Saturday, June 18, 2011

Door-to-Bed Time, ACEP, and the Titanic

You Americans and your "Colleges".... You have college for undergraduates, a college for weight loss, a college for barbers, and even your Emergency Medicine physicians have a "college".

The very funny thing about your "ACEP" (as you call it) is what they concern themselves with. If you will permit me an analogy.... ACEP is the Captain of a ship.... in this case let us call it the USS Allopathia. Most Captains would want to bring it from destination to destination in one piece. It would seem that when threats to the ship were identified, a German submarine, a communist bomb plot, etc.... that the Captain would take evasive action, and then offensive action to eliminate the threat. But then again this is hard, and takes courage, and courage is so out of style in your country today.

And it seems absent at ACEP to be sure.... The problems of a democracy are beautifully displayed by here, for, afraid to recognize a communist bomb plot like EMTALA and Obamacare, ACEP has insisted on building a Maginot Line. And this is a seafaring analogy!

If the members of ACEP were Russian, they would be taken to the rails of the ship, shot, and tossed into the ocean (with full military honors).

Somehow, the captaincy of the USS Allopathia has been handed to, and here many of my former colleagues would applaud, the proletariat. The patients. The 'customers'. And now the overhead screams to the crew "More narcotics", "More free care!", "All ahead full", "Damn the torpedoes!" and such" (and the voice is that of a homeless schizophrenic who has just switched to drinking listerine as the vodka is too expensive).

And what is that on the horizon ACEP? Could it be? No, it's surely not an iceberg. And yet that is what it is. And as laudable and courageous as it is for you to continue to arrange the deck chairs for maximum aesthetic appearance and maximum efficiency, what about that iceberg? What's that? Oh, that sounds good, you are working on a plan to improve your door-to-bed times. Very nice. I am going to borrow one of your boats and lower it down to the waves now, can I borrow some food and water and a radio? Many thanks and really, those chairs have been lined up so nicely. Excellent work chaps.

And of course, in Russia, we do have an saying for this....

когда ничего не помогает, сосредоточиться на процессе. он не будет работать, но вы можете выглядеть занятым на генерального инспектора.


  1. DRX,
    You are, SO HOT.


  2. Nice "Nero" reference Dr. X...
    I'm a "Caligula" man myself..
    That "Head Chopping off Machine"??? gotta get me one of those.
    For SQUIRELs,not Peoples, and anyway Chopping off People's Heads is Ill-Legal at Bushwood.
    Ya gotta go to Saudi Arabia if you wanta see Peoples Heads Chopped off in Public, and ironically, I've spent more time there than in 45 of America's 57 States..
    SA's really not so bad, cheap gas, low minority population, I mean Property Insurance, and it hasn't snowed there in like 40 million years instead of 5 months ago like in Atlanta.
    Last time I heard that "Customer's always Right" crap I was a pimply anti-social 17 yr old fry cook at a National Chain Steakhouse. At least once a week some polyester liesure suit wearing insurance salesman would return a perfectly good 1/2 eaten prime sirloin complaining about the quality of the aged Bolivian beef we had to keep in a secret freezer so we'd pass the Health Dept inspections...
    Oh, the thing's I'd do to Mr. too-cheap-to-go-to-Bonanzas Medium Rare T-Bone...


  3. that's a difficult visual for me frank. you, a t bone steak, a freezer, revenge on your mind... yuk. but, of course, i'm glad you did whatever it is you did to leisure suit dude. if only he knew. hey, did YOU start the AID?

  4. When nothing helps to focus on the process. It won't work, but you can look in the Inspector General.

    -Bing Translator

  5. "When all else fails, focus on the process. it will not work, but you can look busy to the inspector general."

    This is what I came up with ^^

  6. It's all apace with the focus of some EM physicians to get that starry eyed MPH so that they can save the world one public health crisis at a time.


    As Heinlein wrote,

    ‘Bread and Circuses’ is the cancer of democracy, the fatal disease for which there is no cure. Democracy often works beautifully at first. But once a state extends the franchise to every warm body, be he producer or parasite, that day marks the beginning of the end of the state. For when the plebs discover that they can vote themselves bread and circuses without limit and that the productive members of the body politic cannot stop them, they will do so, until the state bleeds to death, or in its weakened condition the state succumbs to an invader—the barbarians enter Rome."

    EMTALA is just another federal law that created problems far worse than the one it was designed to fix.