Here's a little list of "Doc-isms" -- What doctors say, and what they're
really thinking:


"This should be taken care of right away."
I'd planned a trip to Hawaii next month but this is so easy and
profitable that I want to fix it before it cures itself.

"Welllllll, what have we here...?"
He has no idea and is hoping you'll give him a clue.

"Let me check your medical history."
I want to see if you've paid your last bill before spending any more
time with you.

"Why don't we make another appointment later in the week."
I'm playing golf this afternoon, and this a waste of time.
--or--
I need the bucks, so I'm charging you for another office visit.

"We have some good news and some bad news."
The good news is, I'm going to buy that new BMW. The bad news is,
you're going to pay for it.

"Let's see how it develops."
Maybe in a few days it will grow into something that can be cured.

"Let me schedule you for some tests."
I have a forty percent interest in the lab.

"I'd like to have my associate look at you."
He's going through a messy divorce and owes me a bundle.

"I'd like to prescribe a new drug."
I'm writing a paper and would like to use you for a guinea pig.

"If it doesn't clear up in a week, give me a call."
I don't know what it is. Maybe it will go away by itself.

"That's quite a nasty looking wound."
I think I'm going to throw up.

"This may smart a little."
Last week two patients bit off their tongues.

"Well, we're not feeling so well today, are we...?"
I'm stalling for time. Who are you and why are you here?

"This should fix you up."
The drug company slipped me some big bucks to prescribe this stuff.

"Everything seems to be normal."
Rats! I guess I can't buy that new beach condo after all.

"I'd like to run some more tests."
I can't figure out what's wrong. Maybe the kid in the lab can
solve this one.

"Do you suppose all this stress could be affecting your nerves?"
You're crazier'n an outhouse rat. Now, if I can only find a shrink
who'll split fees with me ...

"There is a lot of that going around."
My God, that's the third one this week. I'd better learn something
about this.

"If those symptoms persist, call for an appointment."
I've never heard of anything so disgusting. Thank God I'm off next
week.

Five doctors went duck hunting one day. Included in the group
were a GP, a pediatrician, a psychiatrist, a surgeon and a
pathologist. After a time, a bird came winging overhead. The first
to react was the GP who raised his shotgun, but then hesitated.

"I'm not quite sure it's a duck," he said, "I think that I will have to
get a second opinion." And of course by that time, the bird was
long gone.

Another bird appeared in the sky thereafter. This time, the
pediatrician drew a bead on it. He too, however, was unsure
if it was really a duck in his sights and besides, it might have
babies. "I'll have to do some more investigations," he muttered,
as the creature made good its escape.

Next to spy a bird flying was the sharp-eyed psychiatrist.
Shotgun shouldered, he was more certain of his intended
prey's identity.

"Now, I know it's a duck, but does it know it's a duck?" The
fortunate bird disappeared while the fellow wrestled with this
dilemma.

Finally, a fourth fowl sped past and this time the surgeon's
weapon pointed skywards. BOOM!! The surgeon lowered his
smoking gun and turned nonchalantly to the pathologist
beside him.

"Go see if that was a duck, will you?"

Frequently Asked Questions with answers!
(from http://home.cwnet.com/catspaw/emshumor.php)

Q. Do you need to go to school for this or can anyone do it?
A. You have to go to school, it is long and hard and most of the people
involved like to abuse the hell out of you while you are doing it.

Q. Hey, Ambulance dudes, how do I get to the Dead concert at the Oakland
Coliseum? (or any other request for directions)
A.Hmm, well,uhhh. I'm sorry I don't think you can get there from here.

Q. I'm seeing things, will you take me to the hospital?
A. Sure, if you are seeing rats and bugs we will take you to County
Hospital, if you are seeing music and hearing colors we will take
you to the Berkeley border and drop you off, you'll fit right in.

Q. Do you like you like your job?
A. Yes, in spite of everything I do like my job.

Q. Do you make a lot of money?
A. Not enough by a long shot. At least not after my State, Local, and
Federal Government gets through with my check.

