A 21st Century Doctor's Black Bag

The black bag used to be a symbol of a kinder, gentler medical profession. I can remember getting an embossed one the first day of medical school before they banned such things. It had lots of goodies, like a stethoscope, reflex hammer, tongue blades, and, of course lots of advertising from drug companies. It was sort of like what they give you these days when you sponsor a $10,000 table for the annual hospital fundraiser.

Of course, times have changed and so have the tools of the trade. Most doctors no longer make house calls, although some see it as a new business model. So, there really is no need for all the drugs and paraphernalia you'd need to treat Uncle Bill in his living room. However, given all the changes in medicine and how care is delivered, I'd suggest you have the following handy in the back seat of your Mercedes in your new, improved, bigger black bag:

1. Of course, you'll need an iPhone or an iPad with Wifi in your car. How else would you be able to waste 30 minutes trying to get inaccessible electronic medical records?

2. A portable, battery powered ultrasound machine. Since you had little or no training in physical exam, how else are you going to find out what's going on with the patient's abdomen?

3. Lots of vitamins, neutraceuticals, and, of course, several kinds of antibiotics. What's a doctor's visit without giving the patient something they can swallow? Like Osler said, “The desire to take medicine is perhaps the greatest feature which distinguishes man from animals.”

4. Several white coats that haven't been washed in several weeks. Never pass up the chance to spread antibiotic-resistant infections not matter where you are seeing the patient.

5. Change for a $20 bill. Like the cab drivers, be sure to have a sign that says you don't have any more than that, since you probably won't be paid much more than a few bucks anyway.

6. An Uber account so you can call someone when your car breaks down in a really bad neighborhood.

7. An Automated External Defibrillator (AED). It might even come in useful for the patient someday.

8. Dermabond or a similar surgical adhesive. The last thing in the world you want, given all the blood-borne infections, are shiny, sharp objects in someone's dining room.

9. A Chromecast media streaming device that you can plug into the patient's High Def TV so you can create the patient experience in the comfort of their own home. How else will you get meaningful use credit?

10. A credit card swiper attached to your iPhone since they spent all their money on the High Def TV and won't be getting another paycheck until next week.

A new black bag will only set you back about $1,300. But, so what. Who cares if it's not even all black. The cost of everything in medicine is going up so why should this be any different? Just bill Medicare.