Thursday, May 08, 2008

Future American Physician

More and more bright young Americans are figuring out that there are much easier, faster, less painful and time-consuming ways to make money than being a physician. Hence, you may soon learn that your major surgical procedure, for example, is going to be performed by a gal like the one shown above. I imagine that being a physician will still be important enough, and will remain held in such high esteem by families like that of our little debutante above, that you may someday meet Miss Teen South Carolina just before you head into surgery to remove the meningioma from your cranium. Keep in mind that her valedictorian classmates are all working on Wall Street and at Microsoft.

Have you guys ever heard of 'word salad'? Word salad is a string of words that vaguely resembles language, and may or may not be grammatically correct, but is utterly meaningless. You will never see better videotape evidence of word salad than what I have shown you above.

Imagine the conversation you could have when Miss Teen South Carolina becomes Dr. Teen South Carolina M.D., neurosurgeon.

You: Good morning, Doctor. I have to say that I am a bit afraid of anesthesia and having the tumor removed this morning. Can you answer a few questions for me before we go to the operating room?

Dr. Teen S.C.: Oysters sucking giraffes have not...don't be afraid...alfalfa.

You: What?

Dr. Teen S.C.: Tramway flogging into my question, are you why is it thirty letters down under peanut butter, what is it?

You: Doctor, are you OK?

Dr. Teen S.C.: Hold the patient's nose squarely, waiter, or friendly milk will countermand my trousers. Opossum.

You: What the fuck?!?

Dr. Teen S.C.: I personally believe...that colorless green ideas sleep furiously.

You: Wow. That shit was gramatically correct. NURSE!!!!!!


  1. You forgot all the "such as" and "U.S. Americans" she threw in too. I saw this months ago and worried a bit for the future!

  2. Funny. It sounds like a democratic debate I heard on CNN a couple of days ago.

  3. Pfft... Everyone knows it's the colorless RED ideas that sleep furiously. Jeez. Who are you trying to kid here?

  4. Awesome! LMAO! I agree, until you can offer doctors stock options and other nice perks that could someday turn into millions of dollars, how do we lure the best and brightest to medicine?

  5. Dustin, true, but it IS gramatically correct. Lofty

  6. If she had answered the question correctly,i.e. "Because 1/5 of Americans are Dumbasses" she would have lost style points for congeniality. Physicans often aren't the most verbally expressive people either. I once took over a case from a fellow resident who gave me his entire turnover instructions with hand gestures and grunts.

  7. So the best students don't go into medicine. Big deal. Quality of care will still be better than in most countries. It's a free market. Doctors still make plenty of money and live a comfortable life. I wouldn't mind her giving me a good once-over.

  8. I work with someone who does this exact thing in a business setting. It is so stupid that it is hysterical. So far this eek I have heard regarding my resigning to go to law school full time "well, law is very esoteric." We just busted out laughing because this guy has no idea what the meaning is of 75% of the words he uses. Baffling.

  9. Maybe she is schizophrenic? And who would the Non- US Americans be? I think she is Dutch.

  10. Good on ya, annonymous, I don't think the best students have ever gone into medicine. The smartest people I knew are selling houses or running businesses. I'm sure Miss Teen South Carolina will find her niche in the American marketplace.

  11. As a fmr neuro nurse, I'm a fan of word salad. I once had a gynecologist that stroked out and had the word salad thing going. He went about putting gyno words randomly everwhere.

    Can I get a contraction of placenta?

    A glass of water? ---Yeah.

    I was wondering if the scar will be here on the due date?

    You want to know if the doctor will be here soon? ---Yeah.

    What's cool is that I could usually figure out what he was trying to say based on the affect of the question and the context.

  12. Anonymous,
    Are you serious? You don't care who gets to be your doctor? It's a free market? You are deluded. Medicine is not a free market. And when there is no free market then mediocrity if not downright failure is the result. If you don't care if the doctor cutting your chest open or treating your heart attack is the best of the best then you will get exactly what you want. At least it will be free though, so you got that going for you, which is nice.

