Genesis and exodus of the healthcare industry

Copyright © 2009 Society of Hospital Medicine

He looked upon the earth so filled with misery and pox

On Cro‐Magnon Neurosurgeons taking tumors out with rocks

With the blood banks run by leeches and their pterodactyl nursing

And observed This can't be healthcare these mere creatures are rehearsing

What shall we do when their lifespan will exceed eleven years?

When they no longer drink from toilet pits or make hearts from used pig ears?

There will need to be a better way to care for newer ills

A time when broadband wireless will be cheaper than their pills

He came up with a brilliant plan to revolutionize the health

To advance all medical outcomes and thereby spread the wealth

But for some strange combination of wisdom, luck, and quirk

He devised sufficient stakeholders to ensure this could not work

So a King might hire a knight to wipe out enemies with his lance

Then buy a plan to pay the cost of repairing his chain mail pants

Then along will come men with crosses of Blue who can manage that so much smarter

By inventing rules that convert poor fools from heroic docs to martyrs

He made tiny things that hide in meat and cause nasty cramps and rashes

That leave only the fittest alive to run in the royal 50 yard dashes

He made plants with spikes and purple leaves that can make one very sick

Then companies who turn green goop to gold that can flow thru a needle stick

He made medical schools to teach more tools, taking 10 years from students' lives

Then ruined careers with malpractice fears if they forget to wash their knives.

He made men whose pockets are filled with stuff from frivolous medical suits

When the experts forget the proper dosing of Peruvian medicinal fruits

He made routine birth a hazardous game between midwife, mom, and fetus

He made people who dress in masks and gloves to bravely retrieve and greet us

Then if anything goes wrong because one more time he throws snake eyes on the dice

He made lawyers to ensure that at least someone benefits while everyone else paid the price

Then along came the buildings with gadgets and learning, to find things we can't hope to fix

And those who get paid to know how NOT to pay the providers of care to the sick

He made organized giants that make tablets and gizmos from the minds of the cream of the crop

And made multiple races with all different faces whose subjective complaints will not stop

But alas came the gadgets, the photons and diodes, the software, the web and the data

Then the standards, the knowledge bases, multiuser interfaces, all in perpetual BETA

To automate the arcane, declare real what is feigned, and make INPUT like losing a toe

Then the last fatal strawhe made privacy laws to ensure they can't share what they know

Oh what have I done, this is really no fun, they now live to one hundred and thirty

But there's no more MDs and the few with degrees refuse to get their hands dirty

Next time when I try to take research to practice I'll start with a real I.O.M.

Evidence galore, so when we screw up once more I can put all the blame right on them

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