Keeping An Eye On
Doctors
S.Q. Lapius threw the magazine on my lap. “Here, read this, Harry.” Then he sat
back to await my reaction.
The article was entitled
‘Keeping an Eye on Doctors’ and appeared in the July 15 issue of Forbes
Magazine.
Essentially the article
states that because the government is footing 25 percent of all hospital bills,
and has a hand in setting medical fees in the Medicare and Medicaid sectors, it
can insist that:
1. The
medical profession polices itself or be policed by the Pros (Professional
Service Review Organizations);
2. Under
the aegis of PSRO hospital admissions will be monitored in advance by
committees with the power to turn away patients recommended for admission by
their doctors;
3. New
hospitals will be constructed only by prior approval of consumer populated
regional Health System Agencies under an amendment to the Public Health Service
Act.
According to Forbes, “It
all adds up to regulation of every aspect – manpower, plant, financing and
professional practice.”
“What do you
think?” Lapius asked.
I peered at him. He was
grinning. I thought he would be crying at the thought of his beloved
profession being so dismembered.
“Pretty grim,” I
answered. “What are you grinning about? You find this humorous?”
“Only the first part,”
Lapius answered, “the part I marked in red.”
“Sure,” I said, “I
noticed you marked it. That’s the saddest part of all. The part
where Forbes makes the remarkable discovery that doctors have a ‘virtual
monopoly in medical care.’”
“Precisely,” said
Lapius. “What acumen. What insight! That it is the doctors
who have a monopoly on medical care. Next week they might make the
amazing discovery that lawyers have a monopoly on legal matters, and that
architects monopolize the industry of industrial design. But let us posit
a brave new world, Harry, where doctors have a monopoly on building
bridges. The blue prints are laid. The chief doctor notices that it
calls for a truss bridge to be built.
“’A truss bridge?’ asks
his assistant, ‘There must be a rupture someplace. Perhaps we could
simply repair it.’
“’No no, Dr. Newton,’
his chief says patronizingly. ‘It is a type of bridge where we tie
girders together in a certain way to sustain the road bed.’”
“’Tie girders
together? There is no suture in the world strong enough to hold them.’”
“’We don’t use sutures,
Newton. Either rivets or welds.’”
“’Look chief, leave me
out. Get an orthopedic surgeon for that job. I don’t know anything
about welds and joints --.’” Lapius chuckled to himself.
“Or suppose,” said
Lapius, enjoying himself fully, “that lawyers monopolized the practice of
medicine.”
“They do, they do,” I
cried gleefully.
“Yes, but only in the
courts. Suppose they monopolized medicine in the operating
room. Ah, I can see it now. Two lawyers, having discarded
their chesterfield coats for the green wrinkled gowns of the operating suite,
are leaning over the sterile field. The patient is draped.”
“’Is the patient
anesthetized, Attorney Falstaff?’”
“’No, Attorney
Quicksilver, the judge hasn’t said a word yet.’”
“’What are all these
dames doing here, standing around in rubber gloves?’”
“’They are not dames,
Falstaff--.’”
“’Oh, they are the
jury?’”
“’No stupid, they are
nurses. Now make the incision.’”
“’Where?’ asks Falstaff
nervously.”
“’Where the iodine is
painted on the skin. Now hurry up.’”
“’Look Quicksilver,’
Falstaff wails, ‘Why can’t we get Attorney Grubber down here. He is the
expert in accident cases.’”
“’Nothing doing,
Falstaff. It is our responsibility. Now make the incision.’”
“’Did you read the
patient his rights?’”
“’No, I thought you
did.’”
“’Well, I didn’t,
Quicksilver. We will have to wake him up and read him his rights.
Otherwise some malevolent doctor will sue us for malpractice --.’”
“Well, Harry, quite a
scenario, eh?”
I nodded glumly,
“Great,” I assented. “But,” I added, I also noted that the article cited
the fact that the health bill is ten percent of the gross national product
while clothing is only 7 percent. What an equation. How come the
government doesn’t tell us what to wear?”
“They will, Harry, never
fear. If the trend continues, we will be walking around in dunce-caps.”