The National Residency Match Program (NRMP) is planning a small update in their mystical computer algorithms which will erase one of US healthcare’s greatest shames: the last-name/specialty pun.
“Dr. Payne the anesthesiologist. Dr. Miner the prostate specialist. Dr. BALZAC?! [Stiffled snickering] – excuse me, Dr. Balzac the urologist. These are just a few examples of doctors whose last names, while innocuous on their own, take on a larger meaning when matched up with that doctor’s chosen field of practice,” said NRMP match Director Willis Cramble during a televised news conference.
Traditionally, the NRMP has aimed to “protect the interests of Match participants and ensure an equitable experience for all,” through its complex residency match algorithms. The process tries to satisfy the preferences of the applicants and the residency programs, or at least, to create equal dissatisfaction for both groups. “But this process,” said Cramble, “has overlooked one other invested group: patients.”
“Imagine you are a patient preparing to deliver a baby and the nurse tells you that Dr. Pusch is on call? Or say you’re a patient wanting a vasectomy and then only surgeon in town is Dr. Snipp? [Nasal snorting sound.] The internal strain of the patient, as he or she struggles to keep a straight face when meeting with Dr. Ichi the dermatologist must be very traumatic to the patient’s health,” said Cramble, who had to stop and wipe his eyes at this point.
“Oh man. Woooo. Anyways, starting in 2014, the NRMP algorithms will auto-flag any last names which have a high PP – potential pun – score. Then, our newly-formed PP committee will review the case carefully, looking for short-term as well as long-term ramifications. If, for example, Dr. Hu intends to do a neurology residency, that will not be a problem for anyone – as long as the doctor doesn’t mind all the tardive dyskinesia jokes, haha… But if Dr. Hu has expressed plans to later specialize in Alzheimer’s disease, the committee will need to take preemptive action.”
After review, if the PP committee feels that the applicant’s choice of specialty will put future patients at risk of what I call ‘Suppressed Hilarity Internal Trauma,’ they will match the applicant into a family medicine spot instead, unless the applicant’s last name is like Hippie or Primary, ha!” (Cramble’s microphone suffered a technical malfunction at this point in the news conference.)
The American Family of Family Physicians is understandably thrilled at the potential increase in family applicants under this new plan and other professional groups have spoken up in favor of this proposal. The American Nurses Association is heralding this move as a “valuable step towards reducing workplace snickering and other unprofessional behaviors and possibly something that needs to be considered in the nursing field also,” said Nurse Jennifer Vitals, RN, ANA vice president.
Practicing physicians are supporting the change as well, and even calling for further algorithm adjustments. “I think the NRMP is genuinely trying to help protect med students from future ridicule. They [the students] get all excited about a particular specialty or field or practice and they don’t consider the potentially tragic impact of their own last name until it’s too late. I just hope the NRMP will eventually flag FULL name/specialty combinations, which ca be equally… well, disastrous,” said Dr. Hugh Jass, former chairman of the American Society of Bariatric Physicians.
