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Information for people contemplating
a career in emergency medicine and
other medical specialties

By Kevin Pezzi, MD


Lazy doctors kill and get away with it

by , MD

The article Bonuses for doctors do little to improve cancer screening in Ontario contained this excuse: “… many family doctors in Ontario may not have the tools they need to generate electronic reminders that can trigger screening.”

Hogwash! Don't they have a brain?

When I worked in an ER in the top 5% of acuity in Michigan (translation: we treated a higher percentage of critically ill and injured people than 95% of the emergency departments), it never ceased to amaze me how many middle-aged and elderly patients told me the rectal exam and stool occult blood test I performed on them was the first time in their lives that was done for them. Translation: it wasn't EVER performed by their family doctors.

If comedian Jackie Gleason (nicknamed The Great One by Orson Welles) were alive, he'd tell you that rectal exams and stool occult blood tests can help diagnose colon cancer—which he died of, reportedly because his doctor was intimidated by his celebrity status.

More hogwash: I've had sports stars and sundry celebrities as patients, and if any of them needed a rectal, genital, or breast exam, they got it, pronto, as did virtually everyone else. Almost no one refused, and if they tried, I knew they really wanted to live more than they wanted to avoid unpleasant exams, so I'd quickly persuade them to agree: remember, this was a very busy, high-intensity ER, and I didn't have much time for chitchat.

So if I could do it in an ER pressure cooker (here's a true example), why can't family doctors in Ontario do it? They obviously could, but they're too lazy.

When doctors are offered a $8400 bonus per year for doing what they should be doing in the first place and they still don't do it, thereby sentencing some of their patients to premature and preventable deaths, those docs are so lazy they're a threat to their patients.

The primary responsibility of governments is to protect people. If a $8400 carrot doesn't work and a patient dies as a result (and they inevitably will), either revoke the doctor's medical license or, for greater effect, publicly execute him and compel other doctors to watch—they'll get serious about their jobs, stat, even without the financial bonus.

Am I being tongue-in-cheek? You decide, but think about this: governments often execute people who kill just one person. One lazy doctor can kill hundreds of people. Should he get a pass just because he wears a white coat?

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