Non Pro Nobis
The entire nursing staff was gathered in the Cardiac Care Center’s conference room. We were seated around a huge, oval table facing a bounty of coffee and doughnuts.We were all there but one: Maggie Shea, our senior nurse. She’d been let go the week before. The rest of the nursing office, we were told, would take up her duties. We would do more with less.
This was the mantra of Mike Spinogle, the fellow aiming a laser pointer at the screen in front of us. Several smaller cardiology practices in the region had merged and were literally giving us a run for our money. So the partners had brought Mike in from some big East Coast practice to make us more profitable.
It was his idea to fire Maggie. It was also his idea to stop our free prescriptions for indigenous patients. My office mate, Tom Keeley, who ran the indigenous patient program, was promptly let go as well. Everyone in the nursing office wondered who was next. People were dusting off their résumés and preparing arguments for their own necessity within the Cardiac Care Center. It was this tense bunch that sat before Mike eating doughnuts and drinking coffee, because that’s what you do when you’re a team player. You eat the doughnuts. You drink the coffee. And you keep your mouth shut.
Mike was striding back and forth in front of the screen. He reminded me of George C. Scott in the intro to Patton, except Mike had Italian leather loafers instead of jackboots, a laser pointer instead of a riding crop.
“Everyone gets the tunnel,” he said, referring to the imaging tunnel of the CT scan.“We’ve got studies upon studies that allow us to order MRIs or CTs on every patient. Congenital heart disease?” he paused for effect and turned on his heel. “MRI.” He looked at me and pointed, “High lipids?”
“Bingo!” He snapped his hand back and pumped his fist. “Nurses, if you think someone needs an echocardiogram, order a function MRI.” He hit a button on his laptop, and his PowerPoint screen changed to show a list of prices. “Insurance only pays $178 for an echo, but they’ll give us $312 for an MRI. So we’re phasing out our echo lab. We’re going to create two new exam rooms to increase our patient flow. An extra hundred patients a month will allow us to generate unprecedented revenue for the practice.”
I left the meeting feeling like I’d just been subjected to a fast-food training film. Would you like an angiogram with your coronary artery disease? Supersize that EKG?