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by Mark Plaster, MD
 
When you schedule a dentist appointment for the morning after a long night shift, you run a risk. If the dentist uses nitrous oxide, you will drift off into a deep pleasant sleep and not even remember the appointment. That’s the best scenario. But if he doesn’t, you can descend into the maze of Matrix (for the younger dreamer) or the torture chamber of Marathon Man (for us old Dustin Hoffman fans). This was a new dentist for me and I soon found out he didn’t have nitrous.

As I settled into Trendelenburg position in the chair, I closed my eyes and tried to block out the high pitched whine of the ultrasonic tool. High up in the corner of the room there was a TV softly injecting the days news stories into my subconscious.

“We have with us this morning Dr…” I focused on the water filling up in my hypopharynx. The suction tip hooked over the corner of my mouth wasn’t quite getting to the water and I was beginning to feel like I was drowning. “After the way this company has used sexploitation to sell their products to young people,” the doctor on the TV said, “I think this $10 million dollar gift is simply a way for them to try and ingratiate themselves in the public eye.”

“So, are you saying,” the reporter probed, “that the hospital should return the $10 million dollar gift to Abercrombie & Fitch or do you think that they just shouldn’t name the emergency room after the company?” Suddenly the words Abercrombie & Fitch, $10 million gift and emergency room pierced the fog of my mind.

“id thay thay Athercothie and Fiths?” I almost shouted as I flailed my way to the upright position. In my light blue scrubs I resembled a big blue marlin trying to shake the hook from my mouth.
“Dr. Plaster,” the hygienist drew back startled. “You’ve got the suction catheter stuck to your tongue.”

I yanked the leech out of my mouth. “Did they say Abercrombie & Fitch gave $10 million dollars to get their name on an ER?”

“Uh, yeah, I think that’s right,” she said. “I wasn’t really listening.”

“That’s brilliant!” I murmured as I gazed off into a picture of the future.

Uh, doctor,” she said apologetically. “Do you mind sitting down? I’m almost finished here.”

“Oh, yeah,” I mumbled. As I sat down and closed my eyes to block out the office, I drifted off into a daydream of scantily clad physicians and nurses cavorting through the ER. Each had a perfect body and sported a distant dreamy look as they passed one another in the hall.

“What did they give you back there?” my wife asked as I met her in the waiting room. “You’ve got a goofy grin like they loaded you up with some drugs.”

“You won’t believe what I just heard,” I said excitedly. “Abercrombie & Fitch is giving some hospital $10 million bucks to get their name on the ER. Wouldn’t that be cool if our ER could do something like that?”

“Oh my gosh,” my wife groaned. “You’re having one of your ‘Walter Mitty’ moments again. Don’t tell me. You think the ER could become one big Abercrombie & Fitch commercial.” I hate it when she reads my mind.

“Really,” I argued with a commercial glint in my eye. “Think about it. If we opened up the ER to advertising, we could make a fortune. We wouldn’t have to worry about collecting from the patients. Heck, we could all have our own sponsor.

“Hey, Michelle could be sponsored by Victoria’s Secret and I’m sure Bob could get a contract with Anheuser-Busch. Think of all the millions the drug companies spend on TV advertising. If they sponsored a doctor, think how much more ‘bang-for-the-buck’ that is.”

“Oh, yeah,” she mocked, “you could be sponsored by Viagra.”

“There’s no reason to get ugly,” I pouted. “You have to admit it’s an idea that has merit. Everybody is advertising something. The other day I read an article online that Ron sent to the paper that described the damage that lawyers were doing to health care system. Right next to the article was an advertisement for a malpractice attorney.”

“You’re kidding me, right? You can’t be serious about all this. You better let me drive home. Your drugs haven’t worn off yet.”

“Seriously,” I argued. “I’m as sober as a rock. If an advertiser can be on the outside of the hospital, why can’t they be on the inside? And if a hospital can benefit from putting a commercial advertiser on its building, why can’t a doctor benefit from putting a commercial advertiser on his body?”

“Are you suggesting that doctors should look like NASCAR drivers?”

“Well, not exactly,” I said somewhat sheepishly. “But it wouldn’t hurt anybody to have a little commercial logo on my lab coat?” I shrugged waiting for her response. “Do you have any idea how much Nike pays Tiger Woods just to have their symbol displayed on his cap?”

“But you have a position of respect,” she said plaintively. “You can’t use that to hawk a product like some TV home shopping channel guy.”

“Hey, it’s a new age for medicine. You can see a nurse practitioner in a Wal-Mart who will prescribe a drug for you that is sold by her employer. But doctors and hospitals can’t own their own retail pharmacies. That would be a conflict of interest. Drug companies can spend millions to tell patients to ask their doctors about drugs they don’t need, but I can’t accept a sandwich from a drug rep while he tells me about his drug’s latest research. Medicine needs to move into the 21st century, baby.
 
“Besides, all that advertising money could go into lowering the patients’ cost of care.” I spoke as if my logic was water tight.

“But isn’t the cost of advertising one of the reasons that drug companies have had to raise their rates so astronomically on new drugs? And haven’t you always said that it is advertising that makes people want things that they don’t need and probably wouldn’t buy otherwise?” I hate it when she uses my own words. “Let’s go home and feed you so you can get some sleep. You’ll feel better when you wake up.”

I sulked over the breakfast table as I tried to come up with something to defeat my wife’s logic. Finally as I prepared for bed and threw on an old sweat shirt it came to me. Emblazoned across my chest was the word GAP.

“Look at me,” I yelled from the bedroom. “I’m a walking billboard. I’m wearing a huge advertisement for GAP. I bought this sweatshirt. But by all rights GAP should be paying me to wear it!”

“Go to bed,” she shouted back from the kitchen. “I’ll go to the mailbox to see if you got any royalty checks.”

Mark Plaster, MD, Founder/Editor-in-Chief of Emergency Physicians Monthly
 
 

Comments   

# ER DocJerry Weisberg MD 2008-04-09 01:53
I think your writings are realy great. I look forward to seeing and reading them first after the paper comes. I wish many more of our people would have half of your coments and wisdom. Your series makes my day.
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# Thomas Gray, MD 2008-04-09 17:21
You are right on. Several yrs ago when my children were learning to drive I proposed that DL eligibility be linked to GPA and auto and oil companies be allowed to advertise and support education and schools by sponsorship of books, equipment, etc. Same could work in the ED: Auto makers advertising auto safety features in the trauma rooms; OCPs, condoms, planned parenthood and the churches in the pelvic rooms; toy companies in the peds rooms; wgt programs, gyms, personal trainers in the cardiac rooms. Advertisers wouldn't even have to donate the department, just a room or a wall or a poster. Great Idea. People need something to read while they wait anyway.
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# Post night shift hallucinationsPhilip L. Levin, MD 2008-04-10 12:43
Working too many long hours makes us dingy. It's a joy to read your satire with its many complex underlying themes; considering sleep deprivation, the influence of commercialism in medicine, and even the weird effects of dental care.
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# MDA. Cuatico 2008-04-11 14:08
I thoroughly enjoy your column.
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