During a time of giving thanks, I am forever thankful for our health professionals and their desire to help those in need. I am thankful for Grandaddy, SaSa, Mama, Brandi, Ashly, and all of the others out there who have devoted their working time to serving others. Through observation and conversation, I have picked up on a common concern and complaint from those in the medical field. I honestly don't know how they put up with this mess.
Please read this letter from a Physician...
Viewpoint: A Letter to the Country from an Emergency
Jacobson, Michael E. DO
Emergency Medicine News .
34,(11A,):no page #, 1 November 2012.
Jacobson is a graduate of Kansas City University of Medicine and Biosciences and
the emergency medicine residency at Henry Ford Macomb Hospital in Warren, MI. He
lives with his wife and four children in Omaha, NE.
I am an emergency physician with an apolitical message in
this rather politically charged, polarized time in our country. I have worked
for some time in this profession, and have noticed a disturbing trend about
which I must speak out — the growing number of emergency department scenarios in
which the selfishness and entitlement of those without real emergencies drown
out the quiet suffering of those in real need.
This morning a middle-aged
woman came into the emergency room in cardiac arrest. ACLS was performed to keep
her alive. Other patients were in the ED before she even arrived, certainly with
what they felt were emergencies, but treatments for these individuals were
placed on hold as this event took precedence. After 75 minutes of continual
heroic measures and life-saving interventions, with her grief-stricken husband
crying, holding her hand for the last time, and stroking her face, she
This was no movie, no reality TV show. This was as real as it gets.
Real life and real death. Family huddled around the bed to say their goodbyes
and wished they or we could have done more.
I walked to my office,
emotionally drained and exhausted, and from across the emergency department
another patient, upset that she had to wait, spoke out brashly in tones that
carried to every room in the department. “I know someone's dying and all, but I
am in real pain here.”
What most of America don't know is the emergency
department staff are graded with a nationally based report card by hospital
administration. A survey is sent only to those who are discharged from the ED,
not to those who actually needed admission to the hospital for an emergency or
to those, like this new widower, whose loved one passed. This survey is a
customer service tool used to see if people like coming to our ED and asks
whether we did a good job. The ED staff know this survey is skewed because of
the population to which it is sent, and certainly it is not the only tool
hospital administrators use to evaluate us. That is another topic for another
But you must understand, the real emergencies are rarely graded or
surveyed; they only go to those vast hoards of folks who were sent home, many of
whom did not get their narcotic medication refilled, like Ms.
“I'm-in-real-pain-here” who screamed her needs for all to hear, just within
earshot of a new widower.
Mitt Romney recently was secretly taped
speaking to his party base about the 47 percent of the nation that feels
entitled to health care, to homes, to handouts, and to ever-present help from
the government. If this lady represents that 47 percent, I have a few things to
The widower and his wife were also in need of care and financial
aid. They came to the hospital for emergency care and received it. He was
gracious about it, even when the scenario ended in a way he did not want. He and
his family were thankful for the care. They will not be asked how they felt the
care was, but screamer lady will be. It is doubtful that screamer lady would
have been happy short a lifetime supply of narcotics, free ambulance rides,
meals, and immediate gratification of all perceived needs. In fact, she and her
friend raided the refrigerator for food and beverages without asking permission
of staff or being cleared for eating or drinking prior to her labs and tests
This widower and his family behaved in a way that acknowledged
that there were others in the ED. They realized a limited but adequate number of
doctors and staff were available. They were calm in the face of a real
emergency, but never acted as though the world should stop for them, even though
it ended tragically. They knew how to play fair even though their real emergency
was not fair.
