Less Carrot, No Stick: Life Working for the Man

I do not miss the ER.

Not a bit.

I do feel guilty from time to time for 'wasting my skills', but that, too, is fading I find it very ironic that I have ended up (in a sense) joining the enemy, simply to preserve my sanity. What I mean is that I now work for the government in a 'lifestyle' job when my great desire, from the end of medical school through my 'payback' time in the military and through residency was to become an excellent Emergency Physician and to practice my craft until they kicked me out of the hospital on a walker mumbling about how Zithromax is not really an antibiotic and how you should NEVER order a CBC.

My, my, my. I did, at least, achieve part of the goal. I was, and still am, an excellent Emergency Physician, but I am now almost phobic of hospitals. I won't go back unless I have to for money. The joy, if there ever was any (I think there was) is gone. It may still exist in ER practice but I think that if it does it's in isolated pockets or in Academia, but, for the record, I don't know any ER docs who feel this way. Most see themselves as drones or, perhaps, as performing a 'rear guard action' on a decimated battlefield.

This learned helplessness permeates much of medicine these days. Funny how, when lives are on the line, doctors and surgeons with MD or DO behind their names are beseeched and coerced and prodded into the fray, but when they talk about work conditions and reimbursement they are derided and spat upon.

At the same time charlatans like THIS COMPLETE MORON, a chiropractor (with an 'MD' mysteriously obtained from the University of the Caribbean Breezes) dispensing platitudes and snake oil, becomes rich and people love him. They line up to pay for his crap. The supplements market is booming. It's ALL shit. Big pharma is pilloried, but the people who market 'Raspberry Ketones' and 'Acai Berry' for 'weight loss', 'pro-biotics' and such, can laugh all the way to the bank and escape all manner of liability and regulation.

It's tempting to quote from "Atlas Shrugged" at this point but it's cliche and people think that because things are 'cliche' that they are necessarily false. Not many care about the plight of doctors, but they will.... they will care when they can't find one.

I will take no pleasure in their frustration, but I also will not be running back to help, and for that I think less of myself.

It's all stick and no carrot these days out in real-medicine land. Amazingly, I have found a 'medical' job that is mostly carrot, no stick whatsoever. Guess what? I LOVE it. I feel like I'm cheating. Compared to what I used to do, this is a lark.

I marvel at the surgeons and the ER docs who still man the barricades. They would make much more money with no liability by joining an aesthetic medicine practice and shooting people up with botox or simply hawking the snake oil that everyone does on 'Dr Oz' every day... What's that? It's already happening all over the place? Oh.

 *YAWN*

Follow the Money

America, here's what happens when you remove market forces from physician compensation. Seen above is a flier for a seminar where MDs can learn how to do botox injections and other cosmetic procedures for... drum roll please... money. Wonder where young Doc Jones went? He quit working under EMTALA and opened a botox clinic. I know the plastics guys hate this and I don't blame them... botox injections are expensive when done by an expert and Doc Jones might screw up a few faces before he gets the hang of it. Hope someone is there to replace him in the ER, and I hope that someone knows Vfib from normal sinus. Good luck patients!