Heroes of the Revolution
My father's village was burned to the ground by the communists during the Greek Civil War and he never lost his visceral loathing of Marxists and their ilk. I am an old-school cold warrior and generally despised the former Soviet Union and everything that dark statist empire stood for. Still, you have to admit they had some awesome motivational posters; full of square-jawed, burley heroes of the revolution laboring mightily in the service of some fantastic five-year plan to double the production of pig iron or tractors. Sure, Homo Sovieticus was generally a paunchy, pasty, time-serving hack in some government bureau but their hearts were in the right places when it came to propaganda.
What will our posters look like? I don't think the heroes of our Marxist revolution; 25-year-old men on Methadone for fibromyalgia, polybabydadic tattooed fat chicks, prissy government bureaucrats in the Bureau of Compliance, and sleek Civil Rights lawyers will have quite the same effect. I mean, a poster showing the ideal citizens of 21st Century America with implements of labor in their hands would be so ridiculous as to be unbelievable. I picture instead a large banner showing The People, in solidarity, marching with their food stamp cards thrust defiantly into the future, their other hands holding cigarettes or greasy sacks of fast food.
Out of Control
The obsession of hospital bureaucrats with "Patient Satisfaction" has gotten completely out of hand. I am leaving my current job for a new position in part because the unwritten but official policy of the place is to give the patients whatever they want for whatever reason. Many of you who do not work in Emergency Medicine think we are exaggerating the depth of the problem but I assure you that hospitals will tie themselves in knots over complaints, the majority of which are the result of either not dispensing narcotics like a good little doctor-faucet or not being a bland, compliant, personality-less doctorbot who will just do what he's told.
Either that or telling a dental pain drug-seeker who smokes two packs a day that he actually can afford to see a dentist if he would only divert some of the money he spends on irregular pleasures to his own medical care.
The weight of Press-Gainey ridiculousness of course falls mostly on Emergency Physicians as we are the initial point of contact for a large majority of patients with the hospital. This is kind of ironic because Emergency Physicians, by temperament are the least likely to be as bland and inoffensive as is required not only in corporate medicine but in American society in general.
I know many of you get your knickers in a wad when I say this but American Society is collapsing at an increasing rate mostly because in the name of Empowerment every vestige of personal responsibility, shame, and respect for authority has been eradicated from the people who need it the most. It is a ridiculous kind of empowerment as it does not include any expectation of work or responsibility but only that the the Empowered be prepared to air their grievances at every opportunity.
You are powerless for a reason, Motherfucker. Your opinions don't matter because you are 25, on the public dole for drug addiction disability, and sucking down enough Methadone to sedate an entire town. I don't care what you think and why anybody else does is unfathomable.
Heck, we are all powerless when you get down to it. Most of us are slaves to The Man. The only people who are truly free are those on the public dole because absolutely nothing is expected of them and they are free to live as they please.
Where's my Press-Gainey survey where I get to critique the polybabydadic hordes, the drug seekers, the medically non-compliant, the bureaucracy, the government and all of those things that bother me?
Come On Now
32-year-old "dental pain" Meth-addict with the signature oozing stumps of teeth from the corrosive effects of sucking down toxic fumes for a living:
"It's bottle teeth from when I was a baby."
Dude. Have some respect.
Does anybody remember that quote about 1/2 of the people realizing they can make the other 1/2 pay for them? Scat posted it a couple of years ago? It was from a dude in the 1800's I think...
ReplyDelete"I do not know if the people of the United States would vote for superior men if they ran for office, but there can be no doubt that such men do not run."
ReplyDelete"A democracy cannot exist as a permanent form of government. It can only exist until the voters discover that they can vote themselves largesse from the public treasury. From that moment on, the majority always votes for the candidates promising the most benefits from the public treasury with the result that a democracy always collapses over loose fiscal policy, always followed by a dictatorship. The average age of the world's greatest civilizations has been 200 years."
Alexis de Tocqueville
1776 + 200 = 1976.
ReplyDeleteWe are overdue for the collapse.
Thanks Andrew, but that's not quite the one i was thinking of.
ReplyDeleteYa know I think when you break the law you lose rights. That's how it should be anyway.
PB, you ever feel like Diogenes in the ED? Get a lamp, my man.
ReplyDeleteHahahah "polybabydadic" is my new favorite word!
ReplyDeleteFrank,
ReplyDeleteWhat happened to your blog? It was a high point in my day!
DocV
Frank's mom must have found his blog. That's the end of that!
ReplyDelete-SCRN
Trust me, Panda Bear, those of us outside of the field include people that are also confounded.
ReplyDeleteNot that we need more media to consume, but this may be exemplary:
http://ricochet.com/ricochet-podcast
Go to Episode #65 and listen to the first 7 minutes. Much of the rest is also worth listening to, especially the demographics discussion that follows, but the first 7 minutes is classic. It may be an interesting ER discussion, as well, but as an economic discussion, it's classic.
Peace; I'm sorry if the field loses you.
That's one of the reasons I left the country several years ago to practice in Australia/New Zealand. The pay may not be as good (although getting better with the sinking US dollar), but comparatively much less hassles in many categories - less drug seekers, no Press-Ganey, less litigation, less nights, etc.....
ReplyDeleteDYSLEXICS OF THE WORLD UNTIE!
ReplyDeleteSorry, had to get that out there. So let me ask this again... How do we fight? I fought for years and lost two jobs because of it... Finally found a place that ran a great hospital with payment complaints from the ER abusers put in file 13 immediately, but by then I simply hated the ER. Too bad, I'm damn good at it... So is 'Cat and so is Qixxote, all of us boarded out of excellent programs... All of us out of the ER... So I guess a lot of people have to die for things in medicine to improve... Probably the same for our crumbling society... Wonder how it will happen?
Awesome post! You're right; the motivational posters of the new revolution would not be attractive or the least bit motivational. Maybe prescription addicts trampling down the very 'rich' doctors they tricked into prescribing for them!
ReplyDeleteI can imagine you get a lot of the patient satisfaction idolatry in the ER, but we get plenty in OB too.
ReplyDeleteLast week in a meeting I said something along the lines of, "Almost anything you can do to improve your health is going to be inconvenient, uncomfortable, and unpopular. If we're always being agreeable and telling people what they want to hear, we're not doing our jobs."
This wasn't a popular thing to say, either
"The only people who are truly free are those on the public dole because absolutely nothing is expected of them and they are free to live as they please."
ReplyDeleteA schizophrenic has the right to be free of antipsychotics?
actuallyh mark, many schizophrenics do live free of antipsychotics because they are non compliant with their medicines as a rule. but allowing for this very narrow exception to the statment, what, exactly, is your point?
ReplyDeleteMy point is that to get on and stay on the public dole, the mentally ill must take poison you call medication, so they have no freedom.
ReplyDeleteAs always, a great read Panda. Didn't know you were still posting, so I'll definitely add this site to my RSS reader.
ReplyDelete