Like most physicians, I get a steady stream of recruitment mail. Most of it is predictable and after a while, you can read between the lines. Whey they state the practice opportunity is in “God’s Country,” you can assume that generally means within 50 miles of the Canadian border… bring your long underwear! When they state you will join a “small team of dedicated healthcare workers,” you’ll be the only doctor and on call 24/7/365. (Good luck!) My wife usually tosses them, but she was reading one because the text compelled her to read… when you open the fold-over brochure, it starts off “… herding cattle, families and their dreams.” OK… sounded like a HMO to me. You know, the “herding” part. Maybe they give the clinic nurses cattle prods.
It’s actually an opportunity to practice in Las Vegas. Wouldn’t even need cattle prods… could just use old used syringes with needles from recent news.
They were looking specifically for hospitalists, (the fastest growing segment of medical practitioners in the country, devoted to inpatient care, and benefiting doctors by controllable shift-work hours). So here’s the quote with the new term:
“Full time Nocturnists are paid additional compensation to cover nights.”
A “nocturnist” therefore must be a hospitalist who works at night. Interesting derivation. A “nocturn” is any of the three canonical divisions of the office of matins. It derives from the Latin nocturnus, meaning “of the night.” Well, who would have thought that hospitalists, especially in Vegas!, would be deriving shift work from canon law of the Catholic Church.
Leave it to Vegas, I suppose. New York has the Phantom’s “Music of the Night”… Well, I suppose, Vegas has Phantom also now,… and Vegas most certainly does have their share of Ladies of the night, another form of “nocturnists” I suppose…. and now Doctors of the night!
It’s a bunch of new stuff we’ve got to learn, I guess. But fear not, if Monks can figure it out, I’m sure we can too. Here’s how it works:
The Church, (prior to the Second Vatican Council), divides up each 24 hour period of time into eight “hours”:
- Matins (during the night), also referred to as Vigils or Nocturns… but now, for I’m sure obscure reasons, now called the “Office of Readings.”
- Lauds or Dawn Prayer (at Dawn)
- Prime or Early Morning Prayer (First Hour = 6 a.m.)
- Terce or Mid-Morning Prayer (Third Hour = 9 a.m.)
- Sext or Midday Prayer (Sixth Hour = 12 noon)
- None or Mid-Afternoon Prayer (Ninth Hour = 3 p.m.)
- Vespers or Evening Prayer (”at the lighting of the lamps”)
- Compline or Night Prayer (before retiring)
So technically, a “nocturnist” could also be called a “vigilist.” But I suppose that’s too close to “vigilante”…. and that might send the wrong message to patients filling out HCAHPS surveys.
And we could simply throw out “complinists”… besides sounding a lot like “complainists,” (that woudn’t fly from the office of hospital public relations, now would it?). And besides, it would refer to a hospitalist who is retiring for bed. Might give people the idea that hospitalists are paid to sleep. Can’t have that.
So that leaves, Laudsists, Primists, Tercists, …. hmm…. not so sure about Sextists, especially since we’ve done so much to get away from the “good old boy club” perception of medicine…. and I’m not so sure about being a Noneist. Of course, if you decide to go with “sextists,” I suppose you could have “nunists” for women wanting to basically work afternoons.
Think how “noneists” might screw up employment statistics: “When do you work?” Answer: None.
And naturally, the Vesperists, in addition to working evenings, could also flip on the lights for everyone. Guess the incoming Laudists would have to turn them off.
What do we call all of this? Hospitalists of the Hours?
Which, in a rambling way, brings me back to my point. How can “nocturnists be paid additional compensation to cover nights?” I mean, you could simply pay nocturnists more, because they’re working nights. But you would give nocturnists ADDITIONAL COMPENSATION to cover days!
If this is confusing… well, that’s why there was Vatican Two!
By the way, here’s a quick trivia question I heard on The Tonight Show.
Q: Who lives in the Vatican?
A: Vaticans!
I think medicine is complex enough. We don’t need to create additional dots for hospitalists who work the night shift. After all, we already have “Baylor shifts” (Day/Night) in addition to the traditional Day, (7-3), Evening (3-11), and Nights (11-7). The nature of one appeal of inpatient medicine is control of personal time for physicians. It’s shift work. There’s nothing wrong with “shift work” that has been created to deal with the increasing economic demands and evolutionary forces that affect how we practice medicine.
But imagine the confusion you could cause a plaintif’s attorney.
“Doctor, when did you first examine my client?”
“Well, that would have been the ‘ninth hour’…”
“Nine pm or nine am, doctor?”
“Well actually, 3pm by YOUR measurement of time.”
“Well, Doctor, why didn’t you simply say 3 pm to begin with?”
“Because, sir, as a noneist, we set our clocks by a higher authority than you do.”
Let’s all pray for simplicity in an already over complex healthcare system.
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