AFTER JUNE 30, 1998 THERE WILL BE NO MORE
MEDICAL GRAND ROUNDS. . . EVER!
The reasons for this reasonable action made by reasonable people in a reasonable time frame are multiple. Full minutes of all deliberative councils involved are appended in an attachment to your hard drive. Basically, they are:
1) Grand Rounds interferes with physician productivity. Being cognitive specialists (cardiologists, gastroenterologists, and pulmonary physicians excluded), we must all spend more time seeing more and more patients if we are to compete effectively with other physicians and the encroaching hordes of practitioners of complementary medicine who want to snatch our patients - and their office hours begin at 7:00 a.m.
2) Because of budget cutbacks in Maintenance, the Department of Medicine faculty will be expected to clean up cups, debris and then vacuum Fairchild Auditorium after each Grand Rounds. This, to most of us, seems unreasonable and a great reason in and of itself to cancel grand rounds.
3) The emeritus faculty, increasing in numbers exponentially, is taking all the good seats in the second, third, fourth, and fifth rows - this prevents the house staff from sitting there and requires that in order for them to get a good vantage point to see and hear the proceedings they must arrive before 8:20.
4) Medicine is getting too complicated. It used to be that a patient with congestive heart failure could be presented and there would be useful debate about how much digitalis should be used. Now, the probability that nuclear hormone receptors that relay messages to cytoplasmic intracellular structural proteins and enzymes are at fault make it difficult for the average practitioner to understand what he or she is doing in the clinics and on the wards. Grand Rounds accentuates, underscores, and overemphasizes this problem.
5) The INTERNET has taken over as the primary purveyor of both pornography and continuing medical education. Now it is possible for a physician, in the comfort and privacy of the office, to review Genital Hospital and the latest contents of the New England Journal of Medicine in half the time that it takes to trek to Fairchild. In addition, while being educated by the WWW physicians don't have to smile, say "Good Morning" to colleagues, and waste time in social intercourse for which there is no billing code.
SHOULD THERE BE A GROUNDSWELL OF OPINION TO RE-INSTITUTE MEDICAL GRAND ROUNDS A COMMITTEE OF THE MOST SENIOR FACULTY WILL BE RECONSTITUTED TO REVIEW AN APPEAL.
Preview by Edward D. Harris, Jr., M.D