Q. How come the Police come to the call with you?
A. Investigation, crowd control, and to keep me from getting my ass kicked
by an irate bystander/family member/patient.

Q. How come all the Firefighters come to the call too? What do they do?
A. Beats the hell out of me, it's not like the patient is on fire or
anything!

Q. Have you ever seen a dead body?
A. Yes, in all the various states of decomposition and putrefaction. I've
even seen maggots in ones that weren't dead yet.

Q. Do you have anyone (like maybe a patient) in the in the back of your
ambulance right now ?(asked while we are sitting in the unit eating
lunch in the parking lot of Doug's Bar B Q)
A. No patients. Only the Paramedic Student; don't bug him, he's a stress
case and might crack.

Q. What antacid is best for a stomach ache (asked in the parking lot of
7-11 at 03:30 a.m.)?
A. Pink, white or green pay your money and take your chances.

Q. Do you have any spare change?
A. Take a hike, I don't believe there is such a thing as spare change.

Q. Can I have bus fare to get to the hospital?
A. Yes, if it means you won't take an emergency rescue vehicle out of service
so you can get to a routine appointment for your toothache and if you
promise to quit bugging me.

Q. How long have you been doing this (asked by a recently hired rookie
Paramedic)?
A. Let me figure it out. Since you were in second grade, partner.

Q. How come you are smoking that pipe , don't you know that is bad for you?
A. How can pipe tobacco be bad for you? If it was bad for you they couldn't
sell it at Walgreens Drug Store. Right?

Q. Can me and my four kids ride in the back with my boyfriend to the hospital?
A. No.

Q. Can I ride up front on the way to hospital?
A. Maybe, if I like you and think you wont bug my partner in the back.

Q. How comeis painted on your front grill?
A.There is a device on motor vehicles that is known as a rear-view mirror, some
people have even been known to use it to see what is behind them when
they are driving.

Q. How fast will your ambulance go?
A. I don't pay that close of attention, faster than my employer would be
comfortable with, most likely.

Q. Is he going to make it?!! Is he going to make it?!! (asked in reference to a
patient who puked after too many 40 ounce bottles of Old English 800 Malt
Liquor).
A. Yes, I am sure that in spite of our best efforts , he will survive.

Q. Can I have a band-aid?
A. This is an ambulance, our band-aids are 8 inches x 6 inches. How many do
you need?

Q. What happened? (at an minor fender-bender auto accident).
A. Plane crash!

Q. What happened? (outide of a house where a person was having shortness of breath).
A. Plane crash!

Q. What happened? (at a plane crash)
A. Shark attack!

Q. What does EMT stand for?
A. Every Menial Task,
Eggcrate Mattress Technician

Q. What does the EMS on the side of your rig stand for?
A. Earn Money Sleeping, now please let me get back to earning some money,
thanks.

Q. Does this tie go with the rest of my suit? (asked by a guy on his way to
church).
A. Sure, a red, purple , pink, and black tie always goes with a gray
pinstripe suit.

Q. Do you have an extra one of them urinal bottles. I have to piss real bad.
A. No. We don't carry those any more but thank you for sharing.

Q. What is the worst thing you have ever seen?
A. A 12 gauge shotgun blast to the left side of a woman's face that didn't kill
her, so she was writhing on the floor and trying to scream through the
blood running out of her mouth with a good part of her face missing.
Either that or it was the 6 month old baby who died because his drugged
out parents left him on the floor heater grate until he was so cooked
that the flesh of his fingers split away from the bones. Now aren't you
sorry you asked?

Q. Are you always this much of a smartass?
A. No, I am usually much worse, but the medication is helping.

Q. Why did you bring the patient here?
A. I guess the sign out front that says "Emergency Department; Physician on
duty" fooled me into thinking that this was a hospital that treated
patients!

Q. Do you think the patient can be triaged to the lobby?
A. Since they demanded transport for a refill on their prescription I am sure that
the lobby is more than an appropriate place for them to go. Unless you
can triage them to the parking lot or the nearest bus stop.

