the use "gotcha!" questions in conducting the survey.

"Good" Nurse Practitioner Pam Egan

That said, I somewhat agree with the 6-point plan for patients proposed as a solution to a problem the article claims exists (although this author has his doubts about the size, scope and nature of the problem, if it even exists at all). The alleged problem is doctor dishonesty, and the six-point plan suggests such things as seeking second opinions, trusting one's intuition and urging patients to not 'put up with arrogant doctors...'. To read the entire piece, see the above link (for more practical reading, continue on with this piece).

To begin, there is this thing called Google these days, and anyone in the civilized world can use it to access any information that exists in the world to be presented at the user's fingertips at the speed of light. Anyone taking a medication for which the person has any questions, it never hurts to do a little self-research to compliment the information provided by the doctor and/or manufacturer of the drug.

Additionally, intuition is an extremely important and often overlooked component of finding the best doctors. If you feel uncomfortable around your doctor, it's probably not because he or she is wearing a white coat and has loads of credentials that may make he or she appear to be some sort of authority figure to some patients. If one feels uncomfortable around his/her doctor, there's probably a good reason --- even if one cannot pinpoint the exact source of the discomfort.

Patients should always ask about treatment options. If a doctor does not provide all or at least most of the credible information available via the internet, it may be time to either ask the doctor the reason why he or she omitted one of more treatment options for whichever condition or disease the patient was diagnosed. If the answer is unsatisfactory, it may be time to find a new doctor.

I would take patient reviews of physicians with a grain of salt. As a business owner, I am well aware of the myriad of tactics, tricks and paid services businesses (inevitably including some physicians, clinics and other healthcare professionals) use to artificially control and/or manipulate their own respective reputations. This may come in the form of reviewing oneself under a different name, or exchanging friendly reviews with other businesses, professionals, etc. Other tactics include writing false negative reviews of competing businesses/professionals and paying companies to manage reputation. A number of companies have cropped up over the past 18 months purporting to specialize in "reputation management", for what its worth.

Furthermore, there are myriad reasons why a legitimate customer may leave a disproportionately negative review of a company or individual. Some customers, clients and patients lack the degree of honesty and integrity necessary to be credible when writing a review of a business, person or organization. Just look at this example of an incident involving a couple of scam artists and a used bedside commode.

I wouldn't seek a second opinion unless the health or medical issue/condition/disease was very serious, or if I intuitively felt as though the doctor was (or may be) wrong.

I wouldn't attempt to self-diagnose, which is essentialy what differential diagnosis is when conducted by the patient; but I would research the symptoms. If another condition seemed more plausible than the diagnosis issued by the physician, then it would be time to seek a second opinion.

One final means of weeding out bad doctors is to talk with them about nutrition. The days of reactionary 20th Century medicine are over. The amount of research that has been conducted involving the relationship between nutritional deficiencies and propensity for disease is staggering, and probably more than double the amount of such information available just ten years ago when vitamin D supplements contained a plant-based form of the nutrient that is not well absorbed by humans (vitamin D2, ergocalciferol), but which is cheaper to produce than the more bioactive (readily absorbed for use by the body) form used in most supplements today (vitamin D3, cholecalciferol).

21st Century physicians should not be averse to discussing the role of nutrition in the big picture of one's overall health. The information is readily available, and slowly but surely the stigma long assiciated with doctors, nurse practitioners and other healthcare professionals making claims regarding nutrition (or the lack thereof) as a contributing factor to disease are (or at least should be) long over. The peer pressure physicians face with regard to the role of nutrition in medicine has started to subside in recent years, and a genuinely good primary care, family/general practice doctor who is well informed will ask his or her patients if they'd like to have a blood test conducted to measure one's nutrient levels in order to identify any potentially harmful deficiencies.

Be very wary of those general/family practice and/or primary care doctors who either won't speak in depth about the role of nutrition towards overall health, or who pooh-pooh the notion that vitamins and supplements can help to prevent disease and/or other health maladies.

Following the advice outlined above should help patients find a good doctor who is trustworthy as well as informed.

Drug Shortages in the U.S. Completely Unacceptable

There is absolutely no excuse for an absence of anesthesia drugs in a hospital in the United States of America preventing a surgery to be performed on schedule or as planned. I am not interested in hearing the various excuses being made by the responsible parties.

It absolutely incredible to me that criminals on the street have no problem whatsoever obtaining high-end pain relief drugs yet major hospitals in the U.S. have to issue their patients Tylenol because of these so-called "shortages".

It's not just hospitals that are finding themselves unable to obtain sufficient quantities of medicine to meet patient demand. Retail and infusion pharmacies are also finding themselves on the short end of the stick, unable to obtain the medicines their patients (customers) need.

Can pharmacies sue drug manufacturers for failing to fulfill demand?

It might be time to begin exploring the possibility of instituting fines for pharmaceutical companies that fail to meet demand. Another option would be to coerce them into entering binding contracts which would hold them liable for compensatory damages in the event their supply fails to meet demand.


Whatever the solution, this entire fiasco is reminiscent of paragraph in George Orwell's 1984 about razor shortages and shortages in general, and for this to be happening in the United States is surreal in addition to being completely and totally unacceptable.


This is America, and if the existing pharmaceutical firms aren't able to get the job done, then it's time for a new competitor to emerge who isn't afraid to create enough of a supply to meet an ever-increasing demand.

Regarding Senator Vitter's Proposal to Drug Test Welfare Recipients

WASHINGTON, DC - JANUARY 06, 2011

My favorite U.S. Senator, David Vitter, R-LA, recently published an editorial at USNews.com arguing in favor of random drug testing of federal welfare recipients. While I do not necessarily disagree with the Senator's premise or logic, I do believe that the proposal outlined in the column does not do enough to sufficiently address the monumental waste of taxpayer funds as it pertains to drug addiction.

I most definitely believe that Senator Vitter's heart and mind are in the right place with this proposal. I certainly do not want my tax dollars being used by welfare recipients to purchase illegal drugs.

However, I would like to know what the relative cost would be to put welfare-recipients who are addicted to drugs through treatment versus simply continuing to support their lifestyle? I would be willing to be that the latter actually costs less to the taxpayers.

I believe that any such program should include a provision mandating that anyone arrested for possession of illegal narcotics be sentenced to drug treatment rehabilitation instead of serving time in jail/prison.

The cost of incarcerating non-violent drug offenders far outweighs the cost of their monthly welfare check. If we're serious about reducing wasteful expenditures of tax dollars, let's invest the money currently being used to incarcerate drug addicts into inpatient detox and rehabilitation. This will (by my estimation) more than quadruple the savings as individuals currently incarcerated for nonviolent drug offenses could become taxpaying citizens themselves rather than having their entire lives destroyed permanently on the taxpayers' dime.

I'm all for the testing of welfare recipients, but I will reiterate that if the proposal's real intent is to reduce wasteful government spending at both the state and federal level, any such legislation should also seek to reform the criminal justice system in such a way that nonviolent drug offenders receive treatment instead of jail time.