Monday, January 28, 2019


I recently was at a hospital staff meeting where one of the administrative clowns got up to speak. He was trying to show us how grateful the hospital is to have all of us, and mentioned that the food in the doctor's lounge costs the hospital $350,000 a year, so we should be thankful.

I know this sort of thing varies between hospitals, but here's what mine supplies to doctors for that $350K:

Morning: bagels and donuts. Boxes of cereal and instant oatmeal. Granola bars. Little milk cartons in the fridge.

Lunch: Tray of deli meats and cheeses in the fridge. Irritatingly small cans of soda. A tray of cookies.

Dinner: Not supplied. Whatever is left over from breakfast and lunch.

Always available: coffee, tea, sliced bread, English muffins, little packets of peanut butter, jelly, butter, and honey.

So, I guess that's what $350,000 a year gets you. I'm sure you also have to figure in there the salary of the person who restocks & cleans it each day, frequent repairs to the heavily-used coffee machine, and a few other items. Plus, they probably fudge in how much money they're losing by not giving us the finger and turning the lounge into another endoscopy suite.

That's not a huge sum of money in the modern healthcare world, but since hearing that figure, I keep wondering how it might be better spent. Maybe a few more nurses in the rotation. Or respiratory techs. Or physical therapists.

I'm sure some doctors would whine, but realistically I think most would be happy with coffee and a bagel in the morning, since that's when most round, and the hospitalists buy their own stuff for lunch anyway.

There are certainly bigger wastes of money in modern healthcare: CEO bonuses (at my hospital his was around $7 million last year) and paying Press-Gainey to do surveys, to name two of them. And the people involved in those things don't care about patients, anyway (regardless of what their PR staff tell you).

But I do care about patients, and would be more than happy to give up a deli tray, cookies, or even a bagel, to improve their care.

That's provided the money actually went to that use. Realistically, it would probably just go to some administrator's year-end bonus for the money he saved by cutting coffee and bagels out of the doctors lounge.


John Woolman said...

As a refugee from the English NHS it sounds like heaven...

Anonymous said...

It sounds like Army procurement, where a million considerations other than quality and price drive the price up for substandard goods. At the hospital I used to work at, for instance, we had free coffee all day in the Doctor's Lounge. When I first started practicing there, the cups were styrofoam, and the coffee was made in one of those big stainless steel cylindrical coffee pots that switched out twice a day.

Then they switched to these thin paper cups that were so poorly insulated that you had to use them two at a time to keep from burning your hands.

I asked if it was worth the savings to switch to the paper cups. The food service person laughed as asked if I was joking. It turned out that the styrofoam cups cost 15 cents each. The paper cups, however, were made completely out of recycled paper and were thus "eco friendly," and cost 75 cents each. Since everybody was using them two at a time because they were so thin, that meant that the cost of a cup of coffee at the Doctor's Lounge went from $0.15 to $1.50 per cup just for the cup. Similarly, they switched from those big stainless steel coffee makers to a Keurig-like one, which increased the cost of the coffee itself from about 5 cents to 0.50 to 0.75 per cup. That meant that the whole thing went from about 20 cents in cost to the hospital to a little over 2 dollars per cup. And we physicians went through a *lot* of coffee.

It wasn't the docs being demanding or wasteful. It was the hospital administration being politically correct and in love with gimmicks.


Anonymous said...

I gotta say Doc, it's quite refreshing to hear that angle from a doctor. All of those whom I work with on a daily basis would write the same post saying that it's not enough and would demand much more. Kudos.

Ann said...

You open eyes and fill them with tears. What a kind heart you have. I’m glad you’re a doctor.
But no matter bagels and coffee, ok? Take care of yourself. You matter.

Anonymous said...

And when the CEO's bonus is $7.350 next year you'll know exactly where your bagels and coffee went. Admins are always willing to show the people actually doing the work how to tighten their belts and do more with less over catered lunch meetings.

Anonymous said...

I think you are lucky the hospital gives you anything. When I still worked at the hospital, you had to steal coffee from the nurses station, if you wanted any.

jono said...

