The profession is feeling hard done by according to Leslie Kane in her (frightfully cleverly named) column The Kane Scrutiny on Medscape, who asks “Why Aren’t Doctors Allowed to Care About the Bottom Line?”

It doesn’t take much to provoke bleats from doctors about being hard done by and overworked.

“My plumber with no student loans, no education, and accepting only cash payments has an easier and more profitable career. Yes, medicine is a very altruistic career, but altruism doesn’t pay for college, graduate schools, mortgages, food, etc. The CEO of United Healthcare with $23,000,000 in earnings last year couldn’t give a hoot about the altruism in medicine.” Says one respondent.

And, “Our salaries are because we work our butts off, give up time with our families to take calls and work weekends, deal with stress most business people could never imagine (telling someone their mom has died or is dying, etc.), studied hard AND LONG (anyone get a chance to really enjoy their 20s or even early 30s? Didn’t think so), and we should never have to apologize for being successful through diligence and sacrifice.”

The Other Side

The other side to this is being in a group that owns it’s own imaging department and having mandatory meetings every month or two where the Chief Medical Officer and administration tells us what codes to use to assure the study doesn’t get denied by the insurance company, and cajoles us into ordering as many studies as possible.

Or the coders come and tell you how to “buff” the chart i.e. maneuver the documentation to allow one to charge the highest possible code - even if it’s something totally trivial like a sore throat. So the charge is absurdly overpriced - but it’s OK, you’ve put in enough (unhelpful) documentation to justify a 99214 charge.

Or why does the Institute of Medicine find it necessary to recommend in its guidelines, no “consultant fees”? Could they be thinking of us poor dumb schmuck, grunts being willing to pretend to be  “thought leaders” and regurgitate the Daiichi-Sankyo advertising garbage the reps give us to present at a “Physician Opinion and Discussion” (P.O.D.) lunch meeting. Where we shoot the breeze, eat the lunch they provide, and get paid $600 - which I see as a thinly disguised coercion to steer us away from the opposition’s products (Norvatis’s Diovan and Exforge), and to their products, Benicar and Azor.

So which is the true picture? The downtrodden, over-worked victim? Or the avaricious conniving manipulator?

Probably a bit of both!   ”Order the damn MRI” 

I’ve always told my patients that my memory is like eleven men on a ten man bench. You try to remember something new, and something you know already, falls off the other end - you know, the memory stores are full up (and there’s plenty of new stuff to have to try and remember in the field of medicine - but that’s a whole other post).

Maybe there;s a solution to this too many people on the bench/CRS?  Read the rest of this post here »

 I’m not sure if it is completely correct in calling these neologisms (after consulting the msn encarta dictionary) - but they are entrants in the Washington Post’s ‘Style Invitational’, and are words made from other words by adding, subtracting or changing one letter. Then you have to come up with a clever definition of the new word.

Ignoranus: A person who’s both stupid and an asshole.

Bozone: The substance surrounding stupid people that stops bright ideas from penetrating.

Inoculatte: To take coffee intravenously when you are running late.

Osteopornosis: A degenerate disease.

Decafalon: The grueling event of getting through the day consuming only things that are good for you.

Arachnoleptic Fit: The frantic dance performed just after you’ve walked through a spider web

Adiposure: Someone who exaggerates their weight at the beginning of a diet so his “loss” will be more impressive.

Contestosterone: The hormone that accounts for why 14 of 15 all time top ‘Style Invitational’ losers are male. Females instead have the hormone havealifeogen.

Or some true neologisms from the past:

Coffee: The person on whom one coughs

Flabbergasted: Appalled at discovering how much weight one has gained.

Abdicate: to give up all hope of ever having a flat stomach.

Lymph: To walk with a lisp.

Flatulence” An emergency vehicle that picks up someone who has been run over by a steamroller.

Testicle: A humorous question in an exam.

Rectitude: The formal dignified bearing adopted by a proctologist

Pokemon: A Rastafarian proctologist.

Circumvent: An opening in the front of boxer shorts worn by Jewish men.