The Illegitimi May Be Winning
A favorite motto of mine is “Illegitimi Non Carborundum”. It appears on my cell phone when I activate it. It also adorns an archway at New York University, probably put there in the 19th century. I was an ace in Latin in high school, and that translates to “Don’t Let the Bastards Wear You Down” despite some folks denying it really means that.
The climate in the country is decidedly worrisome in general, and downright apocalyptic in the world of medicine. Congress is passing a near-trillion-dollar “stimulus” bill that will put our nation further in debt as far as the imagination can stretch. (A spider bite is also a “stimulus”.) Tucked into the 837 pages which few have actually read is the beginning of the end of our health care system as we know it. A government agency is to be set up to determine whether the care you need is allowable. If you’re over 65 in most developed countries, you can’t get dialysis, you’ll probably die waiting for your angiogram, and so on. Need an expensive drug? You’re so not worth it! (Unless you’re a congressperson or a large donor to one). Since the bill will effectively put a damper on biomedical research, we and the rest of the world will have to learn to do without the latest medicines. All this control is to be obtained by digitizing your medical records. Lots of luck with privacy issues. Good people, I take it as a serious responsibility to protect those records from snoops. Insurance companies have already gained far too much access in my opinion. Of course the cost of going fully electronic is beyond the reach of most small practices, but that is OK with our pals in Washington – in fact the playbook for this takeover, written by former Sen. Daschle in anticipation of his becoming the health “czar” (before he pulled out in disgrace for his $140,000 income tax slip-up) specifically calls for eliminating solo practices as too inefficient.
Two days ago I saw a case of mumps, my first in several years. It was an “augenblicht” (the blink of a light), a diagnosis I could make from five feet away. This seven-year-old boy had a swelling over the angle of his jaw. His Mom suspected it despite his having been vaccinated twice. Mumps vaccine is only about 90% effective. No treatment, no worries. Yesterday I got a call from the county health department, to which I had already initiated a report as required by law. After many questions, the young lady asked me what lab work I had done. I held my temper and asked what tests she expected. “Well, we can’t confirm this as a case without a viral culture and two blood tests.” I resisted the urge to impress her with my resumé and said, “That’s your problem – goodbye!” Besides the hundreds of dollars wasted, those tests would be of NO value to the patient, which is my criterion. A small example of where medicine is going.
Some days the only salvation is humor. As Art Linkletter, my college roommate’s father-in-law famously wrote half a century ago, “Children Say the Darndest Things.” (He’s still going strong at 96). Two new patients came in recently for physicals. I asked the 3-year-old, as I always do, to copy a circle. Then I asked her to draw Mommy, which she declined. Dad spoke up and said to draw him; she wrinkled up her face and said “You’re too ugly!”
Some years ago my oldest grandkids were in the office because the younger, age 6, had a fever. I first checked his throat, ears and chest, then looked up his nose, whereupon his 9-year-old brother said, “What a way to make a living!” Indeed it is.
March 5th, 2009 at 7:02 pm
In the three weeks since I wrote the above, things have gone downhill fast. In the midst of the worst financial meltdown in 75 years, the growing threat of nuclearized rogue nations, and a moral disintegration throughout governments at all levels, the President chooses health care “reform” as his top priority. He has assembled a blue-ribbon panel to decide the fate of millions of patients and hundreds of thousands of health-care professionals. There is but one national organization representing practicing doctors, the AAPS, of which I am a proud member. Not invited. There are practicing physicians in Congress, Dr. Tom Coburn, senator from Oklahoma. Not invited. Dr. Tom Price of Georgia. Not invited. This is a repeat of Hillary’s top-secret takeover attempt in 1993; her brain trust included nary a one practicing doctor. Stay tuned.