The Science of Wax

I am really bummed about Jacob Goldstein's piece in the WSJ. How dare he mention the secrets we doctors keep about removing ear wax! His piece detailed the American Academy of Otolaryngology's guidelines for getting rid of this annoying complaint. They mention not using Q-tips. Good. They mention not using those dental WaterPiks. Good (even though we doctors sometimes use that in the office). They mention the ear candle sham. Good (by the way, the Amazing Randi proved that it doesn't do anything and the "wax" pulled out really comes from the candle itself).

I guess I am really bothered by the fact that the ENT dudes claimed ownership over cerumen removal in the first place. Can't the primary care doctors have anything? All FPs and IMs need to band together and draw a line in the sand. Did you know that 94% of all cerumen disimpactions occur at the primary care doctors' office? I bet you didn't. Of course I just made that statistic up but prove me wrong.

This very complex procedure actually pays well. We need a way to make it pay more. The way to do that is to make the experience seem important. As my former medical partner once told me, we could start buffing it up by doing it in a sort of "cath lab". We could convert an old storage room and make it all fancy with pictures of ears on the wall. We could create a very cheap fiber optic camera with a cheap TV that we can stare at like we are doing something really important. You know, like how the cardiologists do it. Then we can shoot some cheap dye and make a great show out of it. Who knows, maybe we can come up with a DES or drug eluding stent to place in the ear canal?

This is a shout out to all PCPs, we have got a great opportunity to make this procedure ours. All we need to do is convince others how important and complex it is. Trust me; it is better than pretending you are all into the complementary medicine thing and recommending ear candling or anal candling or whatever. You don't get paid anything for that.