Aug 04

Dentists Part 2 (AKA The Lion Hunter)

This is getting too easy.  I mean, on the surface it seems like it is just one guy with a crazy hobby of murdering animals.  Here’s just one of the 8000 articles on the topic if you missed it.  Here’s the problem though.  Some guy goes to school to learn about teeth and afterward gets into a government sanctioned oligopoly (designed to protect you from bad choices) that allows him to make a premium for cleaning your teeth and feeling your tits while you are under anesthesia.  Now what does he do with his money?  He spends $50,000 to go to Africa and kill a Lion.

Now.  What if we was a nice guy and instead of killing that lion had donated $50,000 of his time to correcting the dental abnormalities of underprivileged retards in the United States?  How many dentists do you think do that yearly?  In their lifetime?  I’d say very few.  Because guess what, Walter Palmer isn’t the exception here.  He’s the rule.  Dentists are about the money, about calling themselves “doctor” when they are the laughing stock of the medical professions, and about killing and raping dead animals.  Fuck you, lion killing dentists.

And just because it’s ridiculous, it’s fair that I let you know that a gynecologist has been over there poaching lions too.  Why do we have the worst, most expensive medical care in the world?  Because our doctors are overpaid fatasses.

Jul 21

Doctor Love Returns to Rant

Overheard in dictation room today:

“Hi, I’m Dr. Kenny. Can I talk to the nurse taking care of bed 4? Oh hello, I’m Dr. Kenny. I talked to my attending and we would like to tell nephrology to remove another liter of fluid in HD today. How would I tell the nephrologist that? Oh, call the nephrologist? Ok, can you give me his number? Ok thanks.”

Next, he calls the nephrologist and says the same thing. Sounds like nephro argues a bit so he says “well, the patient is having a hard time breathing so we think he should have more fluid removed. Ok, thanks so much.”

This person, Dr. Kenny, is a family medicine intern. If I were nephrology I would yell at him to let me know how much fluid should be removed after he completes nephrology fellowship (which is incidentally one of the worst fellowships). Oh wait, he’s family medicine, he’s not even eligibile for nephrology fellowship. Maybe he should get out of the damn hospital and go back to seeing people with runny noses in clinic.

Unbelievable. I can’t imagine having to work with these kids.

Jun 25

Patients over Politics

REUTERS/Joshua Roberts

REUTERS/Joshua Roberts

I have to say that I am a little dumbfounded by the hashtag #PatientsOverPolitics displayed on the sign held by the woman on the left.  Patients over politics?  Really?  When I really think about it, the irony is both laughable and saddening.

The real problem with the unaffordability of healthcare in the United States is waste and overutilization.  It has nothing to do with whether or not people are insured.  Uninsured people should be able to afford basic healthcare.  Period.  When we say that insurance is a “right” and a “necessity”, it’s not a win for the poor or the underprivileged.  It’s a win for the insurance companies.  What if the government said that everyone had a “right” to an iPhone?  What stock would I buy?  Obamacare doesn’t necessarily say that healthcare is a human right…it says that insurance is a human right.  And those two things are not equivalent.

So, the people in this picture are clearly deluded.  They don’t completely see the picture as an insider does.  Instead, they are taking the spoon-fed lines of their political icons and barfing them back out.  Who made those signs?  Patients?  No way.  Politicians did.

The greatest trick the devil ever pulled was convincing the world he didn’t exist.

And just like that.  Poof.  You believe that healthcare is better because the government says it is.

Jun 09

Back to Basics

It occurs to me that I’ve been picking on the Anesthesiologists too much and, you’re right, they aren’t really to blame for the mess the medical profession is in.  Really, all doctors are as stupid and there aren’t any exceptions.

Here is a story by a patient telling about her (?) experiences with cancer.

Now, I can totally see this chick being a histrionic mess and a very inconvenient person to deal with.  But remember that we’re talking about a person who is undergoing surgery for cancer and she is SCARED.  And so no one talks to her, no one sooths her, except to say that, “Hey it could be worse.”  Some doctor (look, I’m not the one that said it was an anesthetist, she did) went on to say that HE had been in worse shape.  I mean…WHO CARES?

The point is that I have seen this story many times.  I have probably done it and not known it.  But what I’ve come to realize is that patients aren’t really impressed by what we can do, how busy we are, what care we drive, or how big our dicks are.  They just want us to talk to them and sooth them and tell them it’s going to be ok.  Or tell them it’s not.  They are scared and alone in this process and don’t want to feel alone.

But doctors, hospitals, insurance companies, and the government…they don’t care about the personal connection you feel to your providers.  And so they all treat you like you are like them – soulless and impersonal.  Welcome to the hell of 21st century medicine.


