A New Doctor And One Less Hero
Growing up, I was in awe of physicians. They seemed to be amazing men, and I use the male pronoun because I had yet to see or meet a female doctor. But I was convinced the local doctor was of genius calibre, a true Renaissance Man. He could diagnose any ailment and provide every cure. And of course he would be an expert on arts, religion, and every other subject worth knowing.
As I’ve gone through life, I have lost much of this wide-eyed mysticism for the medical profession. But I still hold such purveyors in high regard. They have taken a route requiring lots of schooling and rigorous training. The job pays well, but responsibilities are heavy. Especially are their duties a challenge with our unhealthy society and its penchant for laziness, stress, cookies, and lawsuits.
But, I know some things about my doctor today that I did not know many years ago. He is just a man, with foibles and imperfections. For instance, it is hard to listen to a fat doctor tell me to go on a diet. And I know that, sometimes, he simply must make an educated guess, a guess that can be conditioned by hubris and misdiagnosis and laziness. Thus, physicians are a lot like bakers, candlestick makers, and preachers. So I do not begrudge the good physician his Mercedes and Country Club membership. I simply ask him to do a good job, and perhaps allow me to make payments.
Thus I went to the doctor today, my first trip in a couple of years.
Looking up from the chart, he greeted me with an icy smile: “50, huh? We’ll have to get you back in here for a colonoscopy and prostate exam.”
That sounded like fun.
“What brings you here?”
“My shoulder is hurting me. I cannot move it any higher than this.” I raised my arm to about a 40 degree angle.
“I see. You could have a ‘frozen shoulder’.”
“Yeah, that’s what the internet tells me.”
Rhythmically he gave me prescriptions for a muscle relaxant and antibiotic, and scheduled for an x-ray and MRI.
“Come back in two weeks.”
Then for the next 15 minutes, I sat silently and watched the man badly try to type information into his computer. It was fascinating, and made me want to push him from the keyboard and do the job myself. But I simply watched. He was frustrated because his face was about two inches from the screen seeking to discern the characters through coke-bottle glasses. The complicated drop-down menus seemed not to work to his liking. He would punch a key. With no response from the computer, he would punch again. Then he would grit his grey teeth and whisper indiscernible verbiage, and try a different menu. All along, I sat and watched his face, glaring with distortion from the monitor. I was thinking this guy may indeed be a genius, but I know ten-year-olds who can beat him with the computer.
Next it was time for the x-ray. The technician led me to the room as she mumbled, without eye-contact, which made it hard to understand her instructions. To pose for the x-ray, she wanted me to raise my arm up over my head.
“Rummmphh yur um uvverr yuh hed,” she articulated.
She kept pushing and prodding, and mumbling.
“Mam. Stop. That’s why I’m here. I can’t.”
She seemed irritated.
It came time for me to leave. The receptionist cheerily informed me I had no co-pay.
It didn’t cheer me up. I knew it was because I have a $3000 deductible, and I will be paying every penny of the bloated bill when it finally arrives. Let me go on record as saying I am supportive of some kind of federally involved solution to the health care crisis in America. Socialized medicine is not the answer. Neither is the current, ridiculous system. But I’ll save such rantings on this issue for another post.
As I was checking out, the doctor walked by the desk and out the door. The receptionist spoke, and he gave a barely audible reply. I thought it would be nice for him to stop and chat for a second, to at least acknowledge our presence. He could not make eye contact. He looked down at the floor. Seemingly uncomfortable, he hurriedly scurried out the door. It looked to me like this man was painfully shy. And such reminded me anew that he was just a man. Nothing more or less.
He is not a hero, but just a man, very much like the rest of us. As a kid I had lots of heroes: preachers, coaches, police, and especially doctors. Now I am middle-aged, and all of those heroes have turned into simple men. And, that’s a bit sad.
08.02.07 (5:09 pm) [
edit]
posted by:
FinalyFree (
reply)
post date:
08.02.07 (2:26 pm)
Perhaps YOU have been a hero to many people, Pastor? I'm thinking you probably have :) Funny how we put the ordinary people in 'heroesque' positions, huh?
posted by:
sisinlaw (
reply)
post date:
08.02.07 (5:36 pm)
It just takes frozen shoulder about 6 months or more to heal. I wish I could have told you that before you went to the Dr. and saved you some money. Hope you can put up with it til it heals. You're not going to do the MRI are you? I'd suggest just giving it time before you go that big expense. I've had friends who have had this and they just had to live thru it and it finally got better. I'm glad you had heros, I really can't remember that I did, except for Flicka.
posted by:
surrogate (
reply)
post date:
08.02.07 (7:18 pm)
My shoulder is injured as well, the right side. I hurt it carrying a ridiculously heavy craftmatic bed a couple of months ago that simply had no good place to grab it - and it has not gotten any better.
