Editorials from the Executive Medical Director

Irreverent opinions: Dealing with audacity when patients ask you to break the rules


March 21, 2016

“While I’m here, would you mind skin testing the twins?” FYI: the twins were not patients.

What? People never used to ask that sort of thing. One wonders if surgeons get snap requests for gallbladders during lunch hours, or quad bypasses on weekends.

Or here is the lesser ask: What do you say when a patient asks you to “just look at my other child’s ear for a quick second.”

Let’s look at the second patient first. Do you go new school, hard line and say “I can only see people I have worked up properly,” or do you fall back (old school) as I do, and say, “I only see ears on Tuesday, sorry.”

Irreverent opinions: Chocolate: The latest health supplement


February 15, 2016

Every drug has side effects. Is chocolate any different? Like any drug, it must be analyzed in a strict academic manner comparing risks and benefits to outcome. This is the season to revisit chocolate carefully, because of the international orgy of chocolate abuse that just took place because of people who take St. Valentine’s seriously.

First of all – for the edification of those of you who are not Catholic (myself included), Donald J. Valentine was a Roman priest and doctor who was martyred by the emperor Claudius II for marrying Christian couples on or around Feb. 14 of 278 AD. The feast of St. Valentine was established by Pope Gelasius I in 496 because the church wanted to Christianize an ancient Roman February pagan festival, called Lupercalia, which centered around fertility and purification.

Irreverent opinions: A gamble I’m willing to take


February 8, 2016

I’m betting $500 we can win this fight with USP.

I’m betting we can convince the FDA not to support USP proposed regulations that would keep allergists from mixing vaccine kits in the office.

Here’s why I believe that, with our efforts, the FDA will not support the draconian suggestions by USP to mandate that allergists, among other items, will develop a positive pressure clean room, and date vaccines at 28 days as proposed:

Irreverent opinions: An allergist Grinch’s Christmas


December 21, 2015

Somewhere on top of Mount Crumpit, there’s a giant nasty Grinch with a smirk on his face and a giant bulbous green bag. It’s been a good year for the Grinch. He’s taken our contracts and given us lumps of coal, all with the exact ICD-10 code for confusion on them. He took a bad system and made it worse after attending Bill Gates’ seminar on new ways to make things easier.   

You have a nasty smirk, Mr. Grinch, and that green bag is bulging with new regulations and ways to make the children wait longer. You’re a mean one, Mr. Grinch. You’ve been talking to the pharmacists about making our extracts with their license, and giving the children sweet little bottles of albuterol from your pocket with no instructions.

Irreverent opinions: Thank goodness for global warming


November 16, 2015

Have you detected a silent “hurrah” when global warming is discussed amongst allergists? Imagine the horror of ragweed growing like kudzu, making every city the “worst city” in the world. Imagine forests of poison ivy, and Bermuda grass invading Wisconsin. You guys and gals stop rubbing your hands together – you should be ashamed of yourselves! I am just saying what you are thinking.

Irreverent opinions: Should you wear a body cam?


October 19, 2015

I recently read about a physician that allowed a patient’s wife to video her husband’s surgical procedure and when complete, posed with the young couple for a nice photograph and YouTube video.

I was astonished – I was horrified. Something deep in my soul tells me this is just plain wrong. 

But then I thought about how many of my friends enjoy turning the television screen around to allow patients to see their own nose from a rhinoscope and will make them a DVD. And then I thought of all the joy a young family has in presenting the black and white sonogram picture of their unborn baby to their family. Isn’t it the same thing really? How far do we go in sharing?

Irreverent opinions: Can I Yelp you?


August 17, 2015

If you don’t know what Yelp is — ask your next patient between the ages of 20 to 45. Chances are they not only know Yelp but have even “Yelped” some themselves. Have you been “Yelped?” Do you care?

Yelp is a crowd-sourced review site that has just joined the non-profit investigative news organization, ProPublica, to provide a feature called “About this Provider,” reviews. USA Today has the cold, hard facts: “As the healthcare industry experiences a digital boom, 77% of consumers begin their healthcare search online, and 45% read online reviews before booking an appointment, according 2015 Healthcare Consumer Trends survey.” 

Irreverent opinions: The College Is nothing but a bunch of frat boys


September 21, 2015

That’s right, you heard it here. Maybe I should be more politically correct and say that the College has a bunch of frat girls, too.

The worst is that frat boy down in Houston, Texas, David Engler, MD, FACAAI. He had the audacity to correct me on my ICD-10 coding in the last College Insider email. Ok, David, you were right – code V9107XA was incorrectly pictured as the code for fire injury on burning water skis. It should have been fire injury on burning jet skis. 

Excuuuuuuse me!

Perhaps my antipathy towards frat boys is rooted in my being overlooked during freshman rush in college. It is true that I didn’t have enough money to buy shoes or deodorant, but just being barefooted strikes me as inadequate justification for being passed over by THE Lamar University Delta Delta Delta boys.

Irreverent opinions: Worried about certification? Form your own board


April 22, 2015

When ophthalmologist, senator and presidential candidate Rand Paul got crosswise with his ophthalmology board a few years ago, he simply formed his own board. That’s right. With a full membership of two and a P.O. Box mailing address, “Rand’s Board” of Ophthalmology was in business. Did it hurt him? Did it ruin his academic status? I guess we will never know until he goes back to street medicine one of these days, but he practiced 18 years.