“I can’t, I am in training.”
Its my new excuse for everything. Recently, I remembered that we call medical careers, practice. It isn’t very reassuring to think that really we are just practicing on you. “Boy, I hope this goes better then yesterday,” is just not something you want to hear when you are worried about a pimple on your butt, or any number of other ailments. We doctors don’t have offices, we have dugouts. After appointments, we rush to our dugout for the next pep talk for the next appointment. We don’t really take notes, we are musing over how many times this has gone wrong in the last few days.
We started using medical gowns to keep you off balance. They used to be pretty lavish and it wasn’t working to dissuade the questions and google searches, so the back was removed. We figured that even if you were right, if your butt was showing, perhaps it would shorten the conversation. All across the nation, we upped our game to paper gowns when that stopped working. Please don’t push this. I have been told that in Germany, they don’t use gowns at all–just saying.
I just came from ground rounds. After we make sure that everyone there is from a medical practice, we giggle about some of the things we do to avoid conversation. We surrendered to the insurance companies and scramble to comply with some silly guideline and goal. We even hire nasty people to be in charge of provider networks to make it harder to do anything related to medicine. Instead, we have all these benchmarks, paperwork, and formularies. If we spend 30-40% of our time doing mounds of silly paperwork, then we don’t have to look you in the face in that silly paper gown.The meeting today was about a network through an insurance company. I was impressed that the administrator was able to hold a straight face saying that the benchmarks and paperwork were used to help the patient. I was amazed that she spoke of cost savings as she dangled her Lexus keys and wore a 500 dollar pant suit. It hit me in the gut when she kept saying “we” when she talked about providing care as she has no medical experience at all. I estimated the cost of medical care increases in the last decade and mandatory insurance cost. I thought about the 2.2 Trillion dollars that were added to the budget and the actual DECREASED amount spent on patient care. I think this is payback for making government officials wear paper gowns.
I personally have decided to say I cant fill out anymore silly benchmark or paperwork or medication request. I am resorting to my excuse, “I can’t, I’m in training.” When they come to the office to get me to sign, I will tell the administrator to put on a paper gown and wait in the waiting room. If you happen to see them there, make sure to ask them about the latest benchmark as it might improve your health care.