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You know those tasks that you do every day and some days you do it without a thought and other days you do it while grumbling quietly and other days you hate yourself and your life and you would prefer to abandon your spouse and children and live life in a yurt on a remote island than remove ONE MORE TIME the daily mass of hair from the shower drain? Well, I have reached the latter stage with changing the toilet paper rolls, which seem to ALL THREE need changing simultaneously, only by me, and at an alarming rate of turnover.

Of course, my irritation is on the level of hair strands burrowing in a drain, which is a near infinite distance from the level of My House Just Got Leveled By A Hurricane or My Backyard Is Burning And Has Been Since July or My Country May Or May Not Be In The Imminent Path of Nuclear Disaster. But rather than spend $1,000 on all the gas masks and emergency rations that are in my Amazon cart at the moment, I am turning my thoughts instead to the minutiae of life’s drain-hair-nest of irritations in hopes that it distracts me from The End Times for a while longer.

Something that is high on my list of unimportant-in-the-grand-scheme-of-things irritations lately is my eye doctor. Not him, per se. But his office and their apparent COMPLETE INCOMPETENCE with submitting charges to my insurance company. (Let’s acknowledge all the inherent privileges in this source of exasperation: access to health care, access to eye doctor, access to funds to pay for the services in case my insurance company denies the claims, house standing in a hurricane-free area, backyard absent of fire and smoke, etc.)

My eye doctor – whom I’ve seen for nearly a decade, and therefore do not want to leave, not so much out of loyalty as out of desire not to meet a new person – just joined a larger practice. He used to be part of the University Health System for which my husband also works. Now, he works for a practice called, confusingly, University Ophthalmologists. This is important to my plight.

After the eye doctor joined this new practice, my husband and I each went for our yearly eye exam. (I actually had several additional appointments, but that’s another story and I’d rather not fret about my steady march toward sightless doom at this time.) We got a bill several months later.

The bill says clearly, “If there is an asterisk next to the thing we are charging you for, we have submitted a claim to your insurance for that thing.”

The bill had zero asterisks, and it looked as though – unsurprisingly – none of the items had been covered at all by our insurance, despite the fact that our insurance covers yearly eye exams in full.

Since the bill said we had to pay by X date or face a collections agency, I called the number for the billing office.

The woman who answered – let’s call her Doris – said she could help me. I told her it didn’t look like our appointments had been submitted to insurance. She asked me what our insurance carrier was, and I told her. Recognizing the carrier, she asked, “Is your husband employed by University Health System?” and I confirmed that he is.

That’s when her brain shut down tight like a toddler throwing herself on the floor in prone, immovable refusal to wear the perfectly reasonable pants she already agreed to wear. Doris said, “Well, if you have the employee insurance, we don’t take it. We aren’t PART of the University Health System. We’re separate. Even though our name is University Ophthalmologists, we are NOT part of the University Health System. We are out of network to that insurance because we are not part of the University Health System.” She repeated this information several times and in a variety of ways, lest I misunderstand what she was saying.

When she finally ran through all possible variations on “we are not part of the University Health System,” I brought out my trump card (which no longer sounds as pleasantly triumphant as it should) and told her that we had in fact emailed our insurance company prior to our appointments to make sure that our eye doctor was still an in-network provider. The insurance company had responded that he was indeed an in-network provider.

Doris was still on toddler tantrum mode and this information did not sink in.

At some point she paused long enough for me to finally ask the question I had been intending to ask from the beginning, which was, “Did you actually even TRY to submit the claim to our insurance company? Because the bill says you did not. No asterisks.”

That got through somehow – her brain toddler must have spotted a soothing My Little Pony or something – and she said, no, it didn’t look like they had submitted the claim. So she would do that. BUT MARK HER WORDS, she said, it wouldn’t make any difference because they were out-of-network for my insurance company, not part of University Health, yada yada, the sound of my blood pressure drowned out her words at that point.

Internet, we have since received at least a dozen bills. Some of the claims have been submitted to our insurance. Some have been PARTIALLY COVERED.

