Saturday, July 30, 2011

Time Is Money

We have a surgeon whose entire world view boils down to "time is money". It is annoying, and more than a bit pathetic, to see a grown person go through life living this business mantra. Lest anyone forgets this, he utters these three words repeatedly during an entire procedure.

Since any time not working billable hours is time wasted, he doesn't show up for his cases until the preop nurses page him to let him know the patient is ready to go to the operating room. He then rushes to preop holding and says a quick "hi" to the patient, writes his informed consent in the chart, then dashes out of preop, telling us to page him when we are ready in the operating room. In the meantime he has charting and other business to take care of that will earn him more coin.

We then take the patient to the O.R. He is quickly anesthetized, prepped, and draped. Then the surgeon is called. He arrives and does a quickie rubdown with Purell (must have been a godsend for him now that he doesn't have to do a three minute scrub at the sink, just a few swipes of the Purell up and down the arms). Knife. Slash. Cautery. Buzz. Staples. Clip. If he request something that is not on the circulating nurse's table he gets visibly annoyed and impatient. And he mutters, "time is money" to all in the room.

When the skin is closed after the last staple, he quickly rips of his gown. He writes down an illegible three line op report in the chart and hurries out the door. At this point the patient isn't even awake yet. He rarely speaks to waiting family members afterwards since, you know, talking to family doesn't pay the bills. His assistant is usually tasked with that job. Forget about calling him back afterwards for a missed item on his orders. He is usually miles away from the hospital by the time the recovery room nurses have had a chance to examine them. Talking to recovery room nurses doesn't earn him any dinero. That's what the hospitalist is supposed to take care of.

With all the discussions about crushing student loan debts afflicting most medical school graduates, it's a surprise that attitudes like this don't affect more doctors. I have no idea if this guy has any overwhelming student loans he has to pay off. He has been in practice for over ten years and it would be sad if he was still rushing around like this just to pay his debts. But then again, his luxury German sports car belies any difficult financial burdens he may be facing in his life.

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