Q. How come the patient didn't just call a cab or take the bus?
A. Because the taxi services and the bus lines are smart enough not to take
Medi-cal instead of cash payment.

Q. What are the patients bowel sounds? (On a critical 'auto vs. tree' patient).
A. Since we were on the side of the freeway and now are enroute to the
hospital the bowel sounds pretty much resemble a diesel engine.

Q. Did you look for ID?
A. Sorry, no. I might find guns, knives razors and crack pipes during the
physical exam but I am not going to reach into his pockets looking for ID
and find a needle.

Q. What's the patient's name? What's the patient's name?!! (on a cardiac arrest
victim).
A. I don't know, I asked him four times after he coded and he wouldn't answer
me once!

Q. What are the vitals? (Different Nurse, same code).
A. If we're doing CPR right he should have a pulse rate of 80-100/min,
24 respirations/min, and a blood pressure of maybe 40 systolic.

Q. Can the patient sign the insurance and permission forms?
A. Only if they use your pen.

Q. (On the radio) Are you sure she's in ventricular tachycardia? The complexes
are rapid and wide not narrow, right?
A. Uh, yeah I'm sure it's V-tach, we covered this rhythm in some detail in
Paramedic school. Is this a pop quiz?

Q. Can we clear? We don't do this medical stuff. (Fire Captain).
A. Yes, you can clear. I am sure there is a La Z Boy recliner and a quart of ice
cream waiting for you somewhere.

Q. Is he dead? (Different Fire Captian, same department).
A. What tipped you off? The dependant lividity, the rigor mortis, or maybe the
ants crawling in and out of his nose?

Q. Why can't you hold over for a few hours this morning? (Managment).
A. Why not? I've only been awake for 26 hours straight and been puked on twice,
I think it is safe to say I would rather floss my teeth with barbed wire.

Q. Can you guys hear the siren when it's on while you are in the cab of your
ambulance?
A. What?! You will have to speak up I can't hear you from all the years of
listening to the siren inside this ambulance.

By....who else?

OK, Sports fans...it's Saturday night, 3 am and time for inter-service
hospital ping pong. Staff Internal Medicine has won the tossup and has
elected to receive. The other services are in position and here comes the
first patient!!

Chief Complaint: "feel bad"

History: Mr. Amos Leeks, 59 Y/0, 385 pound alcoholic, diabetic,
hypertensive male with history of three old myocardial infarcts, angina,
congestive heart failure, COPD, chronic renal insufficiency, gout,
hypothyroidism and "nerves".

The Medicine service jumps into position. Dr. Shafer Goodloe, medical
raconteur, man-about-town and big time babe magnet gets the nod from the
referee. Shafer enters the room with a spotless white coat, stiff bow tie
and gleaming implements of destruction hanging from every pocket.

The clock starts....Dr. Goodloe jauntily saunters into the room and sidles
up to the patient with a big cheesy smile....

"Hi there Mr. Leeks...ever been in the Army?"

"Yeah, but they threw me out for flat feet".

"Well....in the interest of continuity of care, we feel that you should
return to a Veterans Administration Hospital. The doctors there are
familiar with these problems and they can follow you in perpetuity"

PINGGGG!

"Naaaa...I don't like that place. The nurses are ugly and they let a bunch
of smart ass kids in white coats practice on me when they thought I wasn't
looking....I want to stay right here and have you take care of me."

FOUL! Serve again....

Shafer assumes his most intense young doctor countenance.....

"Hi there Mr. Leeks....... got any pain right here (does hand stand on
Amos's right upper quadrant).

"Arrrggghhh!"

PINGGGG....Surgery consult.

"Hello, Surgery...we got a guy down here with excruciating right upper
quadrant pain, mild jaundice and a history of fatty food intolerance". He
needs to be on the surgery service.

"What else is wrong with him"

"Oh, just a few minor medical ailments"

"How much does he weigh?"

Oh, maybe three hundred and.." (click)

PONGGGG!

Shafer's face darkens..........

"Say...Mr. Leeks....ever taken any Valium?"