  13. Re; Free market medicine, read the post The Wreck of the Good Ship EMTALA by Dr. Edwin Leap

  14. 911 DOC, doctors are not the SMARTEST group of people in the world just because they're doctors. Get over it. If 'pretty smart' people go into medicine, fine with me. You don't have to be in MENSA to take my gallbladder out.

  15. Dear anonymous troll,
    I have never claimed that doctors are the smartest people. Merely that my father could kick your father's ass.

    What I do claim is that you DO have to be smart to be a doctor.

    More importantly you have to be willing to sacrifice many years to training and to continuously and actively pursue excellence.

    I chose medicine because, in my mind, it was the most meaningful thing I could do... It was my greatest opportunity to do the most good for the most people AND to, in some cases, I hoped to be able to save people's lives.

    My med school class was full of engineers, PhDs, authors, Army Green Berets,
    a NASA engine designer,and cum laude grads from the Ivy Leagues so yes, they were smart.

    But they were answering a call too, so peddle your horseshit somewhere else, you don't have a clue.

  16. That chick will marry some dude with cash, which will take her far away from any position where she could f**k something serious up, as long as she doesn't mess up and get real fat eating choclate at the sorority house.

  17. Yeah, but after the chocolate OD she decides she wants "a career of her own." Med schools, now scraping the bottom, snarf her up. She seduces the chairman of a top neurosurgery program and the rest, as they say, is history, as her patients will be.

    Not to be sexist about it, a male doofus would be just as bad.

    Has anyone seen "Idiocracy?" There are some docs in that flick who are pretty scary. But the movie takes place 500 years in the future, so I guess we'll by OK.


  18. Yeah, but after the chocolate OD she "wants a career of her own." Medical schools, now scraping bottom, take her in. She seduces the chairman of a top neurosurgery program, and the rest, as they say, is history. Same for her patients.

    Not to be sexist about it, a male doofus would be just as bad.

    The movie "Idiocracy" has some pretty scary docs. The movie takes place 500 years in the future. The dumb people have outbred the smart people. But we won't be around to worry about it, and it's just a movie, right?

  19. Medical school is sooooo competitive that I think we'll be fine. We may have to start accepting the smartest 10% of the population as less people go into medicine instead of the smartest 3%. But that should be alright - medicine isn't rocket science :)

  20. You need to credit Stephen Fry for your quotation... probably pay him a royalty, too.

  21. 911 DOC, my point is that I don't care if the valedictorian from Duke takes my gallbladder out or the 200th smartest kid in the graduating class. Most doctors I know are above-average intelligence...not geniuses. It probably doesn't matter if THE best and brightest go into medicine. Let the best and brightest go into biomedical sciences to help develop drugs and therapies that the doctors can then use to improve our health. Good discussion, thanks.

  22. Anon,

    say that again with a moron guiding your scope and a HS dropout administering your complicated mix of anesthetics.

  23. LZ: you funny round-eye.

    I would definitely toss her word salad any day.

    I personally believe that, such as, if she was an ugly AND dumb U.S. american, THAT would be a true tragedy.

  24. Do you really think she's that pretty though? Honestly to me it just looks like she's made up nicely, skinny, and she's had her deviated septum repaired.

    I would say that there's nothing really standout beautiful about her. Seriously, make-up application is an artform in the south. With some mad skillz, you can make anyone look pretty good.

  25. Anonymous. What you are talking about is twenty years ago. This year the fellowships for cardio-thoracic surgery filled 50 % of their slots. Of those filled 50% were filled by folks who got their MD degree outside the US. Dr. Patsalmalta may or may not be as well trained as Dr. Smith... You firure it out.

  26. But Doesn't Dr. Patsalmalta have to go through the same residency as Dr. Smith? Same meaning here in the United States?

