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I Bought You Today

Glassner, Samuel H. MD

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doi: 10.1097/01.EEM.0000296416.31231.c4

    I bought you today. Hundreds of you. Thousands of you. In my wildest dreams I never thought an ordinary ER doc like me would be an owner of such a vast empire. But now I am, and I love it. I even got some radiologists, pediatricians, hospitalists, and anesthesiologists in the deal. Not bad for a little guy like me who almost lost everything back in 2003. And now I own you, each and every one of you.

    I didn't buy you at the IPO price. Too much hype, too much hoopla. Let the frenzied and uninformed pay top dollar. I waited for you to come in, and then I pulled the trigger. And if you keep working as hard as I know you do, I just know you'll make me a bundle.

    Of course, if I were you, I wouldn't be expecting that raise anytime soon. If Medicare starts to pay you more or if Medicaid decides to pony up a few more pennies for your services, well, that money is for me. After all, I own you. You're working for me now. I want to see a good return on my investment. I wouldn't risk my hard-earned cash on a loser. Anything less than a six percent dividend, and I'll drop you faster than an NG tube in a GI bleeder. I'm not unreasonable. I'm just an investor, and I want results. I've got a family to support. I want something to retire on.

    Now big business clearly knows a lot that I don't. How do you make money on emergency physicians who are stressed to the max and who have to fight for every dime they get from the government, insurance carriers, and HMOs? Where is the sustainable profit to investors when every year the government threatens to reduce Medicare and Medicaid expenditures? How can they generate such huge amounts of cash when insurance companies are doing everything they can to get out of paying physicians reasonable claims? And where is the profit in depending on income from HMOs that repeatedly seek to pay doctors less and less? I don't know, and I don't care. Corporate America found a way to make money off you, and I've decided to buy in. I'm a shareholder now. I'm getting a percentage of every lac you repair and every weak-and-dizzy you work up. So if you could pick up the pace a little bit, it will help me to retire sooner.

    And you radiologists — no more of this knocking off at 5 p.m. nonsense. We're a 24/7 operation, and I want you in those viewing rooms 24/7/365 reading those films. And you can eat at your desks. Who says a radiologist can't read x-rays and chew at the same time? What is this meal break business? How will I afford my condo in Maui if you don't pick up the pace? Remember, you're not just working for you anymore. You're working for me. So step on it! I'm not getting any younger, and we've got a lot of mouths to feed.

    Of all the investments I've ever made this one is going to be the best. I know this business. I know how hard you ER docs work — nights, weekends, holidays. Heck, most of you never leave a shift on time, and don't even get paid for staying late. How can I lose? You guys are working overtime for me and every administrator above you. What a pot of gold! And me, like an idiot, I've actually been working in an emergency room for 20 years. Long hours, little thanks, unending stress. Forget that! I'll just buy some more ER docs, and let them work for me! I never knew emergency medicine was such a money-maker. Pretty soon I'll be making daily deposits at the bank. Hmm, I wonder if they have a dividend reinvestment program.

    Of course, like any successful business, we need to keep costs down so perhaps we can start paying these addle-brained ER docs a few bucks less per hour. They would gripe about it for a few minutes and then it would be back to business as usual. Less for them, more for me. I like that. Then we could move on to the hospitals; pay me to staff your ER or no coverage for you. Hey, I'm starting to like this more and more.

    We've got a few non-ER docs already, so let's get a few more. Heck, let's see if we can get some surgeons as well. Now you're really talking money! These ER doctors are so docile. How different can these other guys be? Ka-ching. Ka-ching. That Lexus is looking better and better. I think I'll buy another few hundred shares.

    So thank you. Thank you for going public. Thank you for letting me share in your rewards and profit from your ceaseless efforts. But please remember one very important thing: I own you. I bought you on the open market fair and square. I paid the going rate. You work for me. As a cost of doing business, I am paying professional administrators quite handsomely to manage you. But the profit goes into my pocket. Fail to perform, and I'll let management know just how unhappy I am. And don't be late for work. There are plenty more where you came from.

    © 2007 Lippincott Williams & Wilkins, Inc.