Interestingly, it hasn't affect my golf game simply because it's my right side, so, since it only bothers me at work, I haven't done anything about it except to wait and try to treat it kindly. I'm deathly afraid to go to the doctor and have them tell me I need surgery, not because of the possible propect of the surgery itself, but in the time off work it would probably take to heal afterward... So? -I'll live with it. My right arm outstretched to my side can get to about five or six inches beyond horizonal, but only with pain.
Annoying.
posted by:
spook102956 (
reply)
post date:
08.02.07 (7:20 pm)
AS a nurse, I say give the doctor a break. His shy, no eye contact could've really been that he'd just heard one of his patients died. Sometimes medical people are dealing with alot, but we have to put on a smile for all the other patients and act like nothing is wrong. But we're human too.
posted by:
LadyG (
reply)
post date:
08.02.07 (8:24 pm)
PD I hope your shoulder feel better soon, I was having so much trouble with my shoulder that I had to give up my my favorite game, bowling.
posted by:
kurtmaddox (
reply)
post date:
08.02.07 (9:05 pm)
Oh my, "health care"!?! Oy Vay! I don't even have time to start thinking about this issue. Let's just can the whole system and start over!
posted by:
auntconi (
reply)
post date:
08.02.07 (10:10 pm)
Ouch! ~ Frozen Shoulder?
How long has this been bothering you? Maybe it is just stiff and the muscle relaxant will help let the muscles release a pinched nerve. Hope so!
I should send you a 'care package' ~ it consists of: A box of hugs, Hershey kisses, diet Coke and a bell so you can ring for help from fambly members when you need some more iced tea!
((hugs)) ~ keep us updated please!
posted by:
PastorDave (
reply)
post date:
08.03.07 (6:04 am)
Reply to: spook102956
You are right. Bedside manner and friendliness should be matters far down the list of importance when it comes to judging the effectiveness of a physician. This man took very little time with me and was not friendly. And such did make an impression upon me. But he made a diagnosis and issued a plan of treatment, including a follow-up in two weeks. If he had been chatty and personable, likely the results would have been the same.
And, I never considered what might be going on in his personal life, and with other patients. So, I take your advice, he does deserve a break. Thanks.
posted by:
PastorDave (
reply)
post date:
08.03.07 (6:14 am)
Reply to: auntconi
Very much I like the idea of the bell. And, even if the treatment does bring healing, I could continue with the bell for a while longer. It would certainly be worth a try.
posted by:
PastorDave (
reply)
post date:
08.03.07 (6:20 am)
Reply to: kurtmaddox
In this great country of ours, why has the free market not developed an affordable solution to health care? I've been scheduled for an MRI. Today I learned it will cost between $800 & $2000. And I'll pay that out of my pocket, or more realistically with a MasterCard. Surely in this great country with the entrepeneural spirit at work, there would be a creative and affordable solution. Maybe a Walmart or a QuickTrip with a coin operated scanner? I joke a bit. But, why must medical treatment be so incredibly expensive? Greed. And the reality that there are enough Americans who can and will pay the costs, that poor people can readily be left behind, unfortunately are reasons.
It is almost enough to make me consider the Democrat answer to the need. Almost.
posted by:
PastorDave (
reply)
post date:
08.03.07 (6:23 am)
Reply to: LadyG
Now that is sad. I would think, if there is no structural damage to your arm, that bowling in moderation would be good therapy. Dr. PastorDave says you should continue to bowl.
And, if something bad is the result, then read the following: I am not a doctor and do not play one on TV.
posted by:
PastorDave (
reply)
post date:
08.03.07 (6:25 am)
Reply to: surrogate
Your arm may hurt, but at least you have a fantastic bed upon which to sleep. And I like your approach: As long as it does not affect my golf game, I'll forego treatment. To me, that makes sense.
posted by:
auntconi (
reply)
post date:
08.03.07 (8:30 am)
Reply to: auntconi
Good enough ~ one bell coming your way!
