Wednesday, November 11, 2009

Medical (Mis)Treatment

We love to talk about freedoms and liberties in America. We fight for it, we love our freedom, we cherish it, it’s our highest ideal and wish death on whomever attempts to threaten its existence. But man, I never feel more deprived of this freedom than when I attempt a very routine visit to the doctor’s office, in this day and age!

Now, I have been a patient pretty much all my life. I know, we all have been, at some point, but I mean, I have been forced to be a conscientious, very loyal and regular one. And trust me, I am no hypochondriac nor do I get great enjoyment out of it. I go out of necessity. So, you may call me jaded, also – go ahead. I still want to say a few things about our medical (mal)practice.

Lately, it’s more restrictive to go to the doctor’s than it is to fly, which is hard to believe some days. Every time you go in the office, there some new restriction. And while some restrictions are meant for your safety and accuracy of service (like, fast before labs, wear no jewelry before you go under, wear tennis shoes on the treadmill, etc), others are complete bogus infringements to your time, honor and wallet. Complete disrespect for you, as a patient, or as a human being.

You have to provide an insurance card for every visit - why?- if there were no changes from the visit from yesterday, I am not sure; you have to provide a photo id, or else you’ll not be seen. I wonder how many people impersonate someone else, and know exactly the name of the doctor to see, the time to be there, the name and date of birth of the patient meant to be seen. Hhmm …

We’re so afraid the governmental health insurance plan will be “too bureaucratic”?? Are you kidding me? Our very own doctor’s office has bureaucracy down pat! Think of all the forms you fill every year, over and over again! The amount of data they have on you: everything from your address, social security number, credit card account, names of the closest people to you, and their phone number and these have nothing to do with details on your body and your health and condition!

And how about all those copies of all those insurance cards, about 20 times every year?? All that paper trail in a day and age when we’re all paranoid about stealing identity and saving everything encoded and password protected on computers so it won’t be accessible by human eyes?!

Then, on every wall inside all the little waiting rooms you’re a prisoner in, signs warn you vehemently: “Don’t call us for the lab results. We’ll call you. In two weeks”, “We will charge you anywhere from $35 to $55 for each form you need us to fill out” – and then, they have the gall to tell you why: “because insurance companies don’t reimburse the cost”. It’s all about the bottom line, isn’t it??

And that brings me to the other issue: I feel blood sucked and robbed blind every time I walk in there – and that’s to put it mildly. I would invoke violent sexual acts here, but class keeps me from doing so.

If I hear one more person telling me “well, doctors have to pay those huge student loans, so, that’s why they charge so much” I am going to puke! Ppphhhlleeeaaasee, people! Do they also have to live in million dollar homes? And go on a Mediterranean cruise every summer? And marry their only daughter at The Biltmore? And drive BMW’s and have several vacation homes?! I am sure they don’t have to do all those things, but well, they do. I don’t see them living in regular folk condos and shopping at Wal-Mart to pay the loans they got themselves into, willingly, either. And I am not saying all this because I am jealous, God no! But somewhere, there has to be some justice and some middle ground between people losing all they’ve got to get healthy and people providing healthcare and getting ever so richer that it’s blinding to the rest of us. I know capitalism isn’t a fair structure, but the gap is widening every single year. It’s hopeless!

And I don’t know about you, but I have a problem with paying the same amount of money to see a Harvard educated specialist and his Nurse Practitioner! Practitioner or not, she is a nurse! I am sure their “student loans” don’t compare! They can’t, possibly!

And that brings me to the next point, of the quality of care. In the heated and very actual debate of governmental health care system we’re witnessing today, we all hear about “the quality of American healthcare”. We pay the buck, but we’ve got the best! Again, if someone tells me that one more time, I’ll regurgitate!

Let me give you just a for instance from a recent visit. I meet with my general doctor for my six month follow-up. I get about 15 minutes every 6 months of his very expensive time, to look at my recent blood tests, and send me to some more specialists in search for a cure. No, he doesn’t provide the cure, he directs. 15 minutes.

