Skip to main content

Endoscopy also encouraged

Following on Sei's thoughts about robotic-assisted surgery, a fascinating job posting rolled through my inbox that I just couldn't resist sharing. It describes an important driver of US healthcare costs with almost haiku succinctness:
General Internist
  • Step into a lucrative mature practice, no buy-in
  • Practitioner has been here 21 years
  • Practice located in new clinic building attached to Hospital
  • Practice managed by Hospital
  • Need to be able to do stress tests and cardiolytes
  • Reading echocardiograms a plus
  • Endoscopy also encouraged
Nice, quiet community in Northeastern [large Western state]. 
What do stress tests, cardiolytes, echocardiograms and endoscopy have to do with serving a small, (presumably) elderly rural community with a 49-bed hospital? Especially by a general internist? "Lucrative" is indeed an apt description for this particular skill set, for surely it isn't very likely to be "healthy", "caring" or "evidence-based".

But what fodder for haiku. Why is healthcare in the US expensive and inefficient?
Endoscopy and echo
Stress test and cardiolyte
Lucrative internist.
Still, I am no match for the ad's own brilliance:
Stress tests and cardiolytes
Echocardiograms a plus
Endoscopy also encouraged.
Feel free to post your own haiku in the comments...

by: John Newman

Comments

mem said…
Thank you for this blogpost. It so hits the nail on the head of sooooo much that is the crux of what is sooooo wrong with healthcare and so wasteful, as well as too aggressively exposing patients to procedures that are not without risks! So many really wonderful IM Docs,for instance, that I have known have turned into near assembly line procedureists.

_RN of 30 years, recently retired.

September 20, 2012 at 8:39 PM
Eric Widera said…
Lucrative geri clinic
satisfaction guaranteed
but pay not so good
September 21, 2012 at 11:53 AM
Eric Widera said…
This comment has been removed by the author.
September 21, 2012 at 11:53 AM
Alex Smith said…
This haiku is a playful re-purposing of the titular phrase from the iconic balladeer of Summer 2012, the inimitable Carly Rae Jepsen:

I don’t want to die
This medication won’t help me
Maybe?
September 21, 2012 at 9:16 PM
Jerry said…
not just internal
heart, electrolytes, stomach
more important - cash
September 24, 2012 at 6:09 AM
Helen Chen said…
Can’t “bend the curve”, son:
Scopes can be counted and paid--
Hopes have no E/M.
September 24, 2012 at 1:39 PM
Post a Comment

Popular posts from this blog

Practical Advice for the End of Life: A Podcast with BJ Miller

This week we talk with BJ Miller, hospice and palliative care physician, public speaker, and now author with Shoshana Berger of the book "A Beginner's Guide to the End."

As we note on the podcast, BJ is about as close as we get to a celebrity in Hospice and Palliative Care.  His TED Talk "What Really Matters at the End of Life" has been viewed more than 9 million times.  As we discuss on the Podcast, this has changed BJ's life, and he spends most of his working time engaged in public speaking, being the public "face" of the hospice and palliative care movement.

The book he and Berger wrote is filled to the brim with practical advice.  I mean, nuts and bolts practical advice.  Things like:
How to clean out not only your emotional house but your physical house (turns out there are services for that!)Posting about your illness on social media (should you post to Facebook)What is the difference between a funeral home and mortuaryCan I afford to die?  …
Post a Comment
Read more

Improving Advance Care Planning for Latinos with Cancer: A Podcast with Fischer and Fink

In this week's GeriPal podcast we talk with Stacy Fischer, MD and Regina Fink, RN, PhD, both from the University of Colorado, about a lay health navigator intervention to improve advance care planning with Latinos with advanced cancer.  The issue of lay health navigators raises several issues that we discuss, including:
What is a lay health navigator?What do they do?  How are they trained?What do lay health navigators offer that specialized palliative care doesn't?  Are they replacing us?What makes the health navigator intervention particularly appropriate for Latinos and rural individuals?  For advance care planning? Eric and I had fun singing in French (yes French, not Spanish, listen to the podcast to learn why).
Enjoy! -@AlexSmithMD




You can also find us onYoutube!



Listen to GeriPal Podcasts on:
iTunes Google Play MusicSoundcloudStitcher

 Transcript

Eric: Welcome to the GeriPal podcast. This is Eric Widera.

Alex: This is Alex Smith.

Eric: And Alex, I'm really excited about toda…
2 comments
Read more

The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers.  Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous 

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon …
7 comments
Read more