  27. Best and the brightest? My med school class was mostly GW Bush style frat boys. The main requisite for admission is ability to do well on test questions, not really much different from the Jeopardy contestant or baseball trivia expert. Its a myth that women don't do well in science. Its mostly math where they lag a little behind the guys. Not much math in Med School, the little bit you need to know is mostly moving decimal points left or right, and now they've got the Drackman-proof syringes if you're a little off on your epinephrine dose.

  28. Texdoc you stole my thunder. I was totally thinking Idiocracy.

    Doctor: Don't worry scrote. There are plenty of 'tards out there living really kick ass lives. My first wife was 'tarded. She's a pilot now. Why come you got no tattoo?

  29. And foreign medical graduates are less well-trained by definition? As long as I can understand what they are telling me, go for it. I would expect our licensing and qualifying exams are stringent enough to weed out the American idiots as well as the foreign-born and trained idiots.

  30. For some conditions a furrin trained surgeon might be preferable. The Cutting (pun intended) edge of Stomach Cancer treatment is in Japan just because its so much more common in Japan than the U.S. One of the craziest operations I ever saw was an esophagectomy performed by a Japanese Thoracic Surgeon. I think its that whole Fast and the Furious/Kamikaze culture. Dude cut out the patients esophagus, slung up some colon to take its place, all in 2 1/2 hours. Patient even made it to the ICU.

  31. Folks, I actually work in health care. Some of our most well-liked doctors are FMGs. Some of our most well-liked doctors are not necessarily known as the 'smartest' or best diagnosticians. There IS something to be said for bedside manner and listening skills...those docs tend have the fewest lawsuits against them, by the way.

  32. Dude, glad you're not MY hospital administrator, like, such as. You have no frickin' clue how bright and talented our medical school class was a top 15 medical school ten years ago. Would you rather have a nice, chatty, not-so-edumacated grad from L.A. Community College or the University of Islamabad or a really, really bright Duke grad who may not be quite as chatty? See Jimmy Kimmel break it down.

  33. dear anonymous,

    before we continue this discussion, and i have a lot more to say on this subject, i just wanted to ask a couple of questions.

    first. are you shadowfax?

    second, you are "in health care". awesome. what a coincidence. so are we! so what exactly do you do "in health care".

    more to follow.


  34. oh,
    and anonymous. a simple google search turned up the following. turns out doctors, as a group, have the second highest IQ on average of any profession. just a tiddle behind CEOs and professors.

  35. I like my word salad with a touch of ambiguity.

    Besides, it doesn't matter what she said. She's cute and that's all that matters in today's world. ;)

  36. No, sir. I am not 'shadowfox', whatever or whoever that is. I am a medical administrator in the Northwest US. I enjoy perusing medical blogs - those written by docs and patients. I read yours frequently. I thought this post was entertaining and important. We ARE going to have a harder time filling our primary care spots with US medical grads. I do not, however, believe that the quality of our physicians - at least in our medical group and hospital - has dropped over the past decade. Am I not allowed to disagree on your blog?

  37. Its nothing personal Mr. Northwestern Administrator dude, its just that you Admin types generally make doctors lives miserable. The Southeastern U.S has been taking Rangoons best into primary care for the last 15 years, guess its just making its way to your part of the country. I'm not a nativist, my Dentist is a former Russian Speznast soldier who can fill a mean tooth. I don't give a flip if he's got a Stalin statue on his desk, he had an appointment open when I needed one and we just clicked. Again, nothing personal, but how many 11pm-7am shifts have you worked in the last year?

  38. "Dude, glad you're not MY hospital administrator, like, such as."

    Dude! Lofty! You totally smelled admin didn't you. Nice call.

    Anon Medical administrator, you can disagree with them on this blog, just be prepared to defend yourself and your position.

  39. Saw this link on another med student blog and thought it applied to the original post:

    NW Admin Troll,

    If you look at the overall gold standard for every graduating medical student required to go into an American residency, the USMLE exams, FMGs tend to have a lower pass rate and overall scores. From the objective measure of those exams, they are not considered to be on par with US grads overall. Anecdotes with n=1 don't belong as the basis of your opinion.