Jun 06

Anesthesiologists are Dumber than Surgeons

One of my favorite parts of my blogging experience in the area of absurdist doctor hating is the attention that Anesthesiologists have given to my blog.  I work with anesthetists quite a bit, and some of them I like quite a bit.  But it’s telling that my #1 post of all time, and the one that still collects comments today is my treatise on Anesthesiologists.  Look at all the vitriol by small dicked anesthesiologists trying for a feeble come back.  Why on earth would you comment on someone’s blog like this, when you KNOW that I have all the cards?  I can even edit the comments to make them seem stupider than they are.  Thankfully, for these geniuses, it wasn’t necessary.

I then went on to bait the gas-passing pussies behind the curtain more by rating Anesthesia as the stupidest speciality in all of medicine.

Today, I am vindicated, as I have found evidence collected by the British Medical Journal that in fact, Anesthesiologists ARE dumber than surgeons.  By a pretty good amount too.  Not only are Anesthesiologists dumber, but they are also weaker.  If penis size had been included in the study, I think the suicide rate of Anesthesiologists would probably have hit a critical point where they would be killing themselves faster than they can find nurses to replace them.

I welcome your ill-advised but hilarious comments, weak imbeciles.

Jun 01

What are you Afraid of?

The most dreaded part of Obamacare has not gone into effect yet due to the lobbying efforts of physicians.  That would be the IPAB – the Independent Payment Advisory Board.  This is a group that essentially tries to sort out what CMS (Medicare) should pay for certain services.  They only do it if the projected spending of Medicare exceeds the budget.  So essentially, the congress says, “this is how much you can spend” and then Medicare says, “We don’t have that much, how can can we make ends meet?”  And THEN, the the new law (passed by congress) says, “Well, a group of 15 individuals will come together and decide how to trim the fat.”  A big concern of physicians is that the cuts will come from their wallets.  It’s definitely founded, they are probably right.

Currently, rates are set, in part, based on recommendations from a specialty panel of the AMA.  So, of course, the AMA doesn’t want to be superceded by a new panel and be cut out of the picture.  The AMA, however, doesn’t have a very good record of advocating for the patients.  In fact, the American College of Physicians (ACP) has come out in favor of the IPAB as it could reduce the complexity of budgeting without being subject the pressures of lobbyists.

But where the rubber meets the road is the idea of cutting physician payments which are real.  Do you think that family doctors and internists are shaking in their boots over that idea?  No way, they already make less than everyone else.  The fat is going to be trimmed in areas that don’t benefit patients that much.  CMS just quietly cut reimbursement for vacuum erectile devices (VEDs) for men who can’t do viagra or penile injection therapy.  VEDs don’t work all that well and cost about $1000 a piece.  Only 10% of men who ever use them continue to use them.  Now…medicare won’t buy them.  Was there some massive uproar?  Of course not.  Because it didn’t make sense for CMS to continue to pay for them.

Would there be controversy?  Yes.  Would people lose income?  Of course.  But if a group of doctors gets together and says, “We are spending more than we have, where can we cut the budget to live within our resources?” then that is a benefit.

At my house, if we are spending more than we make, my wife and I sit down and discuss what to do to live within our means.  So we might drop our rate plan on our cell phone.  What if AT&T lobbied congress to prevent my wife and I from ever having the conversation?  You can no longer even discuss cutting us out of the pictures says AT&T.  That makes absolutely no sense.  And neither does fear of the IPAB.


Apr 09

Five Signs your Doctor is an Idiot

It’s been a long road, but I finally came up with another list for you.  My 9 Stupidest Medical Specialties gets about 10,000 hits a week, and so I know that’s what you want.  More discussion of what makes doctors so stupid in a format that you can easily cope with.  Because it is now 90% of the internet.

I give you:

5 Signs your Doctor is an Idiot!


Jan 31

Doctor Approved!

You people are such sheep.  Do you know how corrupt, lazy, and stupid doctors really are?  Do you think that if a company came to a dermatologist and said, “Hey, do you think this lotion is good.  If so, here’s $1000!”  Do you think they would not say, “Yeah, J’Approve!”  Because, Dermatologists train for 4 years to become skin dentists who inject things under your skin in the search for Benjamin Franklin and Friends.  Dermatologists don’t give a damn whether you live or die.  In fact, dermatologists don’t even treat black people.  In the dirty south, home of the African American, 27 rich white people see a dermatologist for every black person that does.  Also, if you are poor, you are about twice as likely to be diagnosed with advanced melanoma.  Do you know why?  Because fuck poor people says the Dermatologist.  All they care about is money.  And so this is the person whom you trust to decide which lotion to buy at Whole Foods?  No way, he just sold out to the person that would give him a buck to say he liked the product.


