Paths Less Traveled

Difficult Paths Are the Ones Less Traveled


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I have been a caregiver for my moderately, cognitively impaired 79-year old wife for the past ten years. Two days after Thanksgiving in 2014, at my daughter’s home in Arizona, she lost her balance and sustained a fracture of the right wrist and right hip. The assigned orthopedist was excellent, as was the acute care physician. However, following the transfer to the acute rehabilitation and follow-up rehab facilities, the treatment practices were very problematic. The assigned physicians never examined my wife, wrote inappropriate medication orders, and never returned calls. Everything had to go through the “office manager”, and their answers were not forthcoming. The rehab facilities were also negligent in their standards of care due diligence. I will admit to bending a few rules and regulations, but I’ve never knowingly done anything to compromise patient care, survival or well- being. I consequently reported the two physicians and facilities to the appropriate regulating and licensing agencies in Arizona, Medicare, and my secondary insurance carrier.

I understand the myriad pressures in today’s practice of medicine with increasing government intrusion, rising provider costs, and the temptations to cut corners, contract with extenders and “play the game”. However, you do run the risk of inviting more scrutiny and regulation when you egregiously cross the line. Nevada, where I am licensed, just had its first physician-murder conviction for a gastroenterologist who caused at least 109 cases of hepatitis C by unsafe injection practices. The majority of our great, privileged profession are dedicated to the Hippocratic principles. It is up to us to ensure that we continue to deliver the very best care in the most ethical way.


Leonard Kreisler, MD

Las Vegas, Nevada


Published on March 25, 2015