Tuesday, November 11, 1997
Play it again, Dr. Sam

The Cincinnati Enquirer

Dr. Sam Bierstock became so sick of modern medicine that he tried a radical cure. He laughs about it. Even more radical - experimental, you might say - he has set it to music with lyrics that explain ''where the money is going.''

The Florida physician called after hearing me on the radio. He says he thinks I understand managed care, and ''not one person in 100,000 understands managed care.'' I'm flattered by his attention and grateful that we are not having this conversation while I'm wearing a paper gown. I do not confess I am not that one rare person.

Unmanaged care

I don't even understand why we call it managed care, which implies that before bean counters came along, medical care was disorderly, unmanaged, perhaps even wasteful:

''Nurse, order up a bunch of tests - anything you think we might get away with. I'm off to the golf course. And let's schedule some unnecessary surgery when I get back.''

Most of us think our health care was considerably better than that even before we got so much management from insurance companies. And many of us notice that a lot of the expense is for stuff that formerly was not available. Miracle babies, kidney transplants, heart bypass and hip replacements were not invented by doctors to rack up fees.

We know we're expensive, but when we're sick we want to be made well. Whatever it costs. ''You have no idea,'' Dr. Sam says, ''of the pressure on providers.''

An eye surgeon for 15 years, he gave up practice in 1992 to become a medical information systems specialist. Now, he's a full-time song writer and musician. And talker. He gets $5,000 per appearance for his speeches and up to $10,000 for his ''integrated music delivery system,'' which he jokes does not require a referral from another musical group.

Prognosis seems good for Dr. Sam and his Managed Care Blues Band, with bookings through 1999. Selections from his play list include: ''You're One Hip Mama ('Cause They Won't Pay for Two)''

''Sorry, Man, But Your Bypass Is Considered Cosmetic''

''You Got to Go Back in the Hospital, Mama, 'Cause They Done You Wrong''

''I'd Like to Kiss You, Baby, But I Just Came Across Your Medical Records on the Internet''

''What Now My Glove (a digital recording)''

''Arrivederci Neuroma''

Dr. Sam plays the harmonica, and a medical technician sings and plays lead guitar. A composer - dentist is on the keyboard and a thoracic surgeon on drums. In keeping with his theme, ''if I can use non-medical people and pay them less,'' he says, ''I'll do it.''

A wild ride

They put up their musical shingle only four months ago, and ''it has been a wild ride,'' according to the band's pleasant - and obviously very effective - publicist, Rhonda Price. Dr. Sam has been featured in numerous medical journals, USA Today, on National Public Radio's Marketplace and will be in an upcoming issue of People magazine.

(The doctor is in at www.managedmusic.com and his new CD, Minimal Service, is available at 888-4CO-PLAY.)

Ms. Price, who grew up in West Chester and now lives in Boca Raton, Fla., says she has fielded inquiries from all over the country. They've even had some interest from Blue Cross - Blue Shield. But I'm guessing the band won't be asked to play ''You Picked a Fine Time to Leave Me, Blue Shield.''

''I'm not bashing HMOs. This is a way to educate people,'' Dr. Sam says. ''Very few understand how managed care works, how doctors and hospitals are paid for their services, and where the dollars go.''

Who can blame Dr. Sam for choosing to be a bandleader instead of a doctor? His new gig is more prestigious, the hours are better, the customers more appreciative and the paperwork is almost non-existent.

Laura Pulfer's column appears in The Enquirer on Sundays, Tuesdays and Thursdays. Call 768-8393 or fax at 768-8340. She can be heard Monday mornings on WVXU radio (91.7 FM), and as a regular commentator on National Public Radio's Morning Edition.