cranquis

The Night Before Cranqmas
  • The Night Before Cranqmas
  • Dr. Cranquis
  • The Night Before Cranqmas
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THE NIGHT BEFORE CRANQMAS, BY DR. CRANQUIS ‘Twas the night before Cranqmas, and all through the Urgent Care Not a creature was stirring: no patients were there! We’d been very busy but now it was Q-word. (That’s “Quiet”, but we don’t dare announce it, ya’ heard?) The staff were slumped over, worn out, in their chairs; While visions of leaving on time danced through the air; And Nurse in her smock, and I in my scrubs, Had just called the pizza place to order some grub, When out in the waiting room there arose such a clatter, I sprang from my chair to see what was the matter. Away to the window I flew, lickety-split, Just in time to see some guy throw up through it. The emesis on the breast of the still-heaving guy Was black and smelled like something had died. I glanced to the parking lot to see how he got here: Just as I thought: he’d ridden a John Deere. He slurred out his name in an accent so thick, I didn’t quite catch it, so I nicknamed him Old Nick.  More rapid than eagles his retches they came, And he wheezed, and he shouted, and he called us bad names: “Now, ****er! You *****er! I’ll *** your ****! Give me some Dilaudid, you **********! Whaddaya mean, "Do I drink alcohol?” I had a fifth of vodka today, maybe 2, that’s all.“ Now quick for an emesis basin my skillful nurse flew, As the barf hit the floor, and Old Nicholas too. And then in a twinkling, the emesis turned bright red – Esophageal rupture: this dude was half dead! As I reached for the phone and called 911, He slumped to the floor – (oh joy, here comes the fun). His eyes were so jaundiced! His breathing so shallow! His cheeks and his nose pale as a marshmallow! He had palmar erythema and a distended belly That shook when he retched, like a bowl full of jelly. Classic alcoholic cirrhosis, with Hep C probably, So I pulled on some gloves to hopefully protect me. A feel of his pulse, which felt thin as a thread, Soon gave me to know I had plenty to dread; He spoke not a word, just continued to hurk, As we placed 2 IV’s and tried to make his heart work, His blood pressure dropped as mine steadily rose, But hark! Ambulance sirens! So glad to hear those! The EMTs snatched him, slick as a whistle, And away they all flew like the down of a thistle. But then I heard him exclaim, as they drove out of sight— “Hey it’s Cranqmas, y'all – can I have a Bud Light?”
for those of us on our last spoon.

it’s waking up from a restless night of sleep, bracing yourself to face the day.
it’s willing your body to make it two more steps, so you can brush your teeth.
it’s compromising looking decent for having a bit more energy.
it’s realizing how tired you are…and it’s only nine in the morning.

it’s trying desperately to focus on your professor’s words.
it’s constant shifting to try and get a bit more comfortable.
it’s holding back the tears as you remember that meeting.
it’s nap time, because without it you would collapse.

it’s telling people no, not because you don’t want to but because you can’t.
it’s always feeling like you’ve let someone down.
it’s nagging pressure to try and act normal.
it’s your body shutting down when you do that.

it’s a phone book’s worth of doctor’s office numbers.
it’s lab work every month.
it’s eight, ten, twelve pills a day (or more).
it’s hoping and praying that this new treatment is effective.

it’s looking normal but knowing you’re not.
it’s judgmental glares from strangers when you take the elevator, not the stairs.
it’s misunderstanding from friends who truly do care.
it’s not fair, but you deal.

it’s giving up the life you thought you’d have because you can’t physically do it.
it’s seeing other people happy and healthy and wanting it for yourself.
it’s emotional and physical pain, twenty-four seven.
it’s wishing it would all go away.

it’s hearing you’ll never be able to have children.
it’s feeling inadequate and invisible.
it’s wanting what you’ll never have.
it’s the worry that something else will pop up. 

it’s fibro and lupus and hashimoto’s and crohn’s.
it’s CFS and PCOS and CAH and RA. 
it’s endometriosis and celiac and cushing’s and MS.
it’s chronic illness, and it’s your life.