*p.s. said bell will be included in a/c's special 'care package' and that includes shipping/handling/insurance
(but not medical insurance)
pps ~ I am not a doctor, I just work for one ~
in real life and not on TV!
posted by:
auntconi (
reply)
post date:
08.03.07 (8:32 am)
duh ~ that reply is from ME to YOU!
*maybe a/c go back to bed and start this day all over again!
posted by:
bawdy (
reply)
post date:
08.03.07 (11:57 am)
Why don't you just thaw your frozen shoulder out? Enjoy your colonoscopy and prostate examination!
posted by:
kurtmaddox (
reply)
post date:
08.03.07 (1:27 pm)
Reply to: PastorDave
Well, one problem is the our health care is NOT a free market system. You can trace the outrageous pricing mechanisms in health care to the socialistic worker benefit policies awarded to the big unions from the 50's through today and how the cost of medical care became completely disconnected from traditional free market mechanisms.
I was a big union insurance kid in a small town. My dad was a union coal miner. I can remember like it was yesterday how abused the entire system was by everyone involved. The docs and dentists in this little town got filthy rich for our area because 6 out of 10 families could recieve just about any treatment that could be dreamed up without paying a cent out of pocket.
I worked at Ford Motor Company for 6 years out of college. 1 year as a UAW member and then 5 years in management. The abuses I witnessed as a UMWA kid were even more rampant at Ford - or maybe I was just more aware of it as an adult.
The mines pulled out when my Dad was my age and he never really recovered financially or emotionally.
Ford Motor Company is broke and has lost BILLIONS over the past couple of years. Self-insurance health care and benefits costs are listed as their #1 challenge as a company going forward.
So, we have this insane system where half of our country have great medical insurance with good coverage that meets most all their needs. However, this half of our system is mostly disconnected from any economic decision making when making health care decisions.
The other half of our country has either crappy insurance or has no insurance at all. Of course, if you have no insurance at all, you go to the emergency room to treated. They have to treat you but you don't have to pay. More than 70% of Americans, if I remember the stats I read correctly, have unpaid medical bills on their credit reports.
Of course, someone always pays. It's called TANSTAAFL - there ain't no such thing as a free lunch! TANSTAAFL works like this with emergency rooms:
Many emergency room visits are never paid by the recipient of the treatment. The hospital writes a very large unpaid bill off of their taxes against their income, if they are a for-profit hospital. Then you and me go to the E-room with insurance. We wait 3 hours, we get what would be a $50 treatment at a big city Urgent Care Center and our insurance is billed $600 for the visit. We see the doctor for about 90 seconds during all this and he tells us we'll likely live and to take some ibuprofen and if it isn't better by the morning, go see your regular physician.
So, we already have a form of socialized medicine clearly at work in America and I haven't even talked about Medicare and other government paid medical benefits yet!
The incentives to stay really poor in our country instead of working to become only moderately poor and pay for stuff ourselves after working 60 to 75 hours each week are enormous. Medicare is one these "perverse" incentives, as Milton Friedman would have explained to us.
Just as has been the case in Europe for the past 20 years, America is on the verge of having to have a "come to Jesus meeting" with itself. There is no way we can afford, as a nation, the obligations we've taken on for our social, security and military obligations.
I suspect not much will happen until it is even more of a "crisis" than it is now and that we'll probably move in a socialistic direction which will just make things even worse and then we'll adjust in a more market oriented direction.
See why I don't like to get started on health care!!!! There goes 15 minutes I'll never get back that I could have used to generate income to pay my taxes and my health care insurance bills!
posted by:
surrogate (
reply)
post date:
08.03.07 (3:39 pm)
Reply to: kurtmaddox
You're one of those silly people convinced the "free mraket" fixes everything. See Kurt there's never been such a thing and there never will be, or can be, but I'm not foing to go into a lengthy explanation of why that's so because if you want to know the whys behind that, you already would. So in the end we simply have to decide, is health care to be considered something like police or fire protection, to be provided to everyone as a service we're entitled to, or is it something that ought to be a profit center. Pretty simnple.
Should the Army be "for profit?" How about your local Fire department? How about use of the interstates? Is the fact that they're free to use and paid for by taxes a socialist nightmare to you? Should we get rid of all National parks? They don't pay for themselves.
