Thursday, March 17, 2011

From Quaint to Quackery

Well, the issue of health care still rages on in our country, overshadowed though it might be by both US and international news. But the question is still there -- and no, I'm not going to argue for it again. But we here in the US have some funny ideas about health care in general.

Although most if not all of us have dealt primarily with a modern, medicine-as-business model of health care in our lifetime, many of us still have this really quaint idea of the Country Doctor stuck in our heads. We go to the MD in search of help for what ails us, and expect several things that have gone the way of the stable boy and the milk man....

Do you walk in to your Doctor's office expecting them to know who you are, what your complaint of the day is, and your medical history? Back even 100 years ago this might have been a likely scenario. And there may be some small towns left in the US where there are true "Country Doctors" left. But they are few and far between.

The reality today is, your Doctor doesn't treat a few dozen families for their entire lives any more. Gone are the days when your family Doctor will walk in and ask how your kids are doing, if your bursitis is better, and how did the bake sale at the school go yesterday.

Today's Doctors see thousands of patients every year. They schedule patients in at 15-minute intervals, seeing close to 200 patients a week. They don't recognize you on site, and take perhaps 30 to 60 seconds before entering the treatment room, to peruse your file.

At your Doctor's office, there are probably a litany of MDs and LPNs, all of whom you might see on a scheduled visit. So even the notes in your file, may be a bit disconnected. If you are lucky, a good suburban Doctor will actually note the reason for your visit a few instants before seeing you, and possibly even have a brief idea of your ongoing medical concerns.

Yes, the truth is, your Doctor doesn't know you from Adam!

One might gasp at such an assertion. How is someone going to be able to effectively treat us, if they don't know anything about us? And, at a Doctor's salary, shouldn't we deserve a little more time and personal attention?

Well, that's another thing that has changed. Doctors today are not making money hand-over-fist like we sometimes believe. With constraints on payment amounts imposed by insurance companies, a Doctor working a normal 40-hour week will generate about $400,000 per year in revenue.

Sure, that sounds like a lot of money to most of us... But they don't get to KEEP that money! First, they have rental expenses on their office space. Then, they have to share the cost of their office staff, billing department, and tax accountants with the other Doctors in their practice. And of course their are taxes, and medical insurance to be paid. And lest we forget, the cost of Medical School being somewhat prohibitive, most Doctors have outstanding student loan balances sometimes upwards of $100,000.

A seasoned Doctor today, with an efficient and busy practice, might be taking home about the same as a decent software engineer in mid-career. That's certainly not going to pay for a yacht AND a country club membership. Today's Doctors certainly aren't living like rock stars.

So, when you walk into your Doctor's office, how do you make sure you are getting the care you need? First off, be aware that it is YOUR health, and so it's primarily YOUR concern, and YOUR responsibility to know the facts about any ongoing conditions you might have.

If you take a prescription medication for some ongoing health problem, you should make yourself familiar both with your condition and with your medication. Be aware of the progression of any illness you might have. Be aware of any potential drug interactions with your prescription.

And when you see your Doctor, be sure to give them the "executive summary" when they come into the exam room. With only 15 minutes to spare, you won't have much if any time, to discuss the weather or how the kids are doing with their soccer games. Tell your doctor; your problem related to this visit; any ongoing medical concerns; any medication (include prescription and non-prescription, as well as homeopathic, herbal, or supplements!) you are taking; and the reason for your last visit to them right up front.

Know that, if you are going to need a follow-up, or if you are having any sort of blood work or other tests done -- your Doctor's office isn't going to be able to give these results the same personal attention that you can. You should be aware of how to get your results, when to schedule a follow-up visit, and then be sure to investigate what your results might mean, before seeing your Doctor again.

A good teacher can give you the information you need to learn effectively. They can make it easier for you, they can inspire you, but YOU still need to do the work in order to achieve your own academic goals. A good attorney will advise you on the law and your best course of action, should you need them. But they can't look over your shoulder 24/7 and make sure you always do the right thing. That part is up to YOU. And similarly, a good Doctor is someone who can assist you in making the best choices for your own health care. But there is still considerable work to be done on YOUR part.


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