We live in a society that David McCullough Jr. describes as
rewarding mediocrity because everything fairness and equality. Everyone is
special, so nobody is. Everyone should get a prize for participating. And even
though Johnny didn't win, we're going to give him a trophy for trying because he
is special, too. Competition is bad because there is a winner and loser, and
that's not fair. This fundamentally wrong notion breeds false equality and
ultimately false fairness and entitlement. We do no one a favor by preaching
this. We are lazy parents if we can't find a constructive way to celebrate the
winner and help our children be happy for him. Instead, we have chosen an easier
road: to make all things fair and equal. If nothing can rise above, be more
important, or be first, then all must be mediocre. If all must be fair and
equal, all will assume the position of being just as important and just as
entitled as everyone else despite the real emergency or the real
The government mandates I evaluate and treat everyone who steps
foot in our emergency department, regardless of the ability to pay or the acuity
of the complaint. The government has passed health care legislation that makes
it so everyone must have insurance. Now everyone is equal, everyone is the same
— the broken physically, the broken emotionally, the broken spiritually, the
broken psychologically, and even the broken culturally. Many have primary care
doctors, but they storm the ED at 2 a.m. with the Burger King entitlement of
having it their way rather than waiting for their own doctor to see them the
following day. They will demand to be treated equally regardless of the acuity
of their emergency. And you know what? They will probably get it because we
don't want a bad report card from the feel-goods upstairs intent on establishing
great PR or the lawyers who will use government mandates to take away your pain
and make the other guy pay.
Were I to say something to screamer lady
about her behavior, she likely would fall back on the clichéd finger-pointing
canard, and say, “You're a doctor. You are well off. You don't understand. You
can't relate. And you are the one responsible for the high cost of health care.
It's your fault.”
As a young, married medical student, my family and I
participated in Medicaid because having insurance was a requirement for my
rather expensive medical school. I felt grateful, not entitled, to be able to
sign up for the program. I know poverty in America because I lived it for a
decade despite help from family. Government programs can help for a time. But
know this, I spent my high school years working on grades and homework and at a
job. I went to four years of college, working on grades and a job. I went to
four years of medical school working on grades and leaning on the government for
help, which I am now paying back. Then, I worked four years as a resident on
call, on 12- or 36-hour shifts with just enough sleep to go back and start
again. Now I work. And I work. Work and making good life decisions result in
prosperity. No one — I repeat, no one — becomes prosperous on government
programs. Student loans, food stamps, Medicaid, and unemployment benefits are
there to help temporarily, but for heaven's sake, government aid is not a right
and living your life like you are entitled to eternal government care is not
Anyone who wants to can go to school for 12 more years after high
school and work, incur student loan debt, drive a 14-year-old car for 12 years,
and study (while passing on TV, movies, parties, conversation, family life,
sleep, and eating to study some more). They can then make a living that buys a
nice home, clothes, insurance for family, and, hey, a new car. Anyone who can
work can do this. And I'm all for government help for those who, through no
fault of their own (and not their poor choices), can't work.
however, would reach into my pocket and take my hard-earned money while tapping
impatiently on my watch to give her more of my immediate time and attention when
others need it more, still claiming I am a cold-blooded heartless rich guy
intent on robbing her of all the government assistance that is her due while
simultaneously stiffing the hospital for what she considers an unconscionable
medical bill. I am not cold-blooded or heartless, just tired and beat from the
work I do and proud and gratified that I can do it. The same is possible for
anyone here in the land of opportunity.
Are we so far gone as a society,
in the name of popular progressivism, that we now don't view work as something
to be valued, specifically when the work requirement is removed from the welfare
bill? Are we so far gone as a nation that we vilify someone for their
hard-earned wealth and elect a national leader who believes in taking that away
to pay for those who would act as drains and not aquifers to the national pool
of prosperity? Have we developed a national mindset that makes it normal to
expect others to take care of us?
I think we develop a self-absorption
that is callous in the face of anyone else's need when we rely on the government
to handle our every need. No respect. No decency, no restraint, no
responsibility, and no apology for it.
Frankly, our government cannot fix
this, they cannot mandate a solution to this, and they cannot legislate against
this. Nor should they. The solution to selfishness and entitlement can only be
fixed with a mother and father (who know how to model character) teaching a
child that work is hard and rewarding, that life is not fair and never will be,
and that the freedoms you enjoy in this life are because someone else paid the
price. Get up and get fixing.
Michael E. Jacobson, DO
I think it is time take a deeper look into our health care professionals concerns. It is also time we make a distinction between those who are in need of help and those who think they are entitled to help.