As I get ready for my annual physical, I don’t know what is burning more, my gut or my wallet. It’s not all the poking and prodding that has me worried. Pardon the vulgarity but when you’re a 40 year old female with 2 children, you’ve had more than the average person’s share of being poked, prodded and examined. By now, I have had more than enough time to cope with the loss of dignity that walking into a doctor’s office entails. No – it is the colossal waste of money that has me so riled up.
Ever since I found out that doctors of every shape, size, color and qualification have made it to America’s top 10 highest paying jobs, I haven’t been able to sleep. Never mind the surgeons and anaesthesiologists. They might be the top two, but at least they do something, even if the something is a sponge in the belly cavity. Lives depend on whether they do their jobs properly.
What exactly do the general practitioners do? With all due respect to my sweet doctor with the excellent bedside manner, I am yet to find out what it is they are qualified for.
Here is how a typical encounter at the clinic plays out-
“Ms. Pradhan!” bellows a burly nurse, startling me out of a guilty peek at the month old Cosmo( it is a high-end clinic, sort of).
She ushers me down a maze of corridors. I hang on to her printed tails, fearing that if I lose her, I might be doomed to wandering around forever among a sea of medical equipment, while busy people ignore blinking phones.
We stop in front of a set of weighing scales. Having mentally added 10 pounds to the reading on the scales at home, I barely flinch at the results. My temperature and blood pressure also check out and it’s on to the exam room.
Here there is a lengthy wait, presumably for me to ponder on all the unhealthy habits I have indulged in the last year and prepare myself for confession. Having led a relatively blameless life, I soon run out of self-flagellation and move on to self-pity, having been reduced to counting the cracks in the ceiling.
Eventually, the smiling doctor shows up (as I mentioned before, she is rather nice.) “And how are you?” she beams. This is my cue. Of course, by this time I have forgotten my lines, my aches, pains and my concerns. “Fine,” is my strangled reply while mentally kicking myself. “Great, great,” she beams. She consults a chart which obviously works as a cheat sheet. “So let’s do some tests, shall we?” She hands me a list to be taken to the laboratory and we’re done. If she is in a good mood( or if she’s being paid for it) she will call me with the results.
That’s it. The entire episode has taken about 30 seconds of the doctor’s time, which, if the American Medical Association(AMA) is to be believed, has just cost my insurance $60 (maybe more, given the fact that it was a Cosmo in the waiting room and not a decade old copy of Agricultural Digest).
Once again, what value did she add, exactly?
It is not that I have been healthy all the time. Like any other human being, I have had my share of illnesses, some potentially chronic ones. Apart from one time when she actually bandaged the result of a tryst with a new knife, the doctor has generally acted as a conduit to the specialist, lab or pharmacy, doling out tests and prescriptions. Even the prescriptions are pro-forma. Try one antibiotic and if that doesn’t work, try another.
$150,000 for this?
Thanks to the internet, I have lived a fairly self-medicated existence, depending on the wisdom of the human community to guide me to the supplements that could alleviate my conditions and improve my health. Sometimes they’ve worked and sometimes they’ve not, but at least the person making the decision has a very enlightened self interest. The gap between the informed patient and the doctor has narrowed, especially given the fact that the doctor, faced with a variety of patients and a plethora of symptoms, simply doesn’t have the time to stay on top of the latest research. When presented with some alternatives to the typical allopathic remedies, my doctor just waved them all aside with a blanket “Whatever works.” At least she didn’t dismiss them out of hand.
The annual physical is almost like presenting yourself to the warden to make sure you haven’t violated your parole – I wouldn’t like to give the insurance companies any loopholes in case of a genuine emergency. But someone should measure how the cost of this butterfly fluttering is affecting the overburdened health care of this country.
Why not let the nurses handle it all? Or better still, surely someone can come up with an AMA certified machine that asks a few pertinent questions, does some preliminary testing and sends you off for lab work based on certain criteria?
It’s time for the iDoc. Even if it’s priced at $599 for a 15 Gig memory, a thermometer, a blood pressure monitor and the entire medical encyclopedia download, it’s a steal.
The trouble with prevention is that it is never possible – in a conclusive or a generally agreed way – to show how many deaths and how many deaths from undiagnosed or diagnosed-too-late diseases were prevented. Even so, the predictions remain hugely sensitive in sociological and political terms.
It is also possible for the untrained eye to confuse symptoms e.g. bacterial meningitis looks remarkably similar to viral but in most circumstances, kills much quicker although in Universities, where viral meningitis is more common, viral kills more due to how its spread is aided by specific living conditions.
If you have ever had the dubious pleasure of fiddling in the bookshelves of a psychiatrist, you will find that the novice realises he/ she has every disorder under the sun. I experienced this in 2003 when my psychiatrist sibling assured me that this was no surprise as for years, we were all waiting to find out the reasons for my being how I was..
Someone I know in India recently visited California after being given an all-clear in India. His children thought his ill health deserved a second look. As of now, he has had emergency surgery on his malignant pancreatic cancer and his family are on tenterhooks knowing things are not going to get better for him. There is something to be said for screening..
A recent experience with the NHS had the consultant tell me this – when in doubt about a diagnosis not in keeping with the suffering, persist; but when in doubt, go to a doctor.
And as long as there is reasonable doubt, it is better to spend this money than not.
There will always be a need for the specialist. This was just a humorous look at the GP, who at least in this country, rarely takes an executive decision. For a plethora of minor illnesses over the years, I have always been referred onward and upward and outward.:) Also, unlike a family doctor, who at least has some context to examine you, having seen many members of your family, the modern physician is forced to consider a patient in the most clinical, textbook way possible because of the pressure of patients and the variety of symptom presentation. I can see the impatience in the eyes of the doctors at my clinic and this is one of the better places in this town.
This has resulted in my pointing out possible causes for my symptoms which as it turns out, have been correct in my case. Yes, the novice is always at risk at misdiagnosing himself/herself, but in this age of information, the research minded patient is quite likely to stumble upon both the root cause of his problems and the best possible solution.