"Yeah....someone gave me some once".

PINGGGG! Psychiatry consult...

"Hello, psychiatry...we got a guy down here who looks pretty depressed. May
be suicidal. Has a history of Valium abuse. He needs to be on the Psych
service."

OK, just have him sign a consent for electro-convulsive therapy and send
him around in the morning. We'll buzz him till he sees God".

"What about his work up?"

"What about it?" (click)

PONGGGG!

Shafer begins to sweat and his bow tie droops....the other services
nervously shift from foot to foot....

"Say...Mr. Leeks.....got any pain here? (pops Lumbar 5 with ball peen hammer).

"Yeeeooouuch!"

PINGGGG! Orthopedics consult.

"Hello, Orthopods...we got a guy down here with exquisite low back pain
radiating to both legs, he needs to be admitted to Ortho."

"What day is today?"

"Saturday"

"Sorry, back pain only on Tuesdays and alternate Thursdays. Make him a
clinic appointment for three weeks." (click)

PONGGGG!

Metaphorically speaking, Shafer takes the gloves off...No more Mr.
nice-guy....

"Hi there Mr. Leeks.......have any pain in your head? (Shines
quartz-halogen light in left pupil dilated with homatropine)"

"Hoooooaaaaaaaaarrrrrgggggghhhhh!"

PINGGGG! Neurosurgery consult.

"Hello, Neurosurg....got a guy down here with an exquisite headache
accompanied by flashing lights and not relieved by anything. He needs to be
admitted to you."

"Hey....no problem...get him a CAT scan with and without contrast, lumbar
puncture, angiogram, EEG, put him on your service and we'll consult on him
in the morning" (click).

PONGGGG!

Medical team calls time out, stops the clock and pulls into a huddle. As
they whisper and murmur..a Senior Medical Student pops up to see if the
patient is still there...he is. After a moment they break and return to the
game with broad grins.

"Hello...OB-GYN....we got a woman down here with an imperforate hymen,
adreno-genital syndrome and bilateral femoro-labial hernias...."

Whoosh.......Crash...

Point..Set..Game!

OK, We all go the doctor for our aches, pains worries and some of us just
to have someone to listen to our problems. Guess What, doctors are human
too, so here are is a guide of what to do and not to do

Code of Ethical Patient Behavior
(The Patient's "HYPOCRATIC" Code")

1. DO NOT EXPECT YOUR DOCTOR TO SHARE YOUR DISCOMFORT
They've already heard it before. Just sit back and take the pain

2. BE CHEERFUL AT ALL TIMES
If you make your doctors unhappy, they might just make a slip
with the needle as they are inserting it into your butt.

3. TRY TO SUFFER FROM THE DISEASE FOR WHICH YOU ARE BEING TREATED
Remember that your doctor has a professional reputation to uphold.
It wouldn't look to good if you are smiling when the medical books
indicate you should be wincing

4. IT'S STILL SEXUAL HARRASSMENT
Even if you're babes, your sustained and repeated come-ons to
pay in "trade" are still harrassment.

5. NEVER ASK YOUR DOCTOR TO EXPLAIN WHAT HE IS DOING OR WHY HE IS DOING
Hey, 4 years of medical school, 4 - 7 years in residency and another
one or two in fellowships have already made it impossible for your
doctorto speak normal English anyway.

6. SUBMIT TO NOVEL EXPERIMENTAL TREATMENT READILY
Though the surgery may not benefit you directly, the resulting
research paper will surely be of widespread interest, and you
might even become famous in a medical textbook, or if you really
complain enough, have a procedure named after you.

7. PAY YOUR MEDICAL BILLS PROMPTLY AND WILLINGLY
See #2, Keep you doctor happy..

8. NEVER DIE WHILE IN YOUR DOCTOR'S PRESENCE OR UNDER HIS DIRECT CARE
Really bad form

9. THERE IS NO EXCUSE FOR SMELLING LIKE THAT... YES WE DO SMELL YOU...
TAKE A BATH
Your treatment room can't be used for others for the rest of
the day and you almost killed the doctor.

