Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Friday, April 11, 2008

A "Stupid" Rant

(I wrote this the other day when I was too hopping mad to see straight. Today, GruntDoc's post about waste rekindled my ire; hence the profanity:)

Who the fuck does an MRI on a 14-year-old gymnast with two months of low back pain, no history of injury, no neuro findings and a normal physical exam? A suburban orthopedist, of course. Believe it or not, the study showed "mild degenerative disk disease," but it had no impact whatsoever on management: wear a lumbosacral support; activity to comfort.

Cut me a fucking break! Talk all you want about how much money the "healthcare system" wastes each year/month/week/hour on futile care, defensive medicine, unnecessary medications and bullshit hospital admissions, but this is the bread and butter that pads specialists' incomes to the half-mil mark.

Build it and they will scan! An MRI on every street corner, and they won't go begging for business either. Shit; how long until someone starts to push screening MRIs for brain tumors? Catch them early, you know. Not that you could do anything about them, but at least the patient might live for six months instead of six weeks. Can anyone say "lead time bias"?

This isn't defensive medicine; this isn't zebra hunting; this is intellectual laziness plain and simple. Just because someone got into and out of medical school and an orthopedic residency does not mean they can't be STUPID! And that's what this is: stupid, wasteful and well, stupid.

As of today, I'm changing the Fourth Law of the Dinosaur from "No good deed goes unpunished" (a generalized truism that was suggested originally by Flea and included because I didn't have many Laws at the time) to:
There is no cure for Stupid.


At Fri Apr 11, 10:14:00 PM, Anonymous Anonymous said...

Amen. Or for crazy.

At Sat Apr 12, 01:07:00 AM, Anonymous Anonymous said...

No cure!?!? Good god, I'm fucked!

At Sat Apr 12, 05:39:00 AM, Blogger ArkieRN said...

No, there is no cure for stupid. And, unfortunately, it isn't often fatal. Thus years and years of suffering ensue (not for the stupid, but for those afflicted with them).

At Sat Apr 12, 08:55:00 AM, Blogger CrankyProf said...

Actually, there IS a cure for stupid. It's death.

Unfortunately, most of them have passed on TEH STUPID via reproduction.

At Sat Apr 12, 08:52:00 PM, Anonymous Anonymous said...

re: ...but this is the bread and butter that pads specialists' incomes to the half-mil mark.

I actually highly doubt the orthopod recieved a penny form the MRI. The radiologist however...

At Sun Apr 13, 10:59:00 PM, Anonymous Anonymous said...

OK...sung to the tune of the bandage jingle (you know the one):
I am stuck on stupid,
'cause there's no cure for me;
I am stuck on stupid,
I graduated with a D;
I can treat your back,
and a broken knee;
but don't call back
and question me;
I am stuck on stupid
and I'm so glad I'm me.

At Sun Apr 13, 11:59:00 PM, Blogger Doctor David said...

Amen to your post and all the comments. I hope you don't mind, but I intend to quote you frequently.

At Mon Apr 14, 11:40:00 AM, Anonymous Anonymous said...

I agree. I have a saying: When all you have is a hammer the whole world looks like a nail. That's why everybody that goes to the cardiologist gets an echo a stress test. That's why you can't even and get in to see the neurosurgeon without an MRI.


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