***

i promise i’m not depressed; well, at least not in the sense that i’m gonna go and do something cray. no, i have a strong support system and for that i am eternally grateful. but it’s been a rough week. i feel as if i went from the mountain top last week to the darkest valley this week - and it is all because of my stupid immune system.

invisible, chronic, autoimmune illness has plagued my life. there are some days when i say that everything is going to be alright, that i’m alright, that it’s just another thing, that there is medicine for that. then there are some days, like today, when i’m so spent i can’t even make it out of the apartment. i use up the little energy i have on homework and have nothing left for friends.

one thing that i’m learning - and that my mom reiterated to me earlier today - is that i have to stop worrying so much about what other people think, because it’s not their body that pays the price for me pushing myself too hard. and she’s right. as whiny as it may sound, any person with chronic illness can tell you that if you push yourself just a bit too much, you pay for it the next day. and it takes a while to pay for it, because it creates this snowball effect of trying to catch up on the stuff you miss while you’re paying for pushing yourself too hard, and the vicious cycle continues.

i just want so desperately to lead a normal life, but that is an impossibility. the only thing i can do is make the most of what i have, and learn to love myself, to take care of myself, and to be all i can be. 

this all happened for a reason, i’m sure of it.
one day i’ll know. 

for now, while i try and conserve the spoons i have left, i thank God for specialists who seem to know what they are doing (even though i had to go through some crummy ones first) and for my support system, those loved ones who never fail to make me smile, even on the dark days. 

PMTH Breaks Ground for the All-New Statler E. Cranquis Pillow-Fort Wing

Thanks to several generous donations from Tempur-Pedic, Sear’s, Ashley Furniture, and Mason’s Brick Supply, PMTH is excited to begin construction on a brand new Pediatrics wing. 

The design of the Statler E. Cranquis Pillow Fort Wing, as it will be named, was inspired by a recent interview Dr. Cranquis gave with In-Training. Our current pediatrics wing is full of hard floors and sharp corners, bright lights, and roomy hallways. Things, of course, not conducive to fostering childlike wonderment and imagination. 

We at PMTH are committed to encouraging imagination and fostering a sense of wonderment in our pediatric patients–yes, even those who are seriously ill–so in the spirit of that commitment, we contracted with a team of biomedical engineers, architects, and contractors to design a new Peds wing that would put the focus on fun before sterility and safety.

The Cranquis Fort, as it is affectionately being nicknamed, will be constructed entirely out of specially engineered stain and fluid resistant, hypoallergenic, down-free, self-sterilizing pillows and couch cushions. The wing will be lit with white christmas lights and dim flashlights and a strict no-shoes policy will be enforced there. The quilted ceilings will have a maximum height of 5 feet (speaking of which: we are also searching for more nursing staff for the wing. Applicants under 5 feet tall will be given preference.).

There will be no individual rooms in the Cranquis Fort. Patients will be housed ward-style and separated by age. Age-appropriate books, board games, and puzzles will be provided in each ward, as the Cranquis Fort will also be screen-free.

In celebration of the groundbreaking ceremony, the nutrition department has developed a special limited-time-only pillow-fort menu for the adult patients of PMTH, which will replace green jello with s'mores and gatorade with hot chocolate with extra marshmallows. This menu will of course be available at all times in the Pillow Fort Wing. 

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Donations of pillows, blankets, Christmas lights, and flashlight batteries, as well as cold hard cash, are always appreciated at PMTH. 

anonymous asked:

Where do you think Craquis is?

Cranquis and i have an agreement that allows me 3 guesses of his location per year. Unfortunately, I have used up my guesses for the year, so I can’t really venture a guess now. Also, my location guesses are based on my sleuthing of his blog and are between me and him (her?). 

But I’m currently working on states between New York and California, if that narrows things down for you any. 

anonymous asked:

what did you write in your personal statement for your medical school application :) love your blog whooop whooooop :D

Plus a follow-up question from the same reader:

sorry it is me again XD sorry to ask, who did you ask to get your references as well :P !!!!! happy easter!!! 

——

Well, Whooping Crayon, I had to dig around in my paper files for a while before I finally found it, but here it is: my med-school application personal statement. Despite containing some rather naive viewpoints on child psychology and parenting, I think it also conveys a little of the Ol’ Cranquis Attitude, even way back then! (Obviously, I ended up going into family medicine and urgent care, instead of child psychiatry – but that’s because my 3rd-year child psychiatry rotation quickly convinced me that, should I go on to become a child psychiatrist myself, I would rapidly end up in prison for using a 3-ring binder to assault stupid parents. This just goes to show that your imagined “future specialty” can shift wildly as you go through your medical training.) Anyways, enjoy – and don’t forget to spell my name correctly if you decide to quote me in YOUR personal statement. It’s “Cranquis” with a “Q”, no accent marks.

