Tuesday, October 06, 2009

The pen is mightier than... uh, whateva.

Q: What is the most expensive piece of medical equipment?
A: The doctor’s pen.

You may have heard this chestnut before – now it has become the hot ‘buzz phrase’ in the health care debate. I’ve read it in articles, heard it referred to on TV and even have had it quoted to me by another doc.

Here is how to I read behind the lines: Medical care is very expensive and ergo we need to cut costs and ergo we need to know who is responsible and ergo because the docs are responsible for the most expensive piece of equipment we ergo need to stop them. The presumption behind this Q and A is that MDs are, as a group, out of control, ordering too many tests and that pen needs to be controlled.

Well, I have a reasoned and measured response to this: Fuck you and fuck the cunt you farted in*.

First of all, I strongly question the factual accuracy of this statement and it’s implications. A recent hospital building built in this area cost 450 million dollars. I KNOW that the cost of running a hospital lab is ~70% staffing costs. Our hospital administration keeps up its endless expansion in response to more Medicare “quality” requirements. My pen had shit-all to do with any of this.

Second, don’t we WANT the doc to be the one wielding the pen. That is, even if it is the most expensive piece of equipment, who better to decide how it is used.

Lastly, I have my own Question. Q: How do you get a nun pregnant? A: Bone her.

Thank you very much. Out.

*I must credit this quote to a wonderful patient I had in med school.

26 comments:

  1. From the far reaches of the hospital basement, Gollum rears his head...welcome back E. I guess this means you're not dead yet.

    http://www.nytimes.com/2009/10/01/health/policy/01swiss.html?_r=1

    Some are calling for our system to be more like the Swiss, but read about the dreaded blue letter. How does it help us if insurance companies are more powerful than doctors? How will this reduce money lost to bureaucratic red tape? They must have very limited liability there for docs, is all I can guess.

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  2. My FIL is ex Swiss. I'll ask him about Swiss health care when he comes over for Thanksgiving. I'm sure he can expand on the details. :)

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  3. I have a friend who is a Swiss doctor...I suppose I could ask him. Here's another article discussing it.

    Becker Posner Blog

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  4. I feel left out, I have no Swiss connection. Sob sniff sob.
    Would you accept any other nationality?

    Seriously, it is true that the costs incurred in a hospital are mostly overhead, otherwise how could one explain a $32 dab - a small pea size - of anti bacterial ointment on a 5 year-old freshly stiched forehead?

    Doctors order what they think/know you need, they are not in charge of carrying a price chart in their smart phones and referring to it every time they write orders. This is playing a sad round of blame game.

    However little I care for insurance companies, they do a good job of slashing down the hospital pricing madness to more realistic levels.

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  5. my pen is exactly 89 cents more expensive than it was ten years ago because i am no longer in receipt of those great, free, drug company pens which caused me to mis-prescribe many drugs for years. now i either have to pony up for the pens myself or get them from the nurse's station and that's money right off the hospital's bottom line so there may be something to this after all. and thanks for the info re nuns... who knew?

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  6. I've got swiss relatives Amy-65C, Ha!
    -SCNS

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  7. I have a grandpa who was 1/2 Swiss but he died a couple years back...

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  8. And this just goes to show why E is a pathologist and usually kept at a safe distance from speaking patients.

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  9. Yes, thou must refrain from using the "C" word. It makes us girls want to hurl.
    -SCNS

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  10. dear anon.,
    eto' is in a stable, monogamous relationship with his life partner, and is not concerned with giving offense... especially whilst referring to the pudenda.

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  11. Yes, but 911, what's your medical doctorly opinion on the Swiss type plan that everybody's getting all freaked about? I don't think it'll pass here cause they'll never get AARP to go for it, not to mention others that want freebies.

    BTW, reading Atlas Shrugged...it's a lot to wade through.

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  12. I hate the term: life partner. I always think of animals that mate for life, not people.
    Oh wait, never mind...

    And would someone please answer poor Amy?

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  13. Keep reading Amy. I read it AGAIN last year (first time in college). The paralells between the story and todays gov't regulations and anti-capitalist sentiments are amazing (especially the part about dictating how much Reardon metal could be made and who it went to and what salary could be earned. Sound familiar?)

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  14. dear amy,
    i'm sorry, but my visceral hatred for the swiss with their chocolates, their banks, and their polyglot populus makes it unfair for me to comment.

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  15. "Pen is mightier than the Sword"???
    Yeah Right
    Ever seen Pulp Fiction?

    I'll take my Gladius anyday

    Frank

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  16. If the Big O's health farce passes, will doctors be allowed to opt out, tell the messiah, "bite me, asstard," and work exclusively out of network and therefore have a chance at making a living - because people will quickly tire of having to wait five months for a breast biopsy? Or will all docs be forced to comply, making them government employees?

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  17. dear lynn,
    great question. two thoughts... if he actually wants his plan to WORK for more than a month he will make it illegal for physicians to 'opt out', however, this may create such a storm that he won't be able to pass his socialist farce. interesting question and better answered by a good poker player.

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  18. Yah, that's pretty much what I thought, too, 911. What better way to expose his socialist agenda but to force docs to be government. If that doesn't scare the crap out of people, then we're really doomed.

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  19. dear lynn,
    i think that there is a groundswell of sensible, patriotic Americans who normally do not pay attention to 'politics' because they are under the mistaken belief that there's precious little difference between the left and the right. methinks this old saw is showing itself as a huge, destructive lie. i say this after having attended a town hall meeting as an observer only and being amazed at the turnout and the shear and utter surprise and anger of the attendees at what is being crammed down. Americans may be a lot of things but they are not cowards and they will not shy from a fight. they are mad. and they deserve to be.

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  20. I think the current situation this country is facing can be best summed up by a quote from, I belive Bertrand Russell. I paraphrase..
    "The problem with this country is that the stupid are cocksure, but the intelligent always have doubts."

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  21. Please note that quoting him doesn't indicate I am a fan of his radical pacifism and his left leaning views. Just that the quote makes sense with how certain the left is these days that we need to do something "NOW" regarding every single social economic issue this country has faced for 225 some odd years.

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  22. very interesting quote, 'cat... i think he's right... i noticed in college with my friends who were all educated far beyond their intelligence that logical argument based on history and human nature was promptly laughed out of the room because it was, ipso facto, WRONG based on the new religion of diversity and earth worship. for me, count me an unrepentant Christian, caucasian, conservative mutt.

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  23. oh yeah, fuck the Swiss. Neutral fucks.

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  24. eto',
    i may be part swiss, to my great shame.

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  25. So nobody has an actual opinion about the plan...oh dear. Parts of it sound ok...the whole thing sounds better than Obama's plan if we have to chose something. But the main drawback is the handcuffs they slap on the docs. You'll be bending over to the insurance companies and saying plesae...and the government will have the insurance companies by the balls.

    Nice quote Cat. I haven't gotten too far into the book, like I said, It's a hard slog. But, I find Dagny particularly unappealing. Jim horrifies me and is a poster child for the social progressives. How did he get that way and Dagny didn't?

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