One bill showed that part of my routine annual exam was covered… but my husband’s was not. Same exact service. Same exact insurance. So I had to call again. And Doris answered again. And we went through the SAME EXACT RIGAMOROLE.

Perhaps you are well aware how maddening it is to tell someone a fact and have them completely ignore that fact as they steamroll right over you with their own agenda. She was so completely caught up in this “we are not part of the University Health System” thing that she could not see that my insurance WAS IN FACT COVERING THINGS. Nor could she take a breath and look at the identical appointments my husband and I had, and note that there was no earthly reason for our insurance to make a payment on MINE and not on HIS.

The call ended with me asking, again, for her to re-submit the claim (which, again, had NO ASTERISK on their own form which said clearly that an asterisk means it has been submitted and ipso facto LACK OF ASTERISK means it has NOT been submitted). And again, we got a bill with incomplete asteriskage and mismatched claims information. Exhausting.

I am seriously considering leaving my eye doctor because of this! It is not worth going through this every couple of weeks! I never want to speak to Doris again!

And listen, I can empathize with Doris. I can. She probably has to talk to a billion people a day, many of whom are probably confused/enraged by the fact that University Ophthalmologists is not part of the University Health System and therefore doesn’t accept their insurance. That would be confusing and enraging! And so she probably has to shut off the part of her brain that listens so she won’t be bombarded by insults and profanity from angry, frustrated clients. And probably there is a limited number of variations on how insurance companies respond to claims so she likely thinks she’s seen it all. And maybe she’s worked there for fifty years and HAS seen most things and has a good grasp of her job and what can and cannot be done. She’s probably a very efficient, hard-working woman who maybe has too many things on her plate and might be a wee bit exasperated by all these patients the new doctor is bringing into the practice with their associated ignorance about what the word “University” means when it’s part of a practice name. Maybe she hates her job and goes home each night and cries. I try to think of all these things every time I speak to her, with limited effect on my blood pressure.

When the most recent bill arrived, I waited as long as I could. Then I gritted my teeth and geared up to deal with Doris. But! Lovely, reasonable, fresh-voiced Heather answered the phone! Heather, who trotted out the same “we are not in-network for University Health System insurance” line, but then listened as I pointed out that a) our insurance told us our eye doctor is in-network and b) our insurance had been covering some of the claims. And then she agreed that it was odd! And that she would look into it!

I have no doubt that I will be back on the phone with Doris in a couple of weeks, because insurance matters take YEARS to untangle. (Surely I’ve complained here in the past about the insurance company that had “University of City, Name Memorial Hospital” on their list of in-network providers, but the hospital itself put simply “Name Memorial Hospital” on the claims it submitted, so the insurance denied them all? That was a fun one to deal with.) (No.) But maybe, knowing Heather is around, I won’t have to leave my eye doctor altogether?

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Here it is, Friday, and I’m tired and cranky because my husband and I STILL have not adjusted to the time change, and I’m playing the age-old game of Should I Take Carla to the Doctor?

She seems FINE. She’s happy and energetic and eating in quantities that make me fear bare wrists and ankles are in our near future. But she is also… warm. Not feverish, but warm. (Not that I’d be able to tell if she were feverish; we have owned no fewer than SIX thermometers in her short life and not one of them has ever been accurate. We now have the instant-read kind that you stick in the ear and press a little button, and it’s always – ALWAYS – at least a degree or two high.) And she is also a little more snuggly than normal. And she woke up with some crust in her eyes. “Symptoms” which make me wonder whether she has an ear infection.

Carla has had many ear infections in her not-quite-four years. Not so many that she requires tubes. But enough that I think we may have been to her pediatrician once or twice for other things. Ever. (Not counting well visits, I guess.)

Her brand of ear infections doesn’t come with pain, though. I mean, thank GOODNESS, right? But it does make it a little difficult to evaluate. Sometimes – rarely – she’ll have a brief fever. Usually, she wakes up with crusty eyes. When she was really young, I would have to take her to the doctor just for that, since no respectable daycare was going to let her in looking like she had a severe case of pink eye. But it was always, always an ear infection.

