I'm Sounding The Death Knell

It was a particularly challenging case.  On the car ride into the hospital, I found myself doing something that I rarely do.  I called a local allergist for an inpatient consult.  Most allergy issues are not an emergency.  So it is odd indeed to summon this particular kind of physician into the medical wards.  His nurse took the message and promised that she would plug my mobile number into his pager.

A few minutes later we were discussing the particulars of the case.  He was excited by the details.  This was something that he had only seen a few times in his career.  He rattled off a number of questions and I answered them to the best of my ability.  I was standing in the hospital lobby by now. I didn't want to risk venturing up to the patient room for fear of losing my mobile connection in the stairwell.

I was about to give the floor and room number when the allergist interrupted me with an unexpected question.

Do you work for the medical group?

He was referring to the large hospital based practice that had recently bought up almost all other physicians in the area.  I knew that he had joined them, but generally don't consider such alignments when making decisions about who to consult on a particular case.  I always try to call the best physician for the job regardless of who they work for.  I paused for a moment before telling him that I was still part of an independent practice.  Although I could sense the hesitation in his voice, I would have never in a lifetime expected what came out of his mouth next.

Oh, um sorry, I only do inpatient consults for physicians who are part of the medical group.

It was such an abrupt surprise, I hung up the phone dumb founded before thinking of the litany of questions that were now pummeling through my head.  Since when does the politics of corporate medicine replace helping those in need?

I'm sounding the Death Knell.

The primacy of patients in our healthcare system has now ended.