Taking a page from the medical boards, the medical societies of America, ranging across all specialties, recently announced that doctors who trained before 1990 will be grandfathered into old medical guidelines. This highly controversial policy means that these physicians can practice medicine according to the guidelines that were in place when they were trainees.
“It’s about time!” said Harriett Helmsley, who finished her internal medicine residency in 1979. “I’ve been lobbying for them to let us use old guidelines ever since the medical boards decided to grandfather us into lifetime certifications. New guidelines for everything come out every other day—if we’re not gonna be tested on them, why should we have to learn them?
“Honestly,” she added, “I’m perfectly content diagnosing heart attacks by checking liver enzymes, treating peptic ulcers with Tums, and treating MRSA infections by praying.”
Dr. Henry McIntyre, a 91-year-old physician who trained in the 1950s and still practices today, is so thrilled about this news that he already scheduled lobotomies for his most severely depressed patients. He also says that he plans to dust off his 1st edition of Harrison’s Principles of Internal Medicine and will resume using it in his daily practice.
Surprisingly, patients of these old-time grandfathered doctors seem content with this new rule. “Why would I care if my doc is up-to-date with medical knowledge?” asked Greta Smith, as she was busily boiling a test tube containing her urine and Benedict’s solution. “Every time I pee, I estimate my sugar level this way, just as Dr. McIntyre instructed. But don’t worry, he does the fancy new tests like blood glucose too—last he checked, my fasting sugar was 139, so based on his guidelines, I don’t even have diabetes anymore. Woohoo— Ice cream sundae with all the fixin’s tonight!!”
Some physicians, however, are concerned that the new rules will lead to confusion when pre-1990 and post-1990 trainees interact. Take this recent example of an 80-year-old ER doc and a 29-year-old neurology resident discussing a stroke patient:
The old ER doc says, “I have a guy with suspected apoplexy,” to which the neuro resident responded, “What’s apoplexy?” After finally figuring out it’s an outdated term for stroke, the neurologist asked, “What’d the head CT show? Please order an MRI. Is he a tPA candidate?”. To which the ER doc replied, “What’s a head CT?” and “Order a what now?” and “There’s no treatment for apoplexy!”
But most love the new rules, and although satisfied that she no longer has to take medical board exams nor learn new medical guidelines, Ms. Helmsley said she’s not done lobbying for more perks for the pre-1990 crowd. “Next up,” she said, “is getting us grandfathered into paper medical records!