Now that she’s older, the eye crust looks more like what my mom used to call “sleepy dirt” than Crazy Case of Conjunctivitis. So sometimes the only way we know she’s got an ear infection is that she cries out in the middle of the night. That has happened… twice, I think. And, now that she’s older, it seems that the doctors prefer not to medicate her. We used to get antibiotics every time; now the doctor shrugs and says, it’ll probably go away in a few days. Come back if not.

So if I have a not-in-pain child, who may or may not have an ear infection, and who will likely not even get antibiotics if she does have an ear infection, what’s the point in taking her in, right?

WELL LET ME TELL YOU.

I am deathly afraid of missing something. And having her pediatrician scold me. (And also, you know, having her be sick. That’s really the most important thing, of course.)

Last fall, my family was sick pretty much straight through from mid November, but by early January my husband was finally on the upswing of his lengthy cold, and Carla was still sniffly and coughing but otherwise seemed fine. I was the only one who seemed to be getting actively worse, so I finally decided to go to the doctor. It was just after Christmas and I still had a house full of guests and I just Couldn’t Handle Things anymore, so off I went. I got my diagnosis and my antibiotics and went home.

The next week, Carla had the telltale eye crust that means she had an ear infection, so I took her to HER doctor. And while there, I told him that we’d all been sick a long time, blah de blah, she’d been coughing and having a runny nose for a while, and now I think she has an ear infection. Normal stuff, right?

Defensive Interlude: I mean, we’ve ALL had a cold right? And we ALL know that a doctor can do NOTHING for a cold, right? So we wait it out. Eventually, it gets better, and we congratulate ourselves on knowing that it was a cold and on not wasting a copay or our own time. OR it gets worse, in which case we DO go to the doctor and hopefully s/he can do something about it.

Well, Carla had a cold! Cough, runny nose! No fever! No pain! No loss of appetite! No personality changes! Nothing! The only way we even realized she had an ear infection is that she woke up one morning and her eyes were all pink and goopy. She’d also spent the previous day saying, “What?” a lot, which she does a lot normally, but it was an extra lot. So I was pretty confident: ear infection.

So: to recap: I didn’t take her to the doctor when I thought it was a cold, even though it was a lengthy cold, because I was pretty sure he would shrug and say, wait it out. But when she showed symptoms of an ear infection, which can be treated by antibiotics if necessary (although, as I mentioned earlier, as she’s gotten older, the antibiotics have been replaced by a prescription for wait it out), I took her to the doctor.

But he chided me! He said, “Six weeks is way too long for a child of this age to have a cough like that.” And he said her ear infection was SEVERE and BILATERAL and that she probably couldn’t hear a damn thing (the memory of his chiding may be more strongly worded than it was in real time) and wrote me a prescription and sent us on our way.

Well, I felt TERRIBLE. Really. I mean, what mother wants to put her child’s health at risk? What mother wants to misjudge a situation so badly that the doctor scolds you? NO MOTHER, is the answer.

Poor Carla. She had an ear infection for a whole month after that, because the first course of antibiotics didn’t work. (And even though I could TELL it wasn’t working, we still had to finish the entire ten days before the pediatrician could see me again. That is another huff-fest entirely.) She was having SUCH a hard time hearing, and I was panicking about her somehow suffering longterm hearing loss.

So I think it is perfectly reasonable that now I am feeling a little jumpy about missing something.

And yet I’m dithering.

I really, really dislike going to the doctor for nothing. And the two visits since the Great Ear Infection of 2017 have both been false alarms. (One: Her preschool had me pick her up because she was complaining of a stiff neck, which is code for We Think Your Child Has Meningitis; she did not have meningitis. Two: She and I both had a stomach bug a few weeks ago, and hers presented as belly pain and complete loss of appetite. I tried to give the child a bowl of ice cream for dinner, just to get SOME calories in her, and she refused it. So I took her to the doctor. There was nothing he could do; just wait it out.)