————-

Dr. Cranquis’ Med-School Application Personal Statement (yes, I got accepted with this)

The last day of summer camp was always the hardest for me. Parents would come to pick up their kids after a week of fun outdoors adventures, and I, as a camp counselor, would watch “my” kids reunite with their parents. I would cringe as I watched young boys who had been happy and outgoing all week suddenly withdraw into themselves as their moms and dads approached. “My” campers always introduced me to their folks, and I always dreaded the frequent question: “So, just how naughty did Johnny (or Paul or Ben) behave this week?” I would try to expound on how wonderful these boys, “my” boys, had been all week, but the parents never heard me. They’d apologize profusely for how “terrible” and “sneaky” their sons must have been, and then drag their cowed children away.

I grew up in a home where children were valuable members of the family. I naturally assumed that all homes were this way, until I started making friends with other kids around me. As I discovered the abundance of “bad” homes and families around me, I also noted that many of these dysfunctional families blamed their children as the cause of the family’s problems! Titles like “troublemaker,” “ADHD,” and “delinquent” were tossed around to explain how a family’s problems were the child’s fault. However, from my viewpoint, I saw that the actions of my “bad” friends, while sometimes ill-thought-out and poorly-planned, were often caused by poor parenting and disciplining. Furthermore, as I began to study children with behavioral problems during my psychology training in college, I realized that many psychologists and psychiatrists have been relying on similar labels plus quick medication remedies to diagnose and “fix” these troubled children.

I believe that the very practice of labeling children with a “disorder” or “syndrome” allows them to feel that they are not in control of their lives, and therefore not responsible for their behavior either. Also, I think that parents are too quick to treat their children as victims, as “patients” who just need the right combination of drugs in order for them to finally obey. This is very detrimental to the child-parent relationship; parents become mere “zookeepers” over their kids, and expect their children to mess up often and spectacularly – and the children are happy to meet those low expectations. This obviously does not provide the children with the emotional and moral support which they so desperately need during their formative years at home.

My goal has become to reach out to children and parents in a way which will help them to solve the behavioral problems of the children while also addressing the relational problems of the parents. Through conversations with my father, a psychotherapist, along with other people in the psychological field, I have discovered that there are many professionals who wish they could implement programs and counseling structures through which they could reach out to the many children who are being treated simply with psychotropic medications, instead of with parental care and loving discipline; unfortunately, these professionals’ desire for change is hindered by the pecking order which places psychiatrists above psychologists. So, I have decided that I will be most capable of carrying out my goal by first obtaining as much technical and practical knowledge as I can through proper psychiatric training in medical school, then utilizing the expertise and status which accompanies that training in order to design a program to help “mislabeled” children like my childhood friends.

I must warn you, readers of this statement, that my true goal is not to get into medical school. Medical school, its trials, challenges, and rewards carry no inherent attraction to me; rather, they have all become a means to an end. I intend to use the training I receive, whether in medical school or elsewhere, to increase and enhance the assistance which is made available to children and their parents. “My” kids, the campers I have cared for and the millions of mislabeled children like them, are the focal point of my scholastic and professional efforts.

———-

As for my application references, I think I listed my psychology advisor/professor, the director of my summer camp, and the chairman of my college’s pre-med club.

***Pending Cranquis-Mails: 27***

Hospice meeting

So the background here is that the hospice service has a musician who goes and plays the harp for patients. 

And at the meeting a nurse is giving an update to the team about her recent home visit and how much the patient had enjoyed having the musical therapist come by. So she proceeds to give the rundown on all the pertinent updates and then says, “Our harpist was instrumental in the care of this patient.”

And I’m just like: 

The funniest part was she had no idea of the awful brilliance she’d just said. 

WayfaringMD's FOLLOWER Appreciation Post

You guys are the jam, for real. I woke up around 2am last night from nervousness about the Big Scary Thing today and as I was perusing tumblr, I found the start of the Wayfaring Appreciation posts. Y'all really made my day. All day I saw new ones popping up and they really cheered me up. So thanks for being so awesome. In return, I thought I’d share my appreciation for some of my followers: 

descantforhope

md-admissions

  • Has the greatest anti-gunner posts in Medblr land
  • Convinced me to watch Supernatural, which I am still not sure about but now at least I understand all of her leather jacket and pie references.
  • Is the Medblr I would most like to eat pizza and watch action movies with. 

