Sideline Money, Sideline Docs.

Talk to an investment guy, talk to a real estate gal, talk to a banker and you will hear that there's scads of money 'on the sidelines' pending the election. Conventional wisdom amongst most of the money folks is that a Romney win will be a quick and clear signal for people to invest again in the private sector. I hope it's true. It feels true.

But there is something no one is talking about, and that's the 'sideline doctors'. Every single physician in this country is watching this election with keen interest. For many it will be the deciding factor in whether they practice to retirement or they retire early and cut back on work  (under Obamacare).

Academic physicians are the only ones I have met who are consistently FOR Obamacare. The ones who will be honest with me are scary statists, and I would dearly love to punch them in the nose. It is, I think, the only thing they would understand.

So just like with investments, real estate, and finance in general, medicine also has TONS of it's resources now 'on the sidelines'. Hard to plan for the future when you don't know what the rules will be. Hard to start a practice, much less build one, when you aren't sure what Obamacare will mean to your bottom line. Hard to commit to the hardest profession in the world when it might mean that you work for a government flunkie (with a G.E.D.) reading from a manual, and lecturing you about compassion and diversity. Again, punching in the face seems one's only option here and doctors are averse, as a rule, to going to re-education camps.

In all seriousness. If Romney wins and Obamacare is scrapped then I predict the following.

1. The impending doctor shortage will be averted by physicians choosing to continue practice, or return to practice. Also, applications to medical schools will boom.
2. Research and development of new treatments and drugs will take off.
3. Many who are now choosing to become Physician Assistants may reconsider and go to medical school.
4. The left will have a seizure.

Because of # 4 above and because there is a large portion (20% ?) of citizens and illegal aliens who will continue to favor beer, cigarettes, and cell phones over health insurance,  I think Romney will have to replace it with something.

But that something, while it will no doubt have it's problems, will not turn the great American health care system into the N.H.S., or Brazil.

Go Mitt

Scooping the New York Times

It used to be that scooping the New York Times by a few hours would make your career. Now scooping them by years means Jack-squat. It used to be that promising what you knew you couldn't deliver was political suicide. Let's hope it still is.

Who knew it took ten years to train a doctor? Who knew becoming a doctor was a daunting, expensive, and often thankless task? Who knew EMTALA and Obamacare would wreck our system? Hint!!! Not the New York Times. 

And Paul Krugman is still a pantywaist shill.

The Good Old Days of American Medicine

The 'good old days' for doctors in America were the seventies. But let's talk about the 'good old days' for patients in America. They are right now and they are about to end. 

The good old days for patients have been at the expense of American doctors and nurses and paramedics for thirty years now, and because of EMTALA, Medicare, and gutless politicians and physicians. Group politics, super. See ya later individuality and achievement.

After Obama 'fixes' medicine my life will be easier and I will make more money for less work and with capped liability to boot! I will take some pleasure in pointing this out to all of you muddle headed liberal do-gooders and earth mothers out there, but not too much, because I will pull out a lot more 'pronouncment of death' forms. These patient encounters are easy and there's no risk and I get paid, so cool. You just have to make sure the patient is really dead, and this is only occasionally difficult. Here's a story about what will not happen anymore. 

You will not be an 80 year old smoker who has been struggling to breathe for two days and when you call 911 they will not get there right away. You will not be rushed to the hospital with lights and sirens blaring and you will not be thrust in front of me at 4am with a heart rate of 220, curiously the same as your systolic blood pressure, and I will not, then, do the following...

I will not run into the waiting room to find your family (after shouting out, IV, nitro drip, cardiazem 25 IV, morphine 4 IV, set up RSI, pacer pads!) to find out if you have a living will (you are too far gone to do more than scream and breathe).

Through their tears they will not tell me to 'do everything'.

I will not then run back into your room, pulling a few techs and nurses with me and do the following...

I will not give you 20mg of etomidate followed by 25mg of succinlycholine and slide an 8.0 tube into your trachea and hook you up to a vent.

I will not then push about 50mg of propofol on you before shocking you with 100 Joules of synchronized electricity to get you out of your atrial flutter with aberrancy, and will not rush you to the scanner to make sure you are not dissecting a thoracic aortic aneurysm or pushing against a massive pulmonary embolus.

I will not, after you come back from scan, have a brief moment to look in your eyes (as the propofol has been momentarily stopped), and apologize to you for intubating you (as it seemed like you didn't want me to do it, but I could not trust you (at the brink of death and without documentation) to make a good decision), and have you nod your head to me and try to thank me. 

I will not then send you to the ICU where, in spite of your continued smoking habit and lack of insurance or money, some of the finest critical care physicians I have known will, in all likelihood, succeed in getting you out of the hospital, back home, and comfortably smoking. They will lose money in the endeavor (and sleep and time away from family), but that's what they do now.

Instead, when you call 911, you will get a recording or be put on hold. If you make it past the call screener you will be rushed to the hospice where you will die in a haze of morphine. But, and here's the good part, it WILL be 'free' (and I will be free to take a nice nap on the overnight shift).