    ~An American Medical Student

  40. dear bostonian in NY,

    please do not use big words. also, using terms like "anecdotes" and talking about thingies like "n =1" are very confusing and are likely to lead to less diversity and global warming.

  41. dear anonymous (if that's your real name),

    my dear, if you were not allowed to disagree on our blog i would not publish your comments! the only reason they are moderated is for a persistenly annoying troll who will not go away.

    a medical administrator you say? fabulous! in the northwest you say? fabulous! hillary or obama?

    i gotta say that you have a lot of balls coming to this particularly conservative blog and admitting to being our most loathed adversary (a clipboard carrier) AND to toss grenades around about doctors and how we are just like other folks, neither smarter nor dumber, nothing special.

    well, i disagree, having been in another professional school and the military and business i say we are different than your average joe. more dedicated than most. smarter than most, and irreplaceable. when you sign on the dotted line for med school you are signing on for at least seven years, more likely eight to ten years of high intensity training and sleep deprivation. so yes, we are a rare breed. it should be this way.

    if you still want to play let me ask you the following.

    what degrees do you hold? what is your work schedule? how much money do you make? how many doctors work for you?


    ps shadowfax is an emergency doc in the 'northwest' who does a lot of admin stuff now. the similarities are amazing!

  42. I can't keep quiet anymore. Anon you are a typical administrator idiot
    #1 I'm old. I went to med school in the 70's when it was the most competitive admission process ever. And I got accepted in the single MOST competitive year ever for admission and it still stands today. And we were without a doubt the smartest kids on Campus
    BTW, I went to a major college on a basketball scholarship and I am a member of Mensa. I'm pretty fucking smart
    #2 I am an asshole who has Pussy Gainey scores that make you "administrator types" cringe. But I've never been invited to a malpractice party in all that time. Explain that
    #3 You have no idea what it takes to do what we do day in and day out. I'm posting this at 3AM, just got out of the hospital. When was the last time you were in your hospital at 3AM?
    #4 Their medical school education is markedly inferior to ours except in the advanced nations and that don't include Pakistan et al! We aint getting many Danish educated FMG's over here are we?
    #5 If you had a choice between FMG Dr Samarivistasharmi and USA educated Dr Jones doing your Dad's Bypass you would choose Dr Jones every time and if you deny that you are a lying sack of shit.
    #6 I'd take graduate #200 from any US med school over #1 from the "Autonomous School of Medicine, Guadalajara" every day of the week and twice on Sunday

    Go push some more freakin paper and sign up some more FMG's for your HMO. They won't cost you much to hire and won't spend much $ ordering tests because they will gladly toe your cost effective line and delay care until the patient finally gets tired of it and goes in to the ED and we will find out what's wrong with them!

  43. oh oldfart there you go and wreck the party! dear anonymous, please pardon my oldfart friend. i am writing at 5am, still in the ER, supposed to go home at 2am and then these really sick folks came in and i stayed to help my colleague. reminding myself that folks like you have the ship well in hand will help me sleep better when i hit the rack. so do tell us more captain, we await enlightenment.

  44. Old Fart, what year was that? I had an attending in med school that used to say the same thing, I'm sure he said the year, but I was too busy daydreaming. Everyone knows the Vit K dependent clotting factors are II,VII,IX,and X. For extra credit name the winning and losing quarterbacks from the corresponding SuperBowls. No fair Wikiing it.

  45. Oh yeah Old Fart, must of the legitimate FMGS seem pretty sharp. My aforementioned Stalinist Dentist even uses a sliderule to figure out whatever it is that Dentists figure. The docs who really seem to have gotten off the short bus are the U.S. born who go to University of Baby Doc in the Caribbean. I know, they're all humanistic geniuses who don't do well on standardized tests, but c'mon, I got in for Gods Sake.

