Wednesday, December 28, 2016

The Ear Game

If I could, I would spend all day cleaning ears.  Seriously,  There is almost nothing I do that makes patients happier.  Not diagnosing a rare disease,  not treating diabetes or heart failure.  Of course, those patients are thankful too.  But very little lights up a face more than the instantaneous relief and the rush of sound that comes when knocking loose a particularly egregious glob of cerumen.

I figure I could set up four or five rooms in tandem.  Each with a its own sink, syringe, and various plastic scooping tools.  I would spend all day excavating.  Sifting through the mud to expose tympanic membranes long buried.  I would deliver every doctors dream-sudden, immediate, uncomplicated relief.

I would spurn insurance.  Each patient would come in with ears full and leave with pockets empty.  There would no longer be any electronic medical record or meaningful use.  MACRA would be a thing of the past.  Instead, I would spend my time doing that which I was most trained to do.

Clean ears.

I would become an expert and be known far and wide.  I would be listed as one of America's Top Doctors.  I could be interviewed on the Today Show and Good Morning America about the sinister danger lurking in those funny protruding orifice (who knew orifice was the plural of orifice?)

And life would be good.

Sure, you might argue that I will miss the struggle and humanity of treating real human disease.  The rush of delving into the bowels of human suffering and trying to lift my fellow man.  I can't argue with you there.

But when you clean ears for a living, you don't get those angry calls.  The family members who are convinced that you harmed their loved ones or the drug abuser who finally met a physician who won't just fill the meds.

You don't have to worry about malpractice.  No one is going to bring a million dollar suit against you because you forgot an ear.  Or left equipment in the canal.  In fact, you most likely can stop paying those crazy twenty thousand dollar a year premiums.

When you clean ears for a living no one cares if you use an electronic medical record.  There are no books for medicare to audit.  No ICD 10 codes or CPTs when you take cash.  There are no late nights combing over documentation to make sure that you remembered to mark off smoking status or that your PQRS data are crystal clear.

You can stop wearing your pager and turn off your cell phone at night.  No more interruptions while your sitting on the toilet, or taking a shower, or god knows what other personal things you are doing when all of the sudden a nurse must immediately report a skin tear.

And when you clean ears for a living you can stop building those damn walls.  You know, the ones you make in those dark times when something hurts really bad.  The ones your fortify day after day, week after week, and year after year.  Because before you got into the ear game, there was a lot of pain and suffering.  There were late nights and honest questions of culpability.  There were those patients you couldn't save.  And those that you could save but somehow didn't.  And those mistakes you made, or didn't make, or maybe are not sure about.

You wouldn't wake up in the middle of the night in a cold sweat.  Or jump every time your daughter texted you because you thought it was the hospital.

And maybe,  just maybe,  you would stop getting up every morning before the alarm went off.


James McMahon said...

In Japan cleaning your loved ones' ear wax is a common bit of mutual grooming. The wooden scoop tool is in every house.

The Van Deventers said...

Geez, "it is this all there is" to quote the song?

Cleaning ears is where you get your $$$?

Nurses know how to that and more for the patients with these chronic problems. Is this a good of use of you time and expertise to clean ears? Is this the best ways to use your education and expertise?

Why not have the most suitable practitioners do the jobs that they do well so you can do yours?

Or is money and income your bottom line rather than meeting the needs of patients in you panel?

Gary M. Levin said...

Yes, it is the same when I remove a cataract or laser an 'aftercataract' Large smile !

Gary M. Levin said...

Van, the answer is in the eyes of the beholder. What rocks your world ?

Anonymous said...

I'm with you, Jordan. I'll clean ears any day as it is the most satisfying immediate gratification there is. I steal these patients from the nurses if I'm having a bad day and need to make a patient happy.

Emily from Barnstorming

Diane said...

Whether you are a trash collector or dog walker or stay at home parent or in your case even a Dr. , getting up before the alarm is a sign of adulthood, responsibility, love , concern, passion. When the day comes that the alarm clock wins I might as roll over and die. :-)