patient comes in w/chief complaint of “I need a nuclear scan”

resident’s full assessment & plan is solely the need for said scan.

attending is suspicious, sees patient, who proceeds to describe how people had injected him with strontium while he was sleeping, and he needed a scan to find it and remove it.

this guy gets to rate his doctors online (www.ratemds.com), just like the bozo with a cold who’s pissed at his doctor for not giving him antibiotics – “I once got that pink pill, the one with the ‘z’ that you take two of on the first day, when i felt just like this, and it really worked like a charm then”

that’s the problem with “patient-centered” care.

My brother went to and ortho guy for an elbow problem. He discribed to me a thorough history and exam followed by a referral to PT. He is hacked off because he thinks he needs an MRI. He will go somewhere and get an MRI.

Things like this convince me that the best thing we could do for runaway healthcare costs in American is have less insurance, not more. Eventually the ortho guy may notice his fellows who run a business instead of practice a profession make more money and decide to join them. It will be another one lost from the fold.