Okay, I am still glad I took her in, both false alarm times, a) because you don’t want to mess around with meningitis. And b) because my husband and I were both googling “toddler belly pain” and had become convinced that Carla had appendicitis. Sometimes it is totally worth a trip to the doctor and a copay to find out that your fears are unfounded. (With the latter, though, the pediatrician seemed a little… miffed as to why I’d brought her in. I DID call the nurse advice line in advance! The nurse was who clinched my decision to come in!)

And of course, to add to the whole issue is that it’s FRIDAY. She wasn’t sick enough to keep home from school, but that means I will have to do a quick eval when she gets home, and then hope there’s a spot at the pediatrician… OR wait and see whether she wakes up crying in the middle of the night, and then take her to urgent care.

But none of the above makes me DITHER any less. Especially when the illness in question is just another ear infection.

SIGH.

Hey, at least the urgent care doc is unlikely to chide me, right?

 

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Why he thought to tell me the story then, sharing dinner al fresco amid a dozen strangers, I do not know.

What I do know is that part of this support I give him is to listen.

No matter how sad it is, no matter how much it makes my heart break or my stomach churn, I want him to be able to unload some of the stress, pain, and helplessness that come with being a doctor.

He starts with the man’s struggle.

There was nothing left to do. All the treatments had been tried. All the surgeries had been performed.

But whatever disease had hold of him, it would not be beaten.

This is the worst part of my husband’s – of any doctor’s – job.

To give up. To say, there’s nothing more we can do. To say, go home and wait to die.

* * * * *

There’s this scene in Friday Night Lights where Julie is upset about a death. She collapses onto the couch next to her father, and, without saying a word about what’s hurting her so deeply, begins to cry.

Her father, Eric, wraps her up in his arms and kisses her head. “I’m not going anywhere,” he says.

I’m all teary on the couch next to my husband, which makes me uncomfortable. (For an emotional person, I hate showing emotion sometimes.)

“My dad would just say something like, ‘everyone dies,’” I tell my husband. “Which is not comforting at all.”

“It’s true though,” Husband says. “Everybody dies.”

My father – like my husband – has always been very matter of fact about life and death.

I suppose you have to be, to deal with it every day.

The thing is, I’m a relatively intelligent woman. I know that everybody dies. I know this.

But I still want to hear those close to me deny it. To say, “I’ll be here forever.” “I’m not going anywhere.” “Don’t worry, that won’t happen to me.”

I am not deluding myself into thinking it’s the truth. But I want to hear it anyway.
* * * * *

I’m looking sympathetically at my husband, over the hummus and pita we’re eating. To have exhausted your options, to know this patient you tried your hardest to save is not going to make it after all… It must feel so hopeless. So pointless.

But he’s not finished with his story.

He tells me that the man won’t go home.

This poor guy – nothing’s working, but he won’t give up. He wants the doctors to pull out all the stops. He wants them to keep treating him, keep reviving him, keep him alive.

No. Matter. What.

And this is a familiar story. One my husband struggles with frequently.

When you’re a doctor and you see exactly how futile the treatments are, you can see that going home and preparing for death is the best thing to do.

But when you’re a patient, or a patient’s spouse or child or sibling, I would guess it’s damn near impossible to accept that there’s really nothing left to do. I can’t imagine not wanting to spend ten bajillion dollars to keep my husband alive, even for just five more minutes.

* * * * *

My father tells me he doesn’t want anyone to be sad at his funeral. He wants us to play the Rolling Stones.

I try to hold back tears. He’s one of the four people in the world I don’t think I can exist without.

“Which album?” I tease him, trying to keep it light.

“Oh that doesn’t matter,” he says. “And Jimi Hendrix, too.”

“Okay, Daddy,” I say. “But we’re not going to need that for many years yet.”

I’m shivering a little, willing myself not to cry. The fact is, I know that “many years” is not a guarantee. In the past three years, I said goodbye to an aunt and a close family friend – both younger than my parents.