10. FARTING IS NOT "NATURAL AND ORDINARY" JUST CAUSE YOU'RE WITH A DOCTOR
You may likely be told you need a referral to a "specialist" .

11. IT TURNS OUT THE NURSES DO NOT WANT TO HAVE SEX WITH YOU
It's a shame but true...

This Flu Strong Enough to Daze Even Hercules
By Pat Cashman


I had intended on this morning of Jan. 10 to take a sweeping look back
at the year 2000 -- so far. I was going to offer my list of the most
significant individuals ... the most important developments ... and,
perhaps, the outstanding teriyaki places, of the last 10 days.


It was to be what they call in the column-writing business a think
piece.


Unfortunately, I cannot think.

Granted, that shortcoming hasn't held me back before. But this time, it
is especially acute. A couple of days ago, I came down with the flu --
which is short for fluidcomingout.

My list of symptoms sounds like the lineup you might see on a local rock
band poster: "Live! The Sweats! Nasal Congestion! Dry Cough! With a
special appearance by Malaise!" (To tell you the truth, while I do have
most of the traditional flu symptoms, malaise really isn't one of them
for me. And even if it was, it makes me uneasy and depressed to even
think about it).

It turns out that the flu has been hanging around this planet for a very
long time. Hippocrates -- a large man, known to his friends as Hippo --
first described the symptoms of what he coined as "the crud" back in 412
B.C.

"The patient is sometimes feverish ... but then, sometimes has the
chills. It may indicate that the patient has trouble making a
commitment." Not me. I committed to all of it, including muscle
aches. In fact, as I write this, my love-handles are killing me. I've
also got an oddly deep and throaty voice -- almost identical to that of
the actor Tom Bosley. I've been amusing myself for the last several
days by saying: "Hey Fonzie! Where's Potsie?" This is also part of
the delirium that accompanies the flu.

I've been lying around watching a lot of TV, too. Programs that
normally would seem ridiculous appear incredibly profound when you're
sick and groggy. This snatch of actual dialogue was heard by me from an
episode of "Hercules" the other day:

HERCULES: "Don't you realize that what you're doing is wrong?"

DISGRUNTLED BAD GUY: "Oh, sure, Hercules. It's easy for you! You're
the son of a god! You've had all the advantages!"

I found myself talking out loud to the screen: "The guy's making a
pretty good point there, Hercules."

While the flu can be a very serious thing for people who are not
normally healthy, for the majority of us it's only a moderately severe
illness. In fact, most people are back on their feet within a week.
And acrobats and contortionists are back on their hands and heads.

The best way to understand the flu is to think of it not as a single
malady, but as three different influenza virus families, A, B and C.
Within each family are many viral strains, basically like different
brothers and sisters -- brothers and sisters who have all intermarried.
No wonder they're all mean and ugly.

So just because I might have come down with flu family member Denise
doesn't mean I'm completely out of the woods when I get well again.
Because her creepy little brother Ernie -- who is also her husband,
uncle and grandpa -- could be waiting around the corner. So much for
family values.

Of course, most of us grew up being told to wear a long coat and boots
in chilly weather because a cold head and wet feet were sure-fire ways
to get colds and flu. (If you wear a long coat and boots in warm
weather, you become a person of interest.) But the real way to avoid
germs, of course, is to wash your hands a lot. Because as my mom often
pointed out: You don't know where they've been. Like my hands got up
and walked around when I wasn't looking.

In fact, I knew exactly where those hands had been. I just didn't want
her to find out.

But there really does seem to be something to the handwashing routine.
And even though Lady Macbeth had a lot of other troubles, she never did
come down with the flu. And she was only washing her hands in her
sleep!

So there are a couple of ways to try ducking the flu bug: 1) Avoid
contact with all other humans, at all times, or, 2) get a simple flu
shot. I made my decision early on and decided to avoid contact with all
other humans. But I slipped up and caught the virus while chatting with
my flu-sick uncle last week. It seems odd -- especially since I was on
the phone with him for only a couple of minutes.

