Musings of a Medical Consumer

Yesterday's outing with Mom for a doctor's appointment logged in 5 1/2 hours on the clock with the addition of transportation and prescription pick-up time. There's something very wrong here. Although we got answers to many questions and a plan of action (for some of the issues), I have to wonder if these were hours well spent; for her, for me, or for the doctor.

The winner in this equation was the institution, the four walls that provided the services. These included 3 Xrays, an EKG, blood work and a urine test. Four walls will bill mightily, be reimbursed fairly, and use the influx of dollars to pay those employed in rendering service plus pocket some for "growth and development" of the four walls.

Although we learned a lot about what was NOT going on (much of medical testing is designed to rule out, not rule in), what was learned about the current situation could have come at a fraction of the cost, a minimum of testing, and a thoughtful view of the setting: the who and the what in particular. Yes, I'm grumbling. I can because (1) I know what I'm talking about, and (2) I have the benefit of knowing the results of all said tests. In hindsight I can rest on my laurels and know that had I made the decision to omit the needless testing and simply listen and act (history, exam and prescribe), we would have been in and out of the clinic in a fraction of the time and at a fraction of the cost. Granted, if I had been in this doc's shoes, I may have done exactly as she did yesterday. But, there are times when it makes more sense to put "2 and 2 together" and take a low tech leap.

I'm not naive enough to think that the slow, low tech road would have been the only reasonable course of action. Ask 10 doctors and get 10 answers. We must acknowledge that so many confounding issues play into every doctor-patient encounter. It's rarely just the patient, the story, the findings (exam) and the analysis. We worry about what else visible and invisible accompanies the visit; things like the patient's doctor-daughter-colleague in the room, the chance for mis-diagnosis of multiple, fragmented complaints and the ill defined effect of the day's karmic energy. OK, that last one is weird but I can't imagine a physician not admitting that something to this effect influences how we move through our days. We can't be robots all the time.

We left to pick up a prescription for a medication that has been in use for over fifty years; it therefore cost a whopping 87 cents for a thirty day supply. I hope it helps; I think it will. It would have been my drug of choice had I heard the story over the telephone. Even without my stethoscope ears or my eyes focused on the leg edema just listening to the story (which we've been taught constitutes 80 plus percent of the diagnosis) this drug would line up in first place. We'll see if this inexpensive little pill lives up to its historic reputation for positive effects. If not, we will be on to plan B. Take one: I think many of these initial encounters should be handled by a telephone based plan, call it: telephone plan A. When plan A doesn't work, maybe a clinic visit plan B. Let's take the slow road; these are not emergencies at this age.

My gripes? Three. Time wasted. Money spent. And, being admonished by the doctor that a 20 minute time slot was not adequate to handle "all these complaints". Dear doctor: this is neither the patient nor the family's problem. It is your problem. All we (I) did was call in for an appointment. If the time allotted is not adequate, take it up with your schedulers. That's what I do. What I don't do is pin it on the patient who not only has to live the disease but feel badly for not fitting into your clinic day and providing you with satisfactory "work flow". Please save those comments for the source of the problem. The insensitivity rained a dark cloud on the entire experience. I really want to complain but must proceed with caution as doing so may burn bridges that hurt my loved one way more than they hurt me. Such is the lesson of "sucking it up".