New or Old?

old caculatorWe have an old calculator in our household, and I do mean old. It’s been used regularly for balancing the checkbook and other miscellaneous chores for 32 years. I can’t remember the last time I changed the batteries.

We’ve never had a reason to replace it. It just keeps going. I know we can probably get a smartphone which could outperform it. We still don’t have smartphones, either. We’ve had flip cellphones that fit the bill. As a matter of fact, we barely use them.

Remember the iPad2 (or is it iPad3?) I got last year? My wife bought me a new one, the incredibly thin iPad Air. Great. Now I have to find a use for it. Not that I’m ungrateful, mind you. The display is fantastically sharp and it is fast. I’m just sayin. I still don’t carry the old one around with me at the hospital because I’m afraid it’ll be stolen when I lay it down.

I finally saw that incredible story about the family physician who was reprimanded for giving $30 to a patient to help purchase a prescription she needed. He wrote an opinion piece published in the Journal of the American Medical Association (JAMA) in late September. He got a lot of support for what many thought was his espousal of humanistic principles older than what many would call the business approach to the practice of medicine nowadays.

Just this last weekend, I discovered that our psychiatry consultation service no longer covers both new and follow-up consultations on weekend mornings in the hospital. At some unspecified time in the past, an unwritten rule was changed. Now the on-call resident covers them from 5:00 p.m. Friday to 8:00 a.m. Monday. For the last 17 years, I’ve apparently been the only faculty member who didn’t know that and I have not been telling my colleagues when they page me to help them care for a patient to simply page the on-call resident.

I didn’t get the memo. Apparently, neither did my colleagues in internal medicine and surgery. The reason we divided the job was to save wear and  tear on the residents. I don’t know when we switched from the old way to the new way. I do know that when I checked with the chief resident about it, I discovered that the residents liked the way I’ve been doing it. I will now stop carrying my pager because it interferes with the new protocol.

Maintenance of Licensure (MOL) is a proposal for a new way to regulate the licensure of physicians. Unless you participate in an empty, time-wasting, expensive procedure which has not been proven to change patient outcomes called Maintenance of Certification (MOC) you won’t get or renew a medical licensure. It doesn’t matter if the Iowa Medical Society House of Delegates adopted my resolution to support lifelong learning and opposed MOL in April 2013. It doesn’t matter that the resolution was co-sponsored by the Iowa Psychiatric Society. The Iowa Board of Medicine continues to pursue MOL implementation pilot projects designed to inflict MOL on Iowa physicians.

It’s new and we must make way for the new because the old is…well, old.

Maybe this New Year we could ring in the old.

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