Wednesday, October 17, 2012


There are so many changes in medicine these days, but it takes a bit of time away from the keyboard to appreciate them.

So glued have I become to looking at computer screens, it's been hard to pull my head from them any more.  Doctors lives are spent staring at these damn screens now.  I wonder how many of my youngest colleagues know how to start an IV, a foley, place a central line, or safely pass an nasogastric tube, let alone examine a patient.  Now we just click an order and things magically happen by a team of technicians.  Doctors are now the Masters of Click.  Clicks are now how doctors are measured, quantified, and sadly, actually valued.  If it wasn't clicked, it didn't happen.

The environment for doctors continues to change, too.  But it's even more evident now if we stop and look for a moment.  There used to be the Doctor's Lounge - a sacred inner sanctum in a hospital where doctors could congregate, get a small bit to eat - maybe an fresh apple - and find a few colleagues exhausted from the night before catching up on the news.  Now, there might be a coffee pot that dispenses come hot-water-concocted chemistry experiment it labels as "coffee" but takes like Drano.  Our space called the Doctors Lounge has become an antiquated mail room with long-forgotten names lying askew on a wall of drawers.  No one checks these boxes any more; we're too busy emptying our electronic in-boxes on the screens that replaced the chairs there.  And of course, the same thing's happening to the Doctors Dining room - if such a dining room exists at all any more.  Doctors rarely have a meal together to re-group and share our medical concerns with each other there.  Instead, most now eat in the employee dining room if they have time to eat at all between patients.

But there is an upside.  The hospital has never looked better.  We smile more and watch the Bears on Big Screen TV's with our patient-customers on weekend rounds to improve patient satisfaction scores.  Hospitals are officially in the hospitality business.  This is how those of us in the "business" are getting paid and measured now.

And finally, there's our new dress code.  The once heralded white coat donned as a medical student that later gives way to the once-heralded grey lab coat of an attending physician has lost its respected value, too.  Instead, the grey lab coat of the attending as been relegated to nothing more than a sign of the Responsible Physician.  Far grander now is the Brooks Brothers suit.  Or maybe a really nice sport coat and tie.  Or maybe, for the real Movers and Shakers, just a designer shirt, polished shoes, and tie.  These doctors are the new Leaders now.


There used to be a time where doctors rose above the administrative fray for the good of our patients.   Now, the new standard of "exceptional physician" is that of a keyboard operator and administrator.

Now, excuse me while I get back to clicking.



Anonymous said...

The Doctor's Lounge and Doctor's Dining Room . . . those are history, gone to the Special Spaces Graveyard, along with the Faculty Dining Room and the Executive Board Lounge etc etc. Only congress keeps that stuff going (not that you'd want to send photos from the congressional gym). As for the white coats / grey coats, you guys were the only ones who understood the difference anyway. About spending life glued to the computer screen -- no doubt you're right. But don't ever, ever, ever start giving patients your e-mail addresses, or you'll be stuck like the rest of us.

And you're right, none of it's an improvement!

Anonymous said...