aspiringdoctors

  • Also met with a total stranger from the internet despite her husband insisting that I might be a serial killer.
  • Has excellent taste in tchotchkes.
  • Slaughters the patriarchy and anti-vaxxer arguments with flair and ferocity.
  • Is the leggings-as-pants-est, big-glasses-est, hipster-est Medblr. 

ohheytherehi

  • Let me in on her secret internet identity ;)
  • Is ¼th of the Medblr Three Musketeers (also including the 2 names below hers), which I still don’t fully understand but apparently is a thing where they all reblog each other and say funny stuff…
  • Encourages my love of Bollywood and my “scientific” study of Hrithik Roshan’s face.

modernathena90

  • Posts A LOT, which is great when I’m bored and want to see funny stuff but is problematic when I’m trying to catch up on back-posts.
  • She’s Greek. Like reeeaaallyy Greek. Like Toula was Greek in My Big Fat Greek Wedding. Which happens to be a fave of mine, so I picture her as Toula in my mind when I read her blog even though she occasionally posts her face.
  • Is a big proponent for understanding among people of different faiths, which I love.

irandommomentsdevida

  • Is the Medblr world’s resident troublemaker, trickster, and conspiracy theorist. Our Gollum, if you will ;).
  • Is extremely creative in her(?) questions, posts, and PMTH antics, which infuses the Medblr world with silliness and fun.
  • Though she has questionable food preferences (no bacon? no donuts?), I let it slide because her feuds with Cranquis are so entertaining.

medmonkey  

  • Is apparently the only follower of mine who looks at my Index, which is in serious need of an update (sorry friend.)
  • Loves bacon the way I love bacon (which is wholly and unashamedly).
  • Has some really excellent posts on life as a DO student, is free to come work with me anytime after I graduate (I’m always up for encouraging people to go into family medicine!).

ermedicine

  • Blows my mind all the time at how much medicine he knows, and he’s not even in med school yet. He's gonna kick med school’s tail when a school wises up and accepts him.
  • Was smart enough to nab the name crayfaring.tumblr.com before randommomentsdevida or md-admissions could get ahold of it. 
  • He’s probably not a person I would have been immediate friends with in real life, but despite our many differences he’s always been a super sweet internet buddy.

yourcraysisterinchrist

  • Honorary Medblr, Cranquis minion, and overall Tumblr encourager/sassypants.
  • She’s the most (sometimes painfully) honest blogger on Tumblr
  • Has the most excellent tags you’ll ever read.
  • My only follower who still posts gif replies (which are always appreciated, btw).
  • Follower who I most wish I could visit (cuz heeey New Zealand!)

the blogger formerly known as wordsthatididntsay

  • She’s no longer on Tumblr, but she continues to encourage me through the magic of the interwebs
  • Taught me things about subtle racism that I had absolutely never considered before.
  • Shares my enjoyment of stealth photography and subtle side-eying of people in slides+socks, blue eyeshadow, and other troublesome fashion choices.
  • Introduced me to the world of satin pillowcases and other genius curly hair care products and ideas. 

cranquis

  • Has been role model for me in so many ways beyond internet anonymity and “pranquery”.
  • A blogger I feel privileged to call friend and internet husband. 
  • He (and Mrs. Cranquis!) have been wonderful encouragers and prayer warriors for me and have talked me down from irrational stress-outs on more than one occasion. 
  • Y'all realize he basically invented Medblrland, right? I mean geez. 
  • One day I’m gonna figure out where he lives. It’s gonna happen. This is my year. I can feel it. 

Fun fact: 5 people on this list have seen my face (but are sworn to secrecy), either through my not being sneaky enough, being longtime followers from the pre-anon days, or from IRL meetups. 

And the other 9,765 of you:

  • I started this blog for me and my friends to communicate. I still use it for that, but my friend circle has grown A LOT in the past few years of writing.
  • You guys encourage me every day with your questions, comments, and reactions to my posts. 
  • I hope that you all are encouraged in some way by the things I write.
  • Please keep in touch with me! I love hearing from y'all!
  • And once again, THANK YOU for being the awesome people you are. 