  46. "medical administrator in the Northwest". Now I know you are a socialist douche bag (German-douchenbagen) Go sip your green tea pinky up with some owl and get the hell off this blog. I bet the worst day of your life was when the rest of Oregon failed to approve same sex marriage.

    Oh yeah, peace, love, and can't we all just get along?


  47. The patient will not sue if I am nice to them is a fallicy. Doesn't matter how much they LIKE me. If they have a case, they have a case. Unfortunately, many folks don't know they don't have a case until they have mad my life a little miserable.

    Also a Doctor needs to be good at Medicine and surgery if needed. They don't need to be your prom date. Some of the best Physicians are asshole. I am ok with that.

  48. Frank, I love it when you speak in code. Watch out, you may have used DrX's secret pass word, and now he's on a mission.

    Why don't you boys just swap email addresses, through 911?

  49. OK, this is from long term memory,
    Superbowl II Bart Starr (Packers) don't know the other guy
    Superbowl VII Bob Griese (Dolphins), Redskins was other team, don't know who QB was
    Superbowl IX Bradshaw (Steelers) Tarkenton (Vikings)
    Superbowl X Bradshaw again, Staubach (Cowboys)

  50. one more thing oh missing anonymous.

    if you are surprised at the level of venom directed your way by physicians here let me give you a clue. doctor's where you work are probably nice to you and wouldn't say anything like this. the reason is that they are scared shitless of you and what new quality control measure, new piece of paper, new painfully inane sensitivity training class, new rules for chart correction, or new hospital mission statement you will baffle them with next.

    to them, the best thing you can do is to leave them alone. otherwise all you do is make them miserable, so they smile and wave. smile and wave.

    and between you and any of the excellent physician's at your hospital, who could be replaced with a quick email contact picked off or a quick phone call? what exactly do you add to the equation? you are not "in health care" dear lady, you are around it.

  51. What exactly are you saying Anon Admin?

    "Some of our most well-liked doctors are not necessarily known as the 'smartest' or best diagnosticians."

    What in the hell kind of good does one of these doctors do for your hospital? Oh wait! They get you good Press-Gainey scores!

    Can you imagine hearing one of your friends telling you about their doctor described as this: Well he's not the smartest or the best diagnostician, but he sure is NICE!

    How about, "our dumbest doctor is our best diagnostician, and our smartest doctor is our worst diagnostician."

  52. "what exactly do you add to the equation? you are not "in health care" dear lady, you are around it."

    Pinky is standing up applauding.

  53. 10 points to you for quoting that Stephen Fry sketch!

  54. Well, welcome back to my computer on Monday morning. Venom? Yes. Wow. Are we angry or sad or both, doctors? I will gladly leave your blog if you like. Thought this might be a 'discussion' board for problems and issues we all face in the medical field...guess I was wrong. I won't sling mud. Know only that I think the doctors in our group are wonderful, hard-working, dedicated people. We value them tremendously. Obviously ,without them, there would be no medical group, hospital, or job for me. Good luck to all of you. Enjoy your blog. I will continue to visit your blog on occasion but, sadly, will not comment in the future.

  55. okay mom. good luck with your new lover.

  56. We are just kidding. You can post here. Just know that your take on how wonderful your doctors are is almost assuredly not a reciprocated feeling. Unless they are all socially maladjusted FMG's, they view you at best a nuisance, and you are right, without them, your job existeth not. In my many years doing this the words "wonderful administrator" have never been used together.

  57. "welcome back to my computer on Monday morning"
    Good Grief! Could any words more validate our comments?! And, you Anon Administrator, don't even seem to realize what your words just proved to our readers.
    Go read some more Pussy Gainey scores..

  58. "we value (our doctors) tremendously". what do you have, a mouse in your pocket? are you a queen? "we"? how nice. you are a primo douchebag anonymous. arrogant, irrelevant, and deluded. the queston stands. what exactly do you do other than get in the way? and finally, do you have any idea that doctors think you are a joke who makes your living on their backs and cracks a whip while doing it? douchebag.