Really? Nearly a thousand dollars a day for that? Do they take competitive bids?

danielle said...

press-gainey….let me put it in their is a 4 letter word!
yup, makes about as much sense as those stupid surveys they use to batter us worker bees with

Ms. Donna said...

For 350K, I can keep your tables stocked, maybe have a light dinner (ever hear of salad?) out and coffee all the time. I might keep the tiny cans of soda just to annoy you.

And would have enough to live on happily.

Seriously, this contract needs to be looked over carefully. I think a few corners can be trimmed (not cut) so busy doctors won't perish of hunger AND perhaps get another nurse, RT, piece of equipment, etc.

Thank you for offering, and as a pt I am glad you want more pt care. As a confirmed cynic, I know this will wind up in someone's bonus.

Let's keep thinking. There has to be a way out of the box somehow. . . .

Packer said...

What is it about this country that makes people thing they are entitled to a free breakfast. Are we so freaking lame that we can’t slap a bowl of Cheerios down along with a banana and eat it before going out the door. We have a whole industry throwing food out at schools and apparently hospitals because assholes can’t use a toaster at home. If you want a free breakfast book a room at a Hilton, they will toss one in for you. But beyond that no free breakfast. As for your kid you breed em you feed em. If you can’t feed your own kids they should take away your parent card

Shana you ignorant slut

Packer said...

Anon @ 8:25

How about you bring your ceramic mug with you and rinse it out once in awhile rather than clutter up landfills with billions of styrofoam cups.
As for paper cups, you know they are cutting millions of acres of the Boreal forest just so you can wipe your butt with soft as a cloud toilet paper, and do the quicker picker upper bit. When thus forest are gone and you can’t gasp another breath I hope that coffee in your paper cup taste good. You know my people are boycotting Dunkin over the styrofoam cups, but noooooooo, not you.

I mean really people, you climate deniers are never happy.

Anonymous said...

Whenever I'm asked to fill out a Press-Gainey form, I give everybody and everything a 5 (or whatever the top ranking is). Then in the comments section, I tell them that instead of wasting money on Press-Gainey, they should ask the staff involved what they need and what is the best way to make their jobs easier and better. The staff knows.

People in general are not equipped to evaluate the quality of the medical care they receive--and shouldn't be asked. They can tell if you smile nicely and are pleasant, but they can't tell if you actually know what you are doing and provided appropriate treatment.

--Queen Anne's Lace

Anonymous said...

How is it your problem that the silly hospital paid more than a quarter of a million dollars on bagels and coffee? I'll bet if someone knew of a contract to provide those items 24/7 you could've been treated to homemade blueberry muffins and five choices of herbal teas, plus real mugs and a dishwasher. Someone is not being a good steward of limited resources.

Albinoblackbear said...

I survived in the hospital on stolen PB and cheese packets from endo fridge. Always thought it was funny when I got hassle for this since those things were for feeding patients who had been fasting. Most of the time I had been fasting longer than the patients, and not by choice.
You're right on the money as always, Grump. I wonder what goodies the CEO has stocked in his office?

Lisa said...

Do they mark up the price of the bagel the way they do aspirin? That's a pretty expensive bagel you've got there.

Thoryke said...

It's possible that the real source of the $350K has NOTHING to do with how much food or comfort is being provided to the medical staff. Instead, that number represents "How much money is the hospital losing out on each year because the space is not being used to generate cash from services?"

This is very much the extortion-style thinking I saw in the pharmaceutical pricing world, when I was asked to draft a background document to support a potential diabetes drug. The company wanted to build their pricing around how much it would cost individual European health services to support people who went blind due to diabetes complications; i.e., "Our exorbitant price for x drug is only 80% of what it would cost your nation in economic losses from people going blind, so aren't we a bargain?" [I did not stay with this company very long...]

Tom Bridgeland said...

That's about the cost of three nurses' salaries and benes each year. I eat the cheerios and milk in the patient kitchen.

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