“I hope so,” my dad says. “I’m not planning on dying any time soon.”

* * * * *

My husband is still talking.

I can tell this man’s story really affected him.

This patient is different somehow.

He’s not clawing at life for himself. He’s doing it for his daughter.

She is getting married in a few weeks.

And my husband’s patient cannot miss her wedding.

* * * * *

My husband – then boyfriend – went hiking with my father in the summer of 2006.

They hiked for something like nine miles, up a mountain, while I worked and my mother painted.

It was a hot summer day – mid 80 degrees, cloudless sky, no breeze.

They left at around 7:00 in the morning.

Although this was the first time they’d spend so many hours alone together, one-on-one, I wasn’t worried.

My father – both parents – love my husband.

He is very much like my father. They share the same dry sense of humor. The same quiet confidence. The same gentle hearts.

They even practice medicine the same way – full out, with compassion and kindness, but with the practical knowledge that medicine is not a cure-all, that doctors are not omnipotent, that death is a part of life.

I thought they’d have plenty to talk about.

I was done with work by 3:30, and still no sign of them.

My imagination started playing tricks. What if my husband had fallen? What if my father had a heart attack? What if they’d crossed paths with a hungry bear?

I was stuck where I was, with no car, waiting for them to come pick me up.

I tried their cell phones. But the mountains have notoriously bad service. No answer.

So I sat down, rebooted my computer, and tried to concentrate on projects I had for the following week.

By the time they showed up, I had worked myself into quite the frenzy.

Everyone was accounted for. My husband and father were dusty and sunburned. They’d had an exhausting hike.

Months later, I found out that my husband had waited until they’d come down from the mountain, breathing heavily, sweating like pigs, too tired to move… and then he’d asked my father’s permission to marry me.

The tale of that hike is my father’s favorite story.

* * * * *

When they found out that their patient was delaying the inevitable out of desperation to see his daughter get married, my husband and his team had to do something.

So my husband made some calls.

And he set up a little impromptu wedding at his patient’s bedside.

The daughter and her fiancé got to say their vows to each other, in front of a pastor, in the presence of her father.

* * * * *

I remember waiting in the stairway of the little chapel in the mountains with my father. I am fussing with my veil and putting on a last coat of lip gloss and telling my dad I am so nervous.

“There’s nothing to be nervous about!” he says.

As we’re walking down the aisle, I’m a mess of emotions. My husband is there, the windows at his back, sun streaming in. All our loved ones and friends are crowded into the pews.

I’m gripping my dad’s arm so hard my knuckles are white. I clutch at him, unsure of myself, afraid I’ll fall, afraid of taking this final step into adulthood..

He’s this calm presence beside me. Steady, confident, and proud.

Just like he’s been for my whole life. Confident that I can do anything, from riding horses to skiing to attending the best school in the country – he’s been there, to guide me when I didn’t know my way, to hold me up when I was in danger of falling, to cushion me with love and pride no matter which path I took.

When we get to the end of the aisle, to where my future is waiting, my father takes my hand from his arm and transfers it to my sweet husband.

And then he gives me this gentle but firm push forward.

Away from him. Into the arms of the man who will care for me and love me and provide for me for many years after my father is gone.

* * * * *

My husband’s patient went home the day after his daughter’s impromptu wedding ceremony.

He was finally at peace, having performed the last responsibility of a father.

He died the next day.

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Some things, when I hear them, make me irrationally angry.

I recognize that the anger is irrational. But that usually doesn’t do much to still my pounding heart or force the blood from my cheeks.

However, I do try very hard to see things from the other person’s perspective. So today I would like to explore one aspect of medicine that drives me bonkers.

It’s the bias against medical students and medical residents.

I know one woman whose son is a physician. Yet this woman is adamantly opposed to allowing medical students or medical residents treat her or any of her family members.

I’ve heard her, time and again, mention how she won’t return to a certain emergency department because it’s populated with so many residents. Or how she would never let a medical student perform a physical exam. Or how she would not let a medical resident – especially not an intern – treat her.

