Wednesday, February 28, 2007

Can't Stop Poking it With a Stick

So an anonymous poster commented that my colleague and I were lacking in compassion after reading the prior post. Hmm. I have a few questions for everyone, and particularly for anonymous.

First, at your current job, do you ever speak with your fellow workers about how much it sucks or about old man Smith's dentures or Betty in Human Resources and her poor hygiene? I bet you do. I bet you don't say it to their faces but you know you do it and it relieves stress for you and you get to laugh. Ever see M*A*S*H? Ever hear of "gallows humor"?

Secondly, at whatever job you do, let's say you run a grocery store for the sake of argument, are you mandated by the federal government to give food away to 70% of your customers? After all, without food, people die right? I bet not. In fact, if someone takes food out of your store, even if it's to feed their starving family, don't they get arrested for shoplifting?

Thirdly, is it the case in your job, that the shoplifter can sue you if she slips on the way out of your store and breaks her ankle? Can she, by virtue of the lawsuit, ruin your career as a grocer? Can she get your grocer's license taken away? Your house?

Finally, let's say that you being a compassionate grocer, decide that you will donate some of your valuable produce to unfortunate families, but you find out that you will not be allowed to deduct this loss from your taxable income. Still happy? Still compassionate? I thought not.


  1. If we wrote about all of the compassionate things we do for people, it would seem too much like blowing our own horn. Sort of like Sean Penn hiring a camera crew to videotape his "valiant rescue efforts" in the aftermath of Katrina.

    It's more fun to write about the human foibles we see every day anyway.

  2. Well, I see it both ways. The few times i've needed medical help i've seen alot of hard work and dedication and even a little compasion. And i've seen some pretty amazing incompetence that i probably should have sued over.

    There is some unprofessional behavior, and doctors are completely unable to police themselves in any meaningful way. examples: Back from mexico my girlfiend contracted the runs, two visits later to the ER and they finally give her an oral anti-biotic, but fail to give her the rest of the prescription and almost get her killed.

    Me, i'm a professional; and in over 10 years i've maybe been late 2 times. What is it about family practice doctors and pissing away everybody else's time.

  3. HAHA 911doc, that last reply made me squirt water out of my nose.

  4. Uh... Well... I have no idea how to respond except to say that I think I've met you or your twin or your girlfriend like every single shift in the ED.

    Some suggestions. First, quit going to Mexico. Second, proofread your posts for grammatical and spelling errors prior to posting. Third, find a chiropractor or naturopath for your medical needs.

    Your point about family practice physicians is well-taken however. After their four years of college and four years of medical school they do three more years of training. This is where they learn "How to piss away people's time." I don't know why they do it and think they should stop.

  5. Well, at least I have a better day at work on average than you do. %)

    A going to a naturopath is not a bad idea. It would be a better solution for someone who went to a "traditional" doctor for toe fungus, was prescribed medicine that occasionally destroys people’s liver, when all that was needed was soaking her feet in vinegar. There are too many cures that are not worth the risks. Isn’t quality of life more important? Should people at 80 years and greater be having transplants. What’s the chance of happiness?

    I think factories and fast food set high standards (expectations) for professionalism, speed, and accuracy.

    Modern medicine is failing. Sadly, society doesn’t have an answer, and any solution offered by politicians is likely to make things worse. For example, Gov. Schwarzenegger’s health plan “let the doctors pay for healthcare” makes me laugh.

    Only whiners attack grammatical and spelling errors instead of substance. And going to Mexico is "ok" and fun.

  6. Anonymous,
    You want to discuss substance? It's pretty clear you would not have the substance to be a physician. These two docs have every right blow off steam, b/c the sh*t they see would make your ileum intussuscept.
    -Med student

  7. Without questioning the need to blow off steam, especially on a blog...

    EMTALA dates from what, the mid 1980s. Didn't you know about it when you were choosing your specialty? Knowing about it, why did you choose a specialty where you're most likely to be hit hardest by it?

    You can still complain about it, but it seems sort of hollow to complain about something that's been the law for 20 years now.

  8. Honest question. The easy answer is that it's such a bad law I thought it would be fixed or at the very least funded. The more complete answer is I went into medicine because it is my calling. I can't see myself doing anything else... at least not yet. I always admired medicine as one of the most important and most noble professions and I wanted to be a part of it. I had many practicing physicians back in the mid 1980s warn me against it based on what government was doing to health care but it didn't stop me. I figured that it wouldn't make any difference to me because by the time I was qualified to practice I wouldn't have and memory of "the good old days" so it was a wash. What I could not have forseen, but should have, is that like any government law or program EMTALA has sprouted tentacles and has become a monster ten times its original size. This monster is in part the unfunded mandate to treat all comers with an ''emergency condition'' (not defined in the law) regardless of their ability to pay, regardless of their citizenship, regardless of their being wanted by the police. It's an easy thing for a politician to demand free health care for the poor especially when the expense is laid on "rich doctors, wealthy insurance companies, and those 'wealthy' enough to afford health insurance." The worse part of the monster is the perception EMTALA has created in the public mind that health care in the ED is free and a right. Last time I checked 'free health care' was not listed in the Constitution nor can it be considered to be part of the framer's intent. This has taken years to evolve but is a natural outgrowth of EMTALA. People's sense of personal responsibility and desire to take care of their own needs has been lessened by this law. All of a sudden it's MY job to make up, for free, for all of their bad decisions. See my previous post on EMTALA but the public will get what they wish with this law. Doctors will quit at some point and will be replaced by, well, who exactly? I would strongly discourage my kids from going into medicine. The rewards are not commensurate with the sacrifice required. If you think it's easy to be a good doctor or that people won't die in great numbers when the exodus of US trained doctors occurs then I recommend right now that you go and get all your health care in Pakistan.

  9. OBTW see an excellent discussion of EMTALA and lots of other good stuff at "Movin' Meat".