Then lo, there came a prophet from the Internet, and his name was Doubting Dave. And the prophet didst find the blog of the so-called “Doctor” Cranquis, and he was perturbed by the implied “doctorness” of the blog’s author. Then Doubting Dave wasted no time in reading the blog’s archives in search of any answers to his troubling queries, but instead did stand upon an anonymous ask-box, and proclaim aloud in the manner of the trolls of old: “My people! Hear me! Know ^ye not that ANYONE could claim to be a doctor upon the Internet? Know ^ye not that ANYONE could claim that they must "hide their true identity” in order to preserve their job and livelihood? Canst ^thou not see that this “Doctor” Cranquis is just a sham, who must be simply using Google and Wikipedia to “answer” ^thy medical questions?“

And the people were sorely vexed by this question. Then did a child in the crowd lift up her voice, and she asked, "But prophet, if Cranquis be a sham, and not truly a doctor, then how be it that he speaks so knowledgeably and intimately about the rigors of medical school and residency? Could he have faked this knowledge purely by watching Scrubs, perhaps?”

The prophet pointed his Cheetos-stained finger at the child, and did rebuke her: “If this Cranquis went to medical school and residency, why then doth he not publish his credentials? He doth not name his school! He doth not post a picture of his diploma! Yea, he doth not even deign to include a curriculum vitae with references!”

The child was not frightened by this rebuke, for she had spent a few hours reading Youtube comments before. Instead, she stepped forward and said, “Surely, Prophet Dave, you can see the fallacies in your arguments? When you go to see a doctor in real-life, do you ask to see his diploma? Do you grill him upon the schools he has attended? Do you ask another doctor to give an opinion on your doctor’s qualifications, or do you demand to see a published news article that references the doctor’s work? Do you ask to read his personal statement from his medical school application? I think not. Rather, you observe what he says and does, and if his behavior does not appear doctor-ish, then you inquire about his credentials! It is true, Dr. Cranquis’ blog does not display an Internet Badge that says "No really, I’m a doctor” – but would such a Badge truly increase your confidence in him? And shouldst thou trust the words of ANYONE giving medical advice on the Internet, without verifying such information with thine own real-life medical professional? Verily, to do such a thing wouldst be the height of idiocy.“

Then the prophet cried out in a louder voice, while hip-bumping the child back into the crowd: "Certainly, even if this Cranquis WAS a real doctor, he would not have time to waste (Yes, WASTE) upon writing a Tumblr blog! Tumblr is for the uncouth soft-core porn addict, the hipster, the lover of obscure manga – it is not for medical professionals and leaders in the field of public health. And most certainly not for pre-med and medical students who would dare to forge an unholy union between social media and their scholastic journeys! For truly and most surely, (even though my own experience with the medical profession is limited to that one time last year when I went to the high school nurse to find out why my testicles had not yet descended), I am certain that all doctors must live hectic schedules that do not allow for frivolous activities such as blogging, eating, or sleeping!”

Then the child did once again reply, while tapping rapidly on her smartphone: “But prophet, that is but a stereotype of doctors – for lo, though many physicians do surely choose to work in jobs that are ridiculously time-consuming, Dr. Cranquis is of that rare breed of physic – he choseth to work in a job that would give him plenty of time for family, friends, God, video games, and blogging! And not necessarily in that order, oh verily not.”

The crowd all pulled out their smartphones, and began to verify that child’s statements for themselves (much as Doubting Dave could also do – for naught prevents Doubting Dave from comparing Cranquis’ information and advice against the wealth of medical data that currently doth float throughout the bounds of the Internet).

The prophet, sensing that his moment in the spotlight was ebbing away, decided to resort to personal attacks: “People! People! Verily, I can see how perhaps this Cranquis might be a real doctor, based upon his words alone. And perhaps, when I think about it, there is nothing Cranquis could write/photograph/vow that would be irrefutable proof that he IS a doctor – for this IS the 21st century, after all, and the gods of Google and Photoshop are powerful indeed. But then consider this: What if he is a creep and/or a pervert kind of doctor? What if he somehow gets his jollies by letting people send in medical questions, spending time writing back replies to those questions, and then twiddling himself as the Likes-count rises?!”

The prophet was not even done speaking that last moronic paragraph, before the child had already stepped forward, waving her phone in the air. Displayed there for all to see were some of the nasty (and often nudity-involving) procedures that Cranquis already claimed to do in his real-life job. The child rolled her eyes, indicating with that simple gesture how humorous it is be to propose that a doctor with access to naked naughty-bits every day would invest this much effort into creating and maintaining a blog for the purposes of satisfying some vague “People talking about medical problems anonymously” fetish.

