Before everything today I just want to say rest in peace to Loretta Swit. You were  adored as Hot Lips Houlihan in M*A*S*H. You willingly became a champion for women in the military as well as nursing without doing anything more than playing an honest role as a nurse in a mobile Army surgical hospital in the middle of a war. I met you several years ago and was able to speak to you for about 10 minutes. Even though I’m a male and you were a female you greatly inspired me to want to become a nurse. You will definitely be missed especially by this nurse.

Yesterday, I spoke about the expectation—often unreasonable—that professionals, especially in medicine, must operate with perfection. There’s an unspoken demand for flawlessness from those who hold licenses: nurses, physicians, therapists, and others. But here’s the truth—medicine is messy, and human beings, even trained ones, are imperfect.

Competency and consistency are absolutely essential in healthcare. No one wants Joe Blow, who barely scraped by in high school biology, managing a complex medication regimen. But here’s the flip side: holding a license does not mean someone is automatically competent or ready for every challenge.

Let’s be honest. You wouldn’t want a brand-new provider managing a complex, unstable patient. Just like you wouldn’t want a newly graduated nurse tossed into an ICU night shift with no backup. And yet? It happens. Far more often than most people realize. Nursing schools often teach new nurses how to refuse complex patients due to their lower level of competency. They’re taught to advocate for themselves, to recognize when a situation is beyond their scope.

But in the real world? That gets overridden. The moment someone puts on scrubs and clocks in, the system expects them to rise to the occasion—regardless of readiness.

And when something goes wrong—when the patient crashes, when the outcome is poor—who gets blamed? The inexperienced provider. Not the nurse manager who assigned the case. Not the understaffed system. Not the burned-out supervisor. The individual is labeled incompetent, simply because they weren’t equipped for something they never should have faced alone. They’re expected to be perfect, because they have a license. That’s it. That’s the whole bar, apparently.

When Non-Medical People Investigate Medical People

I also touched on the absurdity of being investigated by people with no medical background. Let me say it plainly: having your license and your livelihood scrutinized by someone who doesn’t understand the basic realities of clinical care is maddening.

These investigators often use checklists, templates, and flowcharts to dissect charts they barely understand. Yes, they sometimes consult licensed professionals—but many times those individuals are no longer eligible to practice. That’s right: you can be judged by someone who can’t legally do what you do anymore. Make it make sense.

It’s like being reviewed for surgery technique by someone who’s only watched reruns of Grey’s Anatomy. They might recognize the words, but they don’t live in this world. And yet, they hold the power to alter a career permanently.

How Insurance Bureaucracy Damages Patient Care

Once I moved from nursing to the world of providers, I came face-to-face with another beast: insurance companies. The moment anything beyond a basic office visit is needed—labs, imaging, specialist referrals—there’s a bureaucratic wall in the way. And that wall? It’s called prior authorization.

I worked in insurance for a while, doing authorizations. I saw the sausage get made. Yes, they hire medical professionals to review charts, and yes, there are criteria. But even with legitimate guidelines, the process eats up critical time. And time, as we know, is often the difference between early diagnosis and missed opportunity.

Worse still, we were told in meetings that we needed a 20–25% denial rate to be considered effective. That’s right. The goal was not about helping patients or supporting providers—it was about saving money. Deny enough, and you’re doing your job. Even if the denial was for something a patient clearly needed. Even if the diagnosis made perfect sense.

So providers are forced to jump through hoops, resubmit forms, file appeals, and meanwhile their patients wait. Some suffer. Some give up. And all the while, the insurance company stays profitable.

When Science Takes a Back Seat in Government Oversight

Lastly, let’s talk about government oversight—or the lack thereof.

Sure, heads of federal agencies don’t necessarily need to be doctors or scientists. But when the Secretary of Health and Human Services pushes anti-vaccine rhetoric and spouts conspiracy theories, we’re in dangerous territory.

Let’s be blunt: vaccines work. That’s why we don’t have smallpox. That’s why measles disappeared for decades—until it didn’t. (Funny-sad aside: I once worked with a resident who needed help diagnosing a textbook case of measles because they’d never seen it before. It was so rare… until it wasn’t.)

We don’t need leadership that wants to take us backward a hundred years, reviving ideas like chickenpox parties or pushing horse dewormer as miracle cures. We need science. We need rational oversight. And we need professionals who aren’t being undercut by politics, red tape, and impossible expectations.

Final Thought

Medical providers are human. We make mistakes. But more often than not, we’re doing the best we can with the training, support, and system we’ve been given. If we want better outcomes, we need a system that values competence over perfection, expertise over bureaucracy, and science over spectacle.

Because one thing’s for sure—expecting perfection while cutting corners is a guaranteed recipe for failure.

Happy Saturday and remember be the kind of person your dog and your mom hope you are.