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McMedicine

McMedicine
Is taking over
Our nation

McMedicine says
Use a template.
That means
The doctor asks questions
That are in the computer.
It saves a lot of thought
But it is McMedicine
it's not real medicine

McMedicine says
See the patient
For one problem only.
Never mind
That the average patient
Has five chronic diseases.

If you see a patient
With diabetes, high blood pressure
Bad kidneys, heart failure and a toe infection
And you see them only for the toe infection
You could damage their kidneys
Or kill the person.

The truth is
No doctor wants to do this
Really
But doctors are told
"We need access!
The community demands it!
The hospital will go bankrupt!
You don't want that, do you?"
Ant the doctor tries
Fails
Doctor have quit nationwide
For years
As they reach 40 or 50
Burned out
By the paradox
"Work faster"
versus
"Do good care."

And at the conferences
We are harangued
"Less than half of diabetics are diagnosed."
"Less than half of hypertensives are controlled."
"You are missing women with heart disease."
Doctors are in a nutcracker
Some crack.
Some quit.
Some die.
"See your patient for one thing."
It is McMedicine.
I won't do it.

McMedicine
Sets a quota.
We are a rural health care site
This gives us extra payments
For medicare.
We need this, we are told
To stay in business
Congress set a quota
For rural clinics
18 patients a day
Per full time equivalent
Primary Care Doctor.

Did they set a quota
For surgeons?
After thirty minutes
In the operating room
Does the surgeon have to close
The patient's belly and stitch it up
Even if it was not appendicitis
And turned out to be cancer?
The surgeons would be up in arms
They would wave their scalpels at Congress
Yell "Change the law!"

And do you think it is different
When I walk in a room?
I saw a woman with tongue pain
They gave me 20 minutes.
It took longer.
She had had treatment with radiation
Two weeks before I saw her
I called a specialist
Radiation Oncologist.
He said, "I don't know.
I will look it up.
I will call you back
In twenty minutes."
She had strep throat too.
He called me back
We had a plan
It took more than twenty minutes.
And it did not fit
In a template.

Quotas and limiting visit times
That is McMedicine.
I won't do it.
I see red
When I am pushed.

McMedicine says
"We want you to succeed.
You need to follow our rules.
The people of our county demand this.
You need to stop telling patients that
You want to talk to Congress."

No.
I disagree.
Anyone may aspire to speak to Congress
That is freedom of speech.
And I think
The constituents
The patients
The people
Want to see a doctor
Not a template
Not a computer
Not be a number in a quota
Not have one visit for every problem.
I think that my patients
Do not want McMedicine
I think they want
To see
A doctor like me.

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