Why do we have to be the ONLY western democracy that thinks privately paid-for health care is sacrosanct? It's just plain silly. You're SO sure that if the government is involved it'll have to fail miserably. Tell me, you like your library? Should we have to pay a poll tax?
Want to know the very best reason we ought to provide health care to everyone? Because we CAN and it would make America a better place to live. Plain and simple. -Don't worry though, I'm sure you'll still be able to buy upgrades.
posted by:
kurtmaddox (
reply)
post date:
08.03.07 (6:41 pm)
Just google Milton Friedman on Health Care and read his How to Cure Health Care on Hoover dot org.
posted by:
truthserum42 (
reply)
post date:
08.03.07 (10:37 pm)
Reply to: kurtmaddox. Why do you refer to Milton Friedman, he never paid for medical insurance it was always provided to him by some institution. Remember he was an economic professor who taught an inexact science and as far as I know he hasn't provided a viable solution to the health care problem
posted by:
ammegan (
reply)
post date:
08.05.07 (6:56 am)
Poor you...at least you were well taken care of..
posted by:
fractalmom (
reply)
post date:
08.05.07 (7:58 pm)
Yeah. The whole health care thingy. Bad. Not being a proponent of government involvement, I do, however, see a need for something.
Unions have played their part. I am very much anti union. When they were started, I do believe they fulfilled a good function, which was to keep children from being abused in the workplace, as well as to protect all workers from abuse.
However, that being said, they have run rampant over our economy and created a falsity which has served to impoverish many. Futher, they protected those workers who should not have been protected in later years. Living, as I do, in the heart of coal and steel country, there are many stories of abuse which is protected by the union. Workers not working but you cannot get rid of them due to the union.
I definitely am in favor of promotions and raises based upon merit, but again, you have many employers out there who are simply not qualified to promote or give a raise. I worked for wonderful people, good friends, who consistently and consciously underpaid and under promoted their staff. They did it in pursuit of the almighty dollar of profit. All the while, complaining about how badly their staff worked, and forgetting that you get what you pay for. If you are only willing to pay minimum wage, you will get disloyal employees who are willing to steal from you.
I do think that out of control litigation has played a huge part of the outrageous medical cost in the US. When you have to budget a whopping 3 - 6 thousand dollars a year for out of pocked expenses for medical treatment and medication, its a bit ridiculous.
I don't know what the fix is. We can all rant and rave about what caused it, but I have never seen a plan for fixing it that made sense.
The bottom line is it would take the ultimate oxymoron, i.e. common sense. Which is neither.
posted by:
PastorDave (
reply)
post date:
08.06.07 (7:19 am)
Reply to: sisinlaw
You are right. I hate to admit it, of course, but your words are sound. I checked about the cost of an MRI, which I will have to pay without help from the insurance company, and promptly canceled the appointment. Flicka? He was a dolphin, I believe.
posted by:
PastorDave (
reply)
post date:
08.06.07 (7:20 am)
Reply to: bawdy
Come on down, we will do the two together. Maybe share a diet coke and talk about t-Blog during the procedures. Just a fun time for the guys.
posted by:
PastorDave (
reply)
post date:
08.06.07 (7:36 am)
Reply to: kurtmaddox
I know you have a post about this subject, and I'll eventually wander over there and give some comment. But I do not understand how the high cost of medical care is the fault of the labor unions. It is true that the muscle of the labor unions forced the companies to provide health coverage at little or no cost to the worker. And this is why I have to pay $20,000 for a car not worth half the amount. But, why does this fact require the physician/office to bill me $1500 for an MRI. It's a complicated machine, and requires a bit of technical skill to operate, but still I should not have to pay that much. You fault the labor unions and the federal government. I fault something much more basic and sinister- greed. It comes from a basic human tendency to be willing and ready to abuse another person for selfish gain. The physician is not satisfied with a reasonable and comfortable lifestyle- he wants to be filthy rich. Same with the technician, nurse, and receptionist. Same with the insurance company. So the pie gets bigger, and everyone wants a big piece of the pie. And, so the MRI costs $1500. And I'm accused of being greedy because I think it should cost about 10% of that amount. I'm thinking someone, and sadly that someone will have to be the federal government, must step in to save the common person from the abuse of this greed.
