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.”