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From: "Steve Harris" <>
Subject: Re: Unsafe At Any Illness
Date: Sun, 29 Apr 2001 23:54:51 -0600

> Docs may have all the glamour and attention, and are at the top of the
> pecking order, but they couldn't do much for patients, especially
> hospitalized ones, without us

> Judy Dilworth, M.T. (ASCP)
> Microbiology 26+ years

Er, Judy, if you think doctors are at the top of the pecking order, then
you're still back in 1984 when the DRGs hit. That was the gravy train. I saw
it from a private hospital in California, man, oh, man. Hospitalize you a
week with the flu just so you could get rest and hydration. COPD in
exacerbation good for at least 5 days on IV steroids before a try at
stepdown. Everybody with chestpain gets a nuclear scan. Everybody with a
neurological problem gets an EEG, a spinal tap, an MRI, and probably EMG if
they don't run (or can't run fast enough, which was most of them).

Little groups of private docs ran all that. And the hospitals that ran the
gravy train kissed their butts. I saw a licence plate on a very nice car
that said EGD PRN. I really did. It was a GI doc's car. It wasn't the Ferari
Testorosa that belonged to the head cardiologist; I forget what that one

Anyway, starting 1984 we're in a whole other world. The docs weren't doing
very well on conserving money so they gave the job to the accountants. Now,
your doc works for some corporation which treats him much like the hospital
treats its nurses. Except the doc has no union (wups). Decisions on who gets
what and how long patients stay are not made anymore by doctors who get rich
off patients staying in hospitals; rather by a special tier of management
(some of them with MDs) who get wealthy from the fact that patients DON'T
stay in the hospital.

And here we are. We're spending just as much money on medicine as we ever
did, except now it's all going to outpatient test procedures and for
pharmaceuticals. The part that goes to the doctors is divided up by the
accountants before the docs ever see it. Enjoy.


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