Now my life has become a smorgasbord of remedies and nostrums. I'm
taking analgesics, suppressants, antihistamines and decongestants. I'm
throwing back vitamin C, zinc, echinacea -- and lots and lots of water,
a liquid found in beer.

I read somewhere that the human body is composed of something like 90
percent water. So according to my most recent measurements, my body is
now 106 percent water.

Yesterday, I decided to buy some over-the-counter stuff at Albertsons.
One product, called "flu, cold & cough hot liquid medicine," came with
this warning: "Do not use if you have difficulty in urination." Being
106 percent water already, that would not be an issue. Difficulty
stopping, yes. Starting, no.

But the warning label continued: "May cause breathing problems, nausea,
fever, aches and pains." Wait a minute! I already have those! I don't
need the medicine, after all!

I also noticed that Children's Bubblegum-flavored Tylenol may cause
excitability in kids. Gee, what a surprise. Why not just go for it and
start manufacturing Children's Pure-Sugar Tylenol?

Now, as I am finishing this column, I have just taken Nyquil ... or
Dayquil ... or Middle-of-the-afternoonquil ... or something. The
warming label says the medicashun might cause drowzines and an
inAconcenrate to ability. Fortunately, I donut seem to have any such
sideburns. And I am sertainly smart enough not to take such stuff such
as like that while columnizing my words. I just saw a giant bunny
floatering past my window wearing a ballerina outfit
and3g/<_o,fc65oighoiejeUO3IE90#%6a.............

(Editor's note: Consult your physician before believing anything Pat
Cashman writes.)

A doctor, a nurse, and the CEO of a HMO all died on the same day. Upon
approaching the pearly gates, St. Peter asked the doctor why he should
be admitted to heaven. The doctor answered, "I healed the sick and
cared for the dying for many years." St. Peter agreed that he should
be let into heaven.

When the nurse was asked the same question by St. Peter, she replied,
"I comforted the ill and the dying for many years, as well as educated
and cared for the families." St. Peter allowed her into heaven as
well.

St. Peter then turned to the CEO of the HMO and asked him the same
question. The CEO responded, "I have cut the cost of health care and
prevented many unnecessary procedures."

St. Peter thought about what to do and then said to the CEO, "I have
decided to allow you into heaven, but only with a referral, and only
for three days!!"

Managed Caring Plan
Friendship Providers, Inc.


Welcome to Managed Caring(tm), a whole new way of thinking about
friendship. The Managed Caring Plan(tm) combines all the advantages of a
"traditional" friendship network with important cost-saving features.

HOW DOES IT WORK ?
Under the Plan, you choose your friends from a network of pre-screened
accredited Friendship Providers. All of your friendship needs are met
by members of your Managed Caring(tm) panel.

WHAT'S WRONG WITH MY FRIENDS ?
If you're like most people, you're probably receiving Friendship Services
from a network of Providers haphazardly patched together based on where
you've lived, worked, or gone to school. The result is costly duplication,
inefficiency and conflict. Some Providers may not meet national standards,
responding to your needs with inappropriate, outmoded, or experimental
behavior. Under Managed Caring(tm), your friendship needs are coordinated
by a designated Best Friend, who Cares(tm) about the quality of all your
Friendships.

HOW DO I KNOW THESE AREN'T JUST A BUNCH OF LOSERS WHO CAN'T MAKE FRIENDS
ON THEIR OWN ?
Many of today's most dedicated and highly trained Friendship Providers
are as concerned as we are about delivering quality Caring(tm) in a
cost-effective way. They have joined our network because they want to
focus on Caring(tm) for you rather than devoting their resources to the
paperwork and high Bad Friendship premiums that have sent the cost of
traditional Friendship Delivery system skyrocketing. Our Friendship
providers have met our rigorous standards of loyalty.

WHAT IF I NEED A SPECIAL FRIEND, SAY FOR POKER OR FISHING ?
Special Friends are responsible for most of the unnecessary Friendship
Procedures that have sent the cost of the traditional Friendship Delivery
system skyrocketing. By training, experience, and by virtue of knowing
you for what you really are, your Best Friend is qualified to refer you to a
Special Friend within the Managed Caring(tm) network should your needs
fall outside the scope of his or her excellent training.