So, this last time: he’s in the room, after 30 minutes of me waiting, of course, for about 2 minutes, while the phone on the wall rings. And … he answers it. It turns out, someone from the hospital paged him, so he can answer a question about a patient of his who is admitted. So, I am on the fence: I am not sure whether to be mad, that he’s using MY time to answer another call, or happy, that he actually cares about his most sick patients and doesn’t send their calls into voice mails, and answers them right away. Still a little uncomfortable. When he’s finished with the call, he doesn’t remember what I was saying, and picks up another train of thought, completely unrelated.

Now, I am mad.

I reiterate, and he nods, and approves. And doesn’t say much. When, I notice he reaches in his pocket and pulls out a black “genuine leather”, black case. While I am talking about, oh, unimportant things like my heart, my overall health, my lack of sleep, and lack of appetite, he’s fumbling to open the case and he does open it: it turns our his IPhone vibrated just then, and he has to look at it. And he doesn’t answer it, but he scrolls and reads an email or a text message on it, while chuckling to himself. (!!!??????!!!!). I am talking. He stopped acknowledging.

Finally, he changes directions and topics on me.

Now, I am madder!

And at the end, off he ships me to the specialist! Gets from me (+the insurance) his fee for his New York taxi on his trip for Thanksgiving, and off I go. And this is a doctor that was recommended to me by another doctor I like, as being “a good listener”!! I rest my case.

Another example of “pristine” health-care comes from a nurse. She coaches me for an approaching test, and she tells me I need to stop my medication before the test for 48 hours before the test, evidently because that’s what the manual for the test tells her. I assure her that this is not possible: the medicine comes from the pharmacy with a big, red label telling me I cannot skip dosages, not even ONE, and if I do, I have to head to the first pharmacy for a dose, or contact my doctor immediately, or else I am in trouble. She swears to me that’s what I need to do: stop it cold for 48 hours! Then, she “gets caught” by the doctor that she misinformed me, and calls me back: “well, because your dose is so high, and you need it in order to function, stop it for 24 hours at the most and take it immediately after 24 hours – don’t skip more”. Well, thank you for not killing me there, Ms. Nurse! Much obliged. I wonder what would have happened if that doctor was distracted for a moment by the phone email … Fortunately, he was the specialist, without an IPhone! It’s all the luck of the draw, isn’t it?!

I could write books (as in plural) about misinformation from the doctor’s office – everywhere I have been in two states. Tests done uselessly, just to get the money: why is a pregnancy test necessary or else the visit doesn’t continue, when you have not had sex in a year, pray tell? So, I am not believing one iota of this “amazingly qualitative American healthcare”. I can’t. Because in 11 years, I have not seen it. I have lived the non-quality, superficiality, and abuse of it, yes. Every visit provides that!

I am not saying that all doctors are like that. And that all practices are like that. I have met honest to God doctors who care about the patients, and will do anything for their wellbeing. Doctors who love what they do more than the mansion they live in. I have had a doctor, here in America, that risked being fired and was brought to face the Board of Directors because she was seeing me for free, while I had no insurance and had a very severe condition that needed treatment. She was supplying me with samples of the medicines I needed to be able to survive. The two doctors I most respect for their attention to their patient and for their love of the trade, quit working for a regular practice and are now working for Health Serve. So, because I am not homeless, I can’t see them anymore! But those are the doctors I bow towards and respect. Not the ones with the villa in Palermo! And unfortunately, those are fewer and fewer, and regular practices the general public has access to have them as extreme rarities. I can myself count three out of probably 50 I have seen in 11 years. That’s not much!

And this was also not meant to bash all the American doctors. I know for a fact Canadian, and German and Romanian doctors have their faults too. But they were not the topic here. For the sake of (some kind of ) brevity, I have addressed here solely my experience with American doctors. After all, those are the ones most of you are more familiar with.

And just our own American comedian tells us, “just for once I want to tell the doctor: you know what: "I am not ready for you, yet!” Now, that would make it fair, don’t you think! That would make it equal, fair and free for all. But it’s not the way it is, unfortunately!

And for some comic relief in (what I see as) a desperate predicament, enjoy the video and remember: “there is a little bit of arrogance in the medical community, I think we could all live without…”.

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