Yeah, I know. We laboratorians are always going on and on about how
we are really involved in direct patient care, that what we do is just
as important as what the nurses and real doctors do, that we would
never do anything not in the patient's best interest, no matter how
well-connected the doctor asking us to do it is, yadda yadda yadda.
In fact, we all know that we are just a bunch of shopkeepers, and the
real customers are the clinicians. And the customer is always right,
n'est-ce pas? Anyway, after years of keeping shop, we all come to
develop certain rules of thumb concerning our customers. See if yours
agree with mine:
Clients with boring names, like "Trask County Oncology Consultants"
or "Rebecca Smith, MD, PA" are usually solid physicians. Clients with
Madison Avenue names like "TotalWoman's NuHealthnessCenter" are
You will never be able to make an accurate definitive pathologic
diagnosis on the punch biopsy of a skin rash, unless the biopsy was
taken by a dermatologist. You will report out all other such biopsies
with nothing more than descriptive goobledegook, or you will try to please and
quixotically attempt a definitive diagnosis, which will be wrong and
will be rubbed in your face by the dermatologist to whom the patient is
eventually referred, and by your competitor across town,
who is actually a worse pathologist that you are, but got the diagnosis right
because the dermatologist who sent him the follow-up biopsy gave him the
answer in advance.
Ostentatious trappings of wealth in a surgeon or other
procedure-oriented specialist is usually indicative of a competent
physician with a successful practice. Ostentatious trappings of wealth
in a physician in a cognition-oriented specialty probably means he or
she is running a scam or is siphoning off income from a protean stable
of hired physician short-timers and walking-wounded, who generate a lot
more revenues than they are paid.
In a surgeon, flat affect and mask-like facies are evidence of focus
and technical competence. In a psychiatrist, flat affect and mask-like
facies are evidence of mental illness.
The best male internists are usually a little scruffy-looking.
However, a scruffy-looking plastic surgeon is probably headed for a
psychotic break or is going through a divorce. Scruffy-looking female
physicians are usually technically competent but are less than
successful because of the perceived lack of "people skills" by their
patients and bosses, despite the fact that style and grooming have
nothing to do with empathy and compassion.
The male physicians with the least glamorous wives are the most
happy, while the female physicians with the least attractive husbands
are the least happy.
The female physicians with the biggest hair are psychiatrists and
dermatologists. The two may be distinguished by the greater volume of
makeup worn by the former.
The number of skin biopsies you get from a client is directly
proportional to the probability that he or she will punch-biopsy a
pigmented lesion and shave-biopsy a rash.
The competence of a gynecologist is directly proportional to how
upset he or she gets at the high number of ASCUS Paps you report.
Ill-tempered physicians get the best treatment from the lab and the
worst treatment from the nurses. Congenial physicians get the worst
treatment from the lab and the best treatment from the nurses. Unlike
nurses, laboratorians have just not mastered the art of
Of course, there are exceptions to all generalizations, and, needless
to say, present company is excluded.