SUPPOSE I WANT TO SEE FRIENDS OUTSIDE THE MANAGED CARING(tm) NETWORK?
CAN MY BEST FRIEND EVER REFER ME TO THEM ?
No. The only time you can see a Friendship Provider without first
consulting your Best Friend is in the event of a Friendship Emergency.

WHAT'S THAT ?
The Managed Caring(tm) Plan covers your friendship needs 24 hours a day,
365 days a year anywhere in the world, even if you need a friend out of
town, after business hours, or when your Best Friend is Caring(tm) for
someone else. You may be on a business trip and find yourself lonely.
In such a case, you may make a New Friend, and all appropriate Friendship
Procedures delivered in this Emergency Friendship will be covered under
the plan, provided you notify us within two business days.


WHAT FRIENDSHIP PROCEDURES ARE COVERED UNDER THE PLAN ?
Typical Friendship Procedures covered include (but are not limited to):
Chewing the fat, slinging the bull, shooting the breeze, hanging out,
checking in, cheering up, kidding around, dropping over, partying,
moaning, gossiping, joshing, ribbing, holding your hand, patting your
back.

ARE ANY FRIENDSHIP PROCEDURES NOT COVERED UNDER THE PLAN ?
Yes. Ineligible services include (but are not limited to): drinking in
excess of six ounces of alcoholic beverages, lending sums in excess of $5,
going the extra mile, exchanging ethnic or dirty jokes, and sex.

HOW CAN I FIND OUT IF THE FRIENDSHIP PROCEDURE I NEED IS COVERED ?
If you need a Friendship Procedure, call the toll-free number on your
Managed Caring(tm) I.D. card to arrange for precertification of the
proposed Procedure. All appropriate Procedures will be approved for
coverage within 24 business hours.

BUT WHO DECIDES WHAT'S APPROPRIATE FOR ME ?
We do. Isn't that what friends are for?

Managed Care Music Critic

The president of a large California managed care company was also board
chairman of his community's symphony orchestra. Unable to attend a concert,
he gave his tickets to the company's director of health care cost
containment. The next morning, the president asked his associate how he
enjoyed the performance, Instead of the expected usual polite remarks, the
director handed him the following memo:

-----------------------------------------------

To: Mr. Michael Holtz
From: Stanley Gogetter
Subject: Schubert's "Unfinished Symphony"; Performance of

The undersigned submits the following comments and recommendations
relative to the performance of Schubert's Unfinished Symphony by the
Civic Orchestra as observed under actual working conditions,

(A) The attendance of the orchestra conductor is unnecessary for public
performances. The orchestra has obviously practiced and has the
prior authorization from the conductor to play the symphony at a
predetermined level of quality Considerable money could be saved
by merely having the conductor critique the orchestra's
performance during a retrospective peer review meeting

(B) For considerable periods, the four oboe players had nothing to do.
Their numbers should be reduced and their work spread over the
whole orchestra thus eliminating peaks and valleys of activity.
If it is indeed at all necessary to have oboes, a break-thru team
should be established to see if their parts could be combined
with those of the clarinet players, who could simply switch
instruments as required, there-by cutting the reed instrument
requirements approximately by one-third.


(C) All 12 violins were playing identical motions. This is unnecessary
duplication the staff of this section should be drastically cut
with consequent savings If a large volume of sound is required,
this could be obtained through electronic amplification, which has
reached very high levels of reproductive quality. Or perhaps the
reduced number of violin players could pre-record their various
parts on tape and co-ordinate the playback(s) with the actual
performance. I doubt the audience would even notice.

(D) Much effort was expended playing 16th notes or semi-quavers. This
seems an excessive refinement as most of the listeners are unable
to distinguish such rapid playing. It is recommended that all
notes be rounded up to the nearest 8th. If this is done, it would
be possible to use para-professionals instead of experienced
musicians. This alone would save a great deal of overhead on the
payroll.

