My doctor thinks I’m an idiot. I guess that’s only fair, because I think the same thing about her. I don’t think she’s really stupid as much as she’s arrogant and brusque. And that kind of has the same effect when it comes to doing her job.
So here I am, making my descent into my senior years without a reliable guide – someone who can tell me where not to step, to make it safely down the mountain side. Instead, I’ve got a woman in a lab coat who is so supercilious, she wouldn’t look down if a patient said, “Oh my. We seem to be walking off the edge of a cliff.”
“What source did you get that from?” she might mutter without looking up from her clipboard. The thing is, she really doesn’t have to be that invested because she’s not really not going to fall off that cliff with me. She’s going to stand at the top watching me plummet toward the inevitable and shout, “Just relax and give this treatment a chance. And I’ll see you again in six months!”
Here’s my problem. I am uninsured. I fall through the gaping cracks in the U.S. health care system for several reasons: I am gay, stay-at-home parent to 2 special needs children who need a stay-at-home parent. My partner is the sole breadwinner for our family, and we live month to month.
Because we live in a state that has illegalized gay marriage, my partner is not allowed to insure me on her policy. I cannot work outside the home (at a job that might provide health care) for two reasons: Our children require full-time attention and support for their individual needs. And I have a chronic, debilitating condition which currently makes me unemployable outside the home.
In the last 5 years, I have seen 8 different doctors and specialists for a total of 37 office visits (all without insurance) and still no one has been able to successfully diagnose and treat my problem. For the last 3 years, I have been in a charity care program sponsored by a university in a neighboring town so I am receiving some health care for a greatly discounted cost, but still to no avail. Currently I have 4 different diagnoses from 3 different specialists and the myriad of treatments for each has failed.
I’m not a hypochondriac. I’m not seeking drugs or attention. And I’m not seeking sympathy, just trying to establish my experience with the American health care system so that I can share a few observations I have made in the course of the last 5 years.
Let me say first, that these are generalizations and there are always exceptions. I’ve met a few.Unfortunately, the exceptions are too few and far between to make a much of a difference in the quality of life for me or my family. And here’s why:
1- Doctors are in a hurry. At most practices I have been to (for myself, my partner, and my children),you will rarely get more than 15 minutes. Talk fast.
2- Doctors don’t listen to the patient. Rarely will a doctor spend time just talking to you in an attempt to gather information about your life that might shed light on your condition. Instead, they will ask you a standard set of questions and stop listening as soon as you try to supply anything more. Then they’ll pick the first explanation of your condition that comes to mind, write a prescription, and tell you to come back in 6 weeks if you don’t get better. When I started complaining of being fatigued and breathless, it took my doctor a year and a half and several visits to figure out I was severely anemic.
3- Doctors are pill-happy, drug dealers. Doctors seem eager to throw some kind of pill at almost every conceivable condition, often without considering its holistic or long-term effects on your life or health. For example, if your doctor has instructed you to take a proton pump inhibitor like Prilosec (for acid reflux) for long periods of time (over 2 weeks), chances are he did not tell you how sick it will make you when you try to stop taking the medication or that it may interfere with your body’s ability to absorb certain nutrients. And chances are, unless you have very good insurance and or a lot of money (or both), he will not even run the tests that will tell him whether or not you really needed it in the first place. It’s easier just to give you the drug and see what happens. This trend seems more than coincidental to me considering the huge amount of time, money, and effort that drug companies put into convincing doctors to push their products.
4- Too many cooks. Doctors don’t coordinate with each other.God forbid you have to go to more than one specialist for the same problem. I’ve been to five. And they’ve all given me different and sometimes contradictory diagnoses for the same problem.They don’t talk to each other and my GP doesn’t talk to any of them or try to make sense of the conflicting diagnoses.
5- Doctors are not available at night or on weekends. There are roughly 40 hours a week that the sick or injured may expect to see their own doctor (or another doctor at the same practice) because most medical practices are only open during “working hours.” The other 128 hours of the week are considered “emergency” care times and you will be expected to go to an urgent care clinic to see a “doc in a box,” often just a pimple-faced nurse-practitioner with a prescription pad.
Or you must go to a hospital emergency room where it’s entirely possible that the harried, inexperienced nurse doing triage will miss the potentially life-threatening nature of your condition and leave you to wait 6 to 8 hours in excruciating pain before you get to see a doctor who then gets called away to work on an accident victim while you get handed over to a nervous resident with shaking hands who has never before performed the painful, potentially dangerous procedure the doctor ordered. (Yes, that last part actually happened – to my partner and I still want to make someone pay.)
6- Emergency care sucks – Most emergency rooms I have seen are underfunded, understaffed, and overcrowded dens of misery, blood and bacteria. And triage is about keeping people from dying right away when there’s not enough staff to take care of them all. It’s certainly not about relieving pain and suffering or providing quality health care. Your regular doctor and his/her practice is supposed to do that. But only 40 hours a week. You see the problem here?
I have no real advice here except to choose your doctor carefully (if you have a choice which many of you don’t) and read up on everything. Exercise, watch your diet, maybe take up take up Yoga. As for me, I think I’ll buy a bag of Granny Smith apples. And next time I think about going to the doctor, I’ll just take one out, draw a little face on it, and stick a fork in it instead.
Be sure to come back and check out my next post where I will explore fun, creative ways to avoid seeing an MD altogether!