Jul 23

Socialized Medicine – The Road to Totalitarianism

Markets cannot be controlled.  They can be influenced by regulatory action, but they cannot be controlled.  Medicine relies on several government points of influence that existed long before the Affordable Care Act.  To practice medicine, I have to be licensed by the state I want to practice in, which is a very arduous and involved process.  Although in general it is difficult to lose my license, without it I cannot legally practice.  Just thinking about that fact causes me some fear.  I have no asset that has any value that generates money – like a machine, a store, or a piece of property.  All I have is my knowledge and expertise which, if the government wishes, I can be prohibited from using.  Permanently.

I drew this myself.  It took 5 times longer than writing this post.

I drew this myself. It took 5 times longer than writing this post.

Hospitals are the same.  In order to have a hospital, it must be licensed to operate and is held to very rigid standards.  Hospitals are in less of a bind because the right to operate belongs to the owner of the hospital and if lost, they can transfer all of the assets to a new owner who can resume operation after a period of review. 

Now, it seems like this level of regulation should lead to a very regiment system whereby the controls in place produce a very predictable result.  Nothing could be further from the truth.  In fact, medicine has the absolute lowest level of standardization of outcomes and practices of any major industry.  You can talk to several doctors and get completely different recommendations.  You can go to completey different surgeons and get completely different operations – and your outcomes may range from tragic to heroic. 

Here is where the concept of equality comes in.  You see, with the ACA, supposedly all people now have the ability to buy health insurance.  As it turns out, it’s pretty crappy and reimburses physicians a small amount of what they feel they deserve.  Whether they truly deserve more or not is irrelevant.  At the moment, every physician can decide if they want to participate in a given insurance program or not.  And not surprisingly, the physicians who can name their price for an operation are not interested in taking what amounts to, in many cases, a 1000% pay cut in order to treat people with crappy exchange plans.  Do you have options with your exchange policy?  Sure.  You can go to the guy who no one else wants to see.  Who routinely botches operations, abuses his physician privilege, and knows that you have no other choice.  His waiting room will stay full of desparate souls because he is the only game in town. 

This is what many opposed to ACA are calling the “two-tiered system” or “multi-tiered system” because while some physicians will be able to demand cash for an operation and may give superior results, other less skilled physicians will give poor results.  What those pushing for government paid medicine fail to account for is that you cannot encapsulate the market.  You cannot create a world where you control the product you are paying for unless you can successfully ensnare ALL factors that influence it.  The next logical step is to REQUIRE physicians to participate in whatever plan – at the cost of their medical license.  Many physicians will quit rather than be told how to practice.  So the next step witll be to REQUIRE physicians not to quit and to stay at their post.  You see where this is going? 

The attempt to control a market that many consider critical will ultimately fail unless the people of our country are willing to actually chain the participants to their “responsibilities” and force them to work for a wage that is considered fair.  To whom?  To the ones paying of course.  The ACA as currently structured will either fail or the attempt to make it work will destroy our country.

Jul 16


If there is a hell (other than the one we all experience daily), then there is a special place there reserved for dentists.  This blog is about doctors, however I will make a special exception for dentists.  Why?  Because they call themselves Doctor.  In fact, dentists are more likely to correct you if you call them “Mister” than an M.D. is.  Why again?  Because they want all of the glory and none of the blame.  Although in our society it is now considered a right for you to receive medical care, there are certain parts of your body that are exempt – specifically those parts between your mandible and your maxilla.

Open your wallet and say “ouch!”

Because the government doesn’t regulate dentistry like it does medicine, dentists are pretty much free to do whatever they want.  First off, they bill you a lot of money to do pretty much nothing but tap your teeth with a piece of metal while they glance at their watch.  Second, although an ER doctor is obligated to treat your life-threatening condition if you show up – dentists are not.  Don’t think there are life-threatening dental conditions?  Think again.  Third, dentists have the ability to prescribe medications, including narcotics, and they do so with abandon. 

Dentists have the highest rate of suicide among individuals who call themselves “doctor” (followed shortly by anesthesiologists I add with no apology whatsoever).  That’s because they know that their lives are completely worthless.  They got into it for the money and found out it wasn’t as good as originally advertised, and now they are trapped underneath a practice loan that isn’t going to get paid for on their undergraduate “Biology” degree.  And so they look for novel ways to make money like doing breast augmentation on the side.  Because they learned to do that in med school, right?  No.  They didn’t go to med school, but they own surgery centers and have a surgical license.  So if they wanted to do your heart surgery, guess what?  They could.

At least they do a good job cleaning your teeth!  Oh wait.  Someone else does that with a vo-tech degree.