(E) No useful purpose would appear to be served by repeating with horns
the same passage that has already been handled by the strings.
If all such redundant passages were eliminated, as determined by
the utilization review committee, the concert could have been
reduced from two hours to 20 minutes. Besides, having heard the
melody once, I fail to see what the audience gains by unnecessary
repetition. being able to reduce the house lights, and either
heating or air conditioning (depending on the season) would
greatly increase the profits on each ticket by ending the concert
forty minutes sooner.

(F) This symphony had two movements. If Schubert didn't achieve his
musical goals by the end of the first movement, then he should
have stopped there. The second movement is unnecessary and should
be cut.

In light of the above, one can only conclude that had Schubert given
attention to these matters, he probably would have had the time to
finish his symphony.

New Revolution in Cheap Health Care -- Affordable HMO Opens
by Baja Arizona Publishing Company


TUCSON -- Federated Health Care of America announced today the newest
innovation in cheap health care -- an HMO without doctors.

"One of the most expensive parts of the health care system is the
doctors," explained Andrew Bongle, President of FHCA. "They cost a lot
of money in salaries and malpractice insurance, and they have this nasty
habit of ordering really costly services such as surgery."

In order to keep the cost of health care affordable for their investors,
FHCA has purchased thousands of do-it-yourself photo booths and
installed them in Walmarts around the country. The booths have been
retrofitted with a microchip diagnostic system similar to the ones found
in auto repair shops, and a series of sensors.

"Our patients will simply have to sit in the HealthChair, as we call
them, and answer a series of questions, such as 'Do you have a fever?'
The sensors will detect the body temperature and other probes can be
inserted in various parts of the body to complete the diagnosis," Bongle
said.

"Our in-store health care booths are the cutting edge of instant service
delivery to our clients," noted Bongle.

The HealthChair Booths will dispense pre-measured doses of generic drugs
such as aspirin.

"For the more serious illnesses or injuries, the HealthChair will
dispense a How To Manual for the patient to take home so they can treat
themselves," Bongle noted. "For a few extra dollars, we will even
provide video instructions."

"For example, many surgical procedures only require a local anesthetic,
so the patient will be given a disposable scalpel, a dose of pain
killer, and instructions on how to perform the surgery themselves,"
Bongle explained. "This gives new meaning to home health care."

In addition to eliminating doctors, the new FHCA HealthChair booths
eliminate nurses and hundreds of other expensive employees. "The whole
system is automated so no human beings are required for health care
delivery," Bongle added. "The only staff we will need is to process
billings to insurance carriers."

Since the HealthChair booths have video cameras installed in them to
view patients, questions of privacy have arisen. "We have solved that
problem by offering our patients discounts on their health care if
they'll let us sell the pictures of their naked bodies on the Internet,"
Bongle said.

America's first rock'n roll nursing home opened today in Green Valley,
Arizona -- a notorious retirement community.

"Given the demographics of the country," explained Richard Sottleworth,
head of the Oldies But Goodies Nursing Home, "it only made sense to
cater to the incoming generation of senior citizens."

The traditional nursing home just didn't seem appropriate for people
weaned on the Rolling Stones. "There is no way the old type of old
folks home is going to work with people playing dominoes and listening
to Lawrence Welk," explained Sottleworth. "What works best is to create
a familiar environment for our clients."

The Oldies But Goodies Nursing Home will feature 24 hour rock music, and
medicinal marijuana. "Actually, the next generation of senior citizens
is going to be a lot easier to deal with," Sottleworth explained,
"because we can really dope them up and they'll love it."

The Oldies But Goodies Nursing Home Company plans a national chain of
rock-oriented care facilities. "We are trying to get Dick Clark or Mick
Jagger to do promos for us, but so far no luck," added Sottleworth.
"But, there's plenty of aging rockers out there, so someone will need
the money," he added.

In addition to round-the-clock dope, the new nursing home will offer
electric guitars for residents. "They're all deaf, anyway," Sottleworth
commented.