Misery loves Company

Last night in the ER I was wondering how it is going to be when we get the full dose of "healthcare reform".  The hospital has no beds to put people, literally no stretchers.  EMS doesn't stop and people keep piling through the door.  "Hey if the kids need to be seen then go ahead and get checked out it helps to meet your out of pocket early this year"

Lesson one - you get what you incentivize.

Now part of this is flu season, but the bigger part is advertising.  The hospital (who told us in orientation that their name can't be used on the Internet without express permission) decided to advertise their wait times on bill boards in the ED.  Well at the time it was far shorter than those at the other hospital in town.  So a few people decided to try it, then they told their friends, and their friends, until I think it might be quicker to be seen at the other hospital that is the "Trauma Center" for the region.  (It sounds impressive, but there just aren't any large towns within 100 miles and a trauma center is mostly about OR staffing and paperwork.)


Lesson two - The only thing government can produce that will out pace demand is Misery and fiat money.

I blame advocates of Keynesianism for this problem.  Here goes:  The hospital I work for is privately held and in a state that has a certificate of need system (CON).  We are being slaughtered in the ED, so that the hospital will stay packed.  Then we they can apply to expand the hospital and point to the enormous wait times to get a room, that the hospital is over capacity at times and always a certain percentage full and this is why we need the CON to expand.  They have factored in the number of people who will get pissed off and the number that will sue because the mistakes that will be made in a system trying to function in spite of being overwhelmed, overtime that will be paid, and hot wings from TGIF's to makes us think they care; as a cost of  doing business to get the CON.

Stop and think before your heart bleeds all over your keyboard about evil corporations.   A group of people picked by the government to maintain the status quo, gets to decide and set rules for getting a CON resulting in this "Devil's Algebra".  If they could just build more beds and take care of sick people, I wouldn't need to be stressed, my patients wouldn't need to suffer, but the bill boards would still be used.

Lesson three -People are governed by greed and fear.

There was a guy who was giving the nurse a hard time about getting a procedure done.  She asked for help.  So the other night I was  with my favorest sister-in-law was watching "Law and Order" where a new attorney had joined the group she said to deal with people you have to identify with their anger or hate, so I listened to the guy and figured it out.  I used his anger about God to calm him down and get him to agree to have the procedure done.

Then I have to go back to dealing with "I crashed my bike a week ago", I'm dehydrated and don't have shit for veins, "how come this is taking so long", "I have been here for 8 hours", "no I'm allergic to ever pain killer except the one I really want" ......

Wait until 2014 when the party really starts, you my dear patients will have plenty more company and soon we will all be millionaires.  Want another hot wing for change?