Wednesday, April 21, 2010

Free Goodies for Docs

One of the perks…a really good perk, to be frank…of being a physician is access to the Doctor’s Lounge. Every hospital has one, although admittedly they vary. At small rural hospitals, there may be nothing more than a couch, a television, and some dated packages of snacks. Bigger hospitals have lounges that look like a British Airways first class frequent flyer club, complete with full-service food lines, big screen televisions, internet access, and a panoply of drinks and other consumables. (The spectrum of snacks will vary…some hospitals, not recognizing that the main drivers of medical practice are science, compassion, caffeine, and sugar, insist on stocking their larders with fruit and juice and granola and Sun Chips and the like. Those hospitals tend to do less well in measures of physician satisfaction. Go figure.)

I recognize it sounds obnoxious, but there is very little that is as satisfying in the middle of getting slammed in the ED than going up to the Doctor’s Lounge and snaring some munchies at will while everyone else has to trudge to the cafeteria or the vending machine for their coffee, stand in line, and drink whatever the machine happens to spit out. Is it fair? No. Is it equitable? No. Does it smack of elitism in our classless society, where people should be measured not by the initials after their name, but by what they contribute to society? Absolutely. (And this is why before going to the Doctor’s Lounge, the socially responsible physician will always ask around to see if anyone else wants some free sodas or ice cream while he’s raiding the pantry.) But would I be willing to trade it? No way. I feel the same way about the Doctor’s Lounge that I feel about physicians getting better parking spaces and nicer treatment from banks and airlines and the way that the police give ED docs an extra five miles an hour over the speed limit and three months after plate expiration because someday we’re going to need each other.

It has occurred to me, however, that the contents of the Doctor’s Lounge can be used as an index of the fiscal health of the institution. The place where I work now is a public hospital with the morally right and valid mission to serve all comers, regardless of financial status. However, the hospital is becoming strapped by increasing demands upon its services from patients who are unfunded or uninsured, and who in this time of recession are really unable to access any other point of care. So there is a continual effort to pare costs to meet budgets in order to continue to provide patient care services.

You’ve probably heard of the canaries that were used in coal mines to detect poisonous gas. I’ve come to the conclusion that the contents of the Doctor’s Lounge are our institution’s own songbirds. For example, in October 2008 when I started work here, the Lounge offered a made-to-order omelet service on Thursday mornings, shrimp cocktail for lunch on Tuesdays, and the food service staff stocked small refrigerators close to physician worksites throughout the institution. Last spring, the omelets went away. (I still see the chef in the halls, who looks genuinely sad when I tell him I miss our weekly visits.) Then the shrimp, which were usually served four to a plastic cup, were reduced to three per serving. And now the peripheral refrigerators are not being stocked, which raises the interesting sight of physicians skulking through the halls holding large plastic emesis basis, going to the main Doctor’s Lounge, and carting off containers full of sodas and snacks to restock their local shelves. Not that I know anything about that.

I’m willing to go along with most of this because I truly believe in the mission of the hospital and I really would miss all the folks I work with. But if they take away the ice cream…specifically the Good Humor Strawberry Shortcake Bars, if anyone’s listening… I’ve got a real career decision to make. And for the record, my loyalty can be bought with Creamsicles.

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