The crowd started to wander off, and the prophet knew he had failed to convince them of the hidden dangers that lay within this innocent-appearing blog. But his last (and as-yet-unspoken) query remained, and now he queried this query to the sky in a clear and ringing pre-pubertal voice: “But nobody would spend this much time doing this without getting SOMETHING out of it!!? Why does he do it? How does Cranquis benefit from this?

The child knew a futile query when she heard one, and so she called back over her shoulder: “Asked and answered, Doubting Dave. Perhaps thou shouldst spend more time reading and less time querying. But rest assured, your objections will certainly be noted, recorded, and replied-to for the benefit of all the Internet, and if he were standing here amongst us this day, I warrant that Dr. Cranquis would thank thee for being willing to ask these important questions in a tone which would motivate him to "waste” 2 evenings creating a suitably-witty response for thee.“ 

(Tee-hee. "Query”.) XD

***Pending Cranquis-Mails: Zero. Ask Box: Will re-open on Thursday, September 1, at 6:30am Pacific Standard Time.***

youtube

OMG. AWESOME TRICKS. Must watch :D

Cranquis Podcast

  • “Humans on both sides of the examination table”
  • “Rich doctor myth. That is a small minority.” And when you have health care rhetoric drumming that myth into existence, it makes it hard to strengthen the physician to patient relationship. 
  • “Shock how much money people think you are making and how much debt you have”
  • “Doctors have a responsibility to be financial transparent. Income is usually a fair income, the income is not why we went into medical, but our income keeps us in medicine.”
  • “{Tumblr medblr community} we are moving through the trench.”

My thoughts

This podcast was excellent. Social determinants of health, med blr community, premed bloggers (myself). I found myself nodding and thinking doctors are real people, telling myself stop romanizing and dehumanizing the profession I want so bad, just work in the present moment, pray, and medical school will come to me, I will make it.

I am also taking the Mcat in September, and I also think sometimes about what if I do not get into medical school:

I have no idea where my life will go. (I know, scary)

The hoops medical students must jump through are easy to forget about, but very real. Many of my classmates have studied for and taken the MCAT multiple times …. laying awake in bed agonizing over whether your failure to grasp Organic Chemistry might be a sign of your future competence as a physician is horrible. Merit based, competition, is exciting and also very stunted in terms of viewing students who complain as lazy or ungrateful when the students are being human.

Then, enter medical school (if lucky) and residency, notorious for being times of dangerously low sleep, health, time ….. How can it all be done? Something’s gotta give. I’ve always promised myself that I would prioritize family, friends, and happiness above all things. But I’ve also promised myself that I would rather be no doctor than a mediocre one.

In the end, an intense love for the human body and an intense love for people prevails. While I want to help people, and “cure”, I feel as a doctor I want to connect with patients, educate them about their health, and weaken fear. Being sick is a fear. While I cannot abolish that fear I can reduce the amount. Since I was senior in high school cranquis has been a mentor and asset. For that I am grateful. 

I respect medicine, the mcat, medical students, health professionals, because the professions puts a value on healing, and competition.

I understand this may seem as a ramble but I have a few questions. If you are a health student/professional, how would you answer the following:

Do you think increasing access to healthcare will improve health disparities?

What are your thoughts on medical (MD/DO, PA, NP) education, am I over- exaggerating the context, or I am finding realistic insights?

What are your thoughts on healthcare, can the biomedical and psychosocial model ever combine?

Reflecting on your experience as health student/professional, do you wish there was more collaboration among md-phd, do, pa, np?

The Challenges that come with Obamacare

about-hortense replied to your post: Great, lots more people are about to have insurance.

i don’t understand the meaning of that BUT. This topic intrigues me a lot and, as a non-american, I’d like you to stretch out ya point of view which, obviosuly, lingers behind that opening adversative.

What I was referring to is that there’s a huge deficit of primary care doctors in this country, and our system does not do a very good job of encouraging trainees to go into primary care.  

Putting it simplistically, billing in the American medical system is based on procedures, tests, and the complexity of diagnoses. Doctors bill a certain amount for different things, and insurance companies generally pay a higher percentage of what doctors charge than government programs like Medicare and Medicaid pay. So the more patients you have with private insurance, the better your reimbursement rates.

The problem is that things like preventive care and regular follow-ups for chronic conditions (things which should theoretically save the system money by preventing conditions that require expensive procedures and tests) are not considered complex enough to warrant decent pay from government payor sources (Medicare/Medicaid). And guess what takes up the majority of primary care docs time? You guessed it, preventive care and follow up visits. 

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