May 1999

Survey This

By Michael J. Katin, MD

Now that the United States has succeeded in driving most of its industry to Mexico and beyond, the question has been raised about what truly keeps our economy going. Most consumer electronics equipment is made overseas. It can't be Starbucks, since the coffee itself is imported. I think one possibility is that at any given time we can be inspected by any of ten organizations and government agencies--JCAHO, the ACR, ACRO, the RTOG, the NRC, etc. Like the Strategic Air Command, representatives of these organizations are constantly in the air, traveling to the same destinations sequentially, consuming airline seats, hotel rooms, and other expensed items.

Just as with Tinker Bell, these organizations exist only because we believe in them. If we stopped taking them seriously, they would vanish. With their having attained credibility, however, their has been an empowerment which has allowed them to become more and more intrusive into our practices. Now, not only are there persons from these organizations responsible for carrying out these surveys, but there are people in each department whose main responsibility is to interact with these inspectors, making sure all items are covered up adequately. Sorry, covered adequately. There are skills involved in having all the necessary forms assembled, having key personnel available for interview, and, most importantly, getting the surveyors out to lunch and out of the department as much as possible.

Experienced staff members, who can discuss sports, weather, and current events with the surveyors and keep them distracted from their job, are invaluable and undoubtedly at some point will be required to have MBI (Master of Bureaucratic Inspection) degrees. As with tax consultants, these will usually be persons who previously worked for the inspecting agencies and then went over to the dark side of the Force.

We have come into possession of an internal memorandum from one of these agencies and will process and release this information in next month's column. In the meantime, I would like to call for all radiation oncology centers other than ours to not only refuse to go along with any more JCAHO and other inspections, but to show their courage by burning their previous certificates. I know you'll feel much better afterward.

email: mkatin@radiotherapy.com