Romans 3:10-18 explains it to me, Rev. Kurt!
posted by:
kurtmaddox (
reply)
post date:
08.06.07 (9:22 am)
Reply to: PastorDave
I blame the labor unions because they are real and important part of the history of how we got to where we are with health care today. Greed is just an ugly name for self-interest and we agree that self-interest is a fundamental driver of human behavior. We disagree on its "sinister" nature.
(I will use the generic neuter term "man" for all human beings.)
Man's programmed survival instincts make him self-interested. Enlightened self-interest leads man to understand that to share and to submit to certain limitations of his freedom is in his self-interest and that to steal, murder, be a meanie, etc. -- is not in his self-interest.
Any system built around anything but the rational principles of self-interest inevitably fails. Collectivist idealogies such as communism, socialism, fascism, corporatism and labor unions are all manifestations of the same flawed philosophy of altruism -- or what man "ought" to do versus what man actually does when we objectively observe him in action.
The greedy doctor and the greedy labor union and the greedy corporation quickly become agents of excess when behavior that would otherwise be eventually corrected by competition, which is what we call it when the self-interest of one group checks the self-interest of another group.
In other words, if Ford Motor Company, the UAW and the corner doctor's office all had rational rules to play by that applied equally to all everyone then you wouldn't have the $1500 MRI, the health care policy that would pay the $1500 or the company that would allow their workers to hold the company hostage every 4 years to get a raise regardless of whether or not they added additional value to the comnpany.
Sure, markets have disequillibrium that result from temporary imbalances of supply and demand -- but, these imbalances have proven to be self-correcting over reasonably short periods of time when market mechanisms are allowed to work.
Now, on to your solution that the federal goverment "must step in to save the common person from the abuse of this greed."
Of course, the federal goverment creates the problem with irrational laws, corporate favoritism and political pandering and then they come riding in on a white horse with more half-baked legislation that is a band-aid on the gaping the wound they opened with their spear. Of course, the companies that contribute that find favor with their congress find new ways to exploit a rigged system or they find ways around the new rules.
So, what do I believe is the solution?
Well, I'm an incrementalist, so, I'd look for every possible change in the rules that would bring true market competition and market choice to the equation and inact those changes. I'd let states innovate and then let other states see results from these innovations and follow what emerges as best practices.
What I would certainly never do is support a "single-payer" system or increases in socialized medicine!
Is this because I'm a meanie?
No, its because of what I believe to be in the rational best-interest of all parties, most specifically the consumer of health care who desires to survive on this ball of dirt for as long as possible in as healthy a condition as possible.
Remember that the worst thing we can do for ourselves is to create systems that remove responsibility for cause and effect from our lives. Each time we do this, we create conditions for massively increased human suffering rather than for the intended decrease in suffering.
My human ability to reason explains it to me, Rev. Dave!
;-)
posted by:
PastorDave (
reply)
post date:
08.07.07 (1:03 pm)
Reply to: kurtmaddox
I live in an affluent community. Yet we have residents, including myself, who do not have a lot of money. The physicians here make good money, lots of money. They have patients ready and willing to pay top dollar for the very best of care. Really, these physicians have more business then they can handle. Therefore, they could care less whether I can afford to pay $1500 for an MRI. Enough wealthy people with top-notch insurance coverage will accept their services and their prices, that I can take it or leave it. Should I have a cancerous tumor or torn rotator cuff, they do not care. When I show up with $1500, then they'll care. I feel compassion for the least of our society, who do not get equal treatment. Surely there is a compassionate solution?
posted by:
PastorDave (
reply)
post date:
08.07.07 (1:10 pm)
Reply to: fractalmom
Unions. My hometown proclaims itself "The Sock Capital Of The World." The hosiery mills are essentially sweat shops. The workers have no protection. They work for measly sums of money, while the owners are fatcats. There, in my hometown, is a need for labor unions. Conversely, the GM plant that for years was the major employer of people in my current area, will be closing for good in January. Why? In my opinion, the labor unions sucked the blood out of them. Both examples I share are extremes. In my opinion, man left to his own devices without checks and balances will gravitate to the worse, not the best. Those restraints can be God and scripture. Or government, which at its best is the rule and wishes of the people. So, I think health care today needs some regulation from the federal government.
posted by:
PastorDave (
reply)
post date:
08.07.07 (1:12 pm)
Reply to: ammegan
Thanks for your kindness. Yes, I'm doing fine. Even at the worst, my days are better than what most people in our world must face. Life is good.
