The Human Comedy: Dr. Hamster and the Medical Industrial Complex Empire
“Good morning, Dr. Hamster!”
“Hi, Janice.” Dr. Hamster was out of breath. There had been construction on the GW Bridge again. “How was your weekend?”
“Your 8:30 is here.”
“But it’s not even eight!”
“I know, doctor. But in the interest of seeing more patients per minute, the Mighty Insurance Conglomeration ruled last night that 8:30 would actually mean 8:00, and 9:00 would mean 8:30, and so forth. And because the patient gets to be seen earlier than his or her scheduled appointment, we get to charge double! Of course, the visits will only be able to last half the time.”
“That’s not fair at all! How can we -”
“Your 8:35 just walked in, Dr. Hamster! You need to get to work!”
Dr. Hamster was a family physician at New York City’s Ur Hospital (a.k.a. “The Center for Inferior Care at Astronomical Prices”). He had worked there 35 years, and in that time he had seen it go from a place where doctors knew their patients like family members to a place where doctors knew their patients as customers in a fast food restaurant. He had seen it get devoured by the Medical Industrial Complex Empire (MICE), of which the Mighty Insurance Conglomeration was part. He had seen medical personnel become variables in an algorithm that sucked up principles, ethics and professional standards and spat out money and red tape. He had seen lawyers, pharmaceutical companies and venture capitalists swoop in like vultures. He had seen physicians and their patients become forgotten pieces of a profession which had, for thousands of years, centered around physicians and their patients.
“Good morning, Mrs. Pierce!” His 8:30 (at 8:00) was a 72-year-old woman he had never met before. She had transferred to Ur Hospital’s care after the passage of the Let’s Insure Everyone (They’re All Screwed Anyway) Act.
“Hello, Doctor. I have a couple ques-”
“Let me look at your chart a moment, Mrs. Pierce.” Dr. Hamster knew she had questions. They all had questions. But questions took time to answer (and sometimes couldn’t be answered), and the hospital only made money off the questions that could be answered by super-expensive tests. The MICE had trained Dr. Hamster to look for the money-makers. He picked up her chart – a Bible of data, spanning 15 medical institutions and 45 years of patient history – and scratched his head. “You have hypertension,” he told her.
“That’s what they tell me, but I’m neither hyper nor tense.”
“It means you have high blood pressure.”
“You would, too, if you had to sit in that waiting room.” Mrs. Pierce sighed, her list of ailments ready for presentation. “About a week ago, I -”
“Just one moment, Mrs. Pierce.” Dr. Hamster swerved his head to the opened door. “Yes, Janice?”
“Your 8:35 is here.”
“Tell Mr. Green I’ll be right with him.”
“Your 8:40 is here as well.”
“Aren’t these people ever late?” he wondered aloud.
“Your 8:25 was. She wants to squeeze in at 9:00 – which is really 8:30.”
Dr. Hamster shook his auburn-shagged head. “Mrs. Pierce, you’ll have to excuse me.”
“But I didn’t get to express any of my health concerns!”
“I’m terribly sorry.”
“So what? I should email you?”
“Email would actually be way more effective, if your concerns are minor. The problem with emailing is that we wouldn’t know how to bill you for it.”
“See you in a week, Mrs. Pierce!” Dr. Hamster rushed across the hall to greet Mr. Green. “What brings you in today?”
“My elbow hurts.”
In Dr. Hamster’s well-conditioned brain, a light bulb popped: MRI – totally billable!
“And my wife left me.”
That was more delicate issue that would require Dr. Hamster’s attention, listening skills and long-standing relationship with the patient. He knew Mr. Green was telling him something important, but he didn’t see how that something could be profitable and, therefore, a justifiable use of his time. “You’re in luck!” he told Mr. Green. “We are going to look at your elbow with the world’s most state-of-the-art technology! We needed a $20 million grant to acquire the machine, but now we can see into elbows as if they were made of glass.”
“That’s great, Doc,” Mr. Green said, sounding nowhere close to enthusiastic. “I really don’t think anything’s wrong with my arm, though. Just a little sore from raking leaves. Really I just wanted to see you because of how I’ve been feeling after my wife -”
“Just a minute,” Dr. Hamster said, examining Mr. Green’s arm. He knew what Mr. Green wanted from him – an ear to listen, a heart to care, and some kind advice – but he also knew that there was no way he could provide all that in a two-minute office visit. So he gave the sore elbow a jostle. “Listen, we don’t have this great equipment for nothing. I’ll write you a referral.”
“But my wife, Doc!”
“We can look at her elbows, too. And here’s a script for some Prozac.”
“Prozac? I -”
Dr. Walker turned to the door before it even opened. “Yes, Janice, I know. I’m coming.”
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