Deirdre Neilen, PhD: Lynette Lamp practices family medicine in St. Charles, Minnesota. She shows us an ugly side of medicine, the business side, when physicians must answer to a predetermined model of care that is assigned to them by the bean counters. Here is:
"Relative Value"
Management is explaining Relative Value Units,
RVUs, discussing our worth to the organization.
The numbers are swimming on the page, taking turns
jumping off the high dive, congregating
by the snack bar. I wonder if there are extra points
for kindness, for rescuing numbers from the deep end.
They say no, just for complications.
But it's complicated to be kind. Or it can be.
Suturing a dangling earlobe while
the handcuffed patient tries to bite me
is complicated. If the wound has several layers,
they tell me, that's more points. How many
cops it takes to hold him down while
I work does not figure into the calculations.
How I feel about the profanities he yells
is irrelevant. And if I don't record what occurs,
it didn't happen. So, I type in: multilayer closure,
four centimeters, facial location. I leave out
his spit dripping off my face shield,
all his curse words, my nervous sweat
seeping through my gown. Adding that,
they say, wouldn't be professional.
So, it didn't happen.