Friday, May 4, 2007

M.D.O.D.: I Swear It's Dead but Give me That Stick Anyway (the Unintended Consequences of EMTALA)

M.D.O.D.: I Swear It's Dead but Give me That Stick Anyway (the Unintended Consequences of EMTALA)

Well, finals are over. Just one summer term to go, and they'll turn me loose on the public again. I came across a nice article done earlier this year, yet still timely about EMTALA. As I officially leave the ranks of General Surgeons, I look at this and my decision is confirmed. Some comments, and I'll try to leave the acid in my Coca-Cola:

1. It's a shame that every many specialties in the surgery community can set up their own ASC's. General Surgery has been left the abandoned mother of all these subspecialties, to the point that what's really left for the General Surgeon is Trauma and Pus. Personally, I don't mind pus, but I detest trauma. Neither pays well.

2. Oh, and that ear laceration? I wish you would sew it up. However, when there is no Plastic Surgeon taking Call any more, the General Surgeon is mobilized as the Surgeon in General, and he is often the one who sews that laceration, at least where I come from. After 5, on weekends, and holidays, the General Surgeon is the smartest guy on the planet. Remember, unless you have $50,000 laying around that you don't know what to do with, you MUST go if you are called by the ER doc and he says, "I need you here," even if you don't have privileges to manage the problem. You do, however, get to make the telephone calls to make the transfer to someone who does.

3. Hey, you General Surgeons out there: In order to limit your exposure to 1cm chin lacerations and ER train wrecks, did you ever try to limit your hospital privileges to abdominal surgery? What kind of Hell did that raise?

4. There is not a nursing shortage. There is a shortage of payment for nurses. I agree that they are worth their weight in gold. If they were paid more, they would put up with the BS that hospital work requires. Tens of thousands of nurses have left the field, but they would return if the money compensated them adequately for their working conditions. If they were paid enough, I'd be a nurse. For an example, what would it cost you to get someone off the street to come into your house and take you to the bathroom and wipe your butt then take you back? So, someone who has training and who cares about their patients is paid less than someone who doesn't care and who hasn't had training? This is perverse.

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