I’ve heard her tell others that new interns start in July, so that’s the worst time to get admitted to the hospital or be seen in an ER.

And the other day, I heard the wife of a medical resident telling another wife that “You have the right to request a medical student or resident NOT provide care to you.”

Listen, I am going to say right up front that I find this offensive. Not to me, personally, but to physicians-in-training everywhere.

And especially when it comes from a family member of a physician. How can you expect your son or spouse to become a top-notch doctor if even you – you who know just how hard he’s worked, how much education he’s had, how smart and dedicated he is – won’t give people in his position the chance to gain experience?

Now I’m taking a breath.

You see, I understand where these women are coming from. To an extent. And maybe you share their reluctance. When it’s your health – or your life – on the line, you want the absolute best care possible. It’s natural to want the most experienced physician to treat you. And it’s natural to want these things for your loved ones as well.

If there’s even a chance that your doctor is too inexperienced to spot a tricky symptom… or to make a rare diagnosis… or to know of a specialized treatment… Well, you’d want her off the case, right?

I get it. When it comes to yourself or a loved one, you need to be selfish. I totally understand that impulse to get “the best.”

But on the other hand…

How do you expect a doctor to gain experience if he’s shut out of cases when he’s an intern?

How do you expect him to hone his diagnostic skills if he’s limited to the “easy” cases?

How do you expect him to think of all the latest technologies and drugs if he’s not been exposed to them?

It is reasonable to expect the best care from an experienced physician if you refuse to help a young physician gain that experience?

On the other hand…

Why should YOU – or your child or grandmother or husband – be the person on whom a young doctor practices?

Why not reserve that dubious privilege for the poor, the uninsured, the mentally disabled? *

Or why not leave it to “someone else” to say, “Sure, even though you’re just a third year med student/medical intern, you can operate on me/treat my diabetes/sew up my face/deliver my baby.”

Yes, I see that it’s distasteful to be someone’s “test case,” to have a physician “practice” on you. It can’t be fun to be the guinea pig when a med student is first learning how to do stitches or an intern is learning how to insert a chest tube.

On the other hand…

How else will they learn? I know there are tricks. His third year of med school, my husband had a weird contraption made up of a sponge glued to a piece of wood on which he practiced sewing. I’ve heard of practicing “drawing blood” on oranges.

But nothing can stand in for a real human, with real health issues.

Sometimes I think this is a side effect of the “American way.” Many of us feel entitled to the best of everything. And we want it without putting ourselves at risk.

But I think in this case, we are not only looking out for our own self interests… we are doing it to the detriment of future classes of physicians.

So is there a way to reconcile this problem? I believe so.

Now, I’m not saying that you have to swallow your fears and allow a med student to sew up your face… or have an intern perform heart surgery on you. If you are concerned, maybe ask that an attending oversee your case, or that your intern work in tandem with an upper-level resident. But I’d encourage you to be open to allowing med students examine you (they aren’t responsible for your care – they will discuss your case thoroughly with a more experienced physician) and even stitch up your arm. (My husband was excellent at making stitches – even as a med student.)

And no matter which doctor you have, ask questions. Be informed. Bring a friend or family member with you to listen in and ask questions you might not have considered.

Share your concerns with your physician. Ask her to explain everything she’s doing and why, so you know her thought processes and her reasoning behind the treatment she gives you. And if something doesn’t seem right to you… if something doesn’t feel right… if you feel like something is being overlooked – SPEAK UP.

If you take an active role in your healthcare, I firmly believe you can get the best care AND you can help a physician-in-training gain more experience.

* I have actually heard people suggest this as an alternative to having to deal with interns themselves.

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When you go to the doctor, you want to get her undivided attention, right?

And you want her to address all of your concerns.

My last PCP (primary care physician) was like this. She would always let me get through my rambling explanation of what was wrong before starting an exam or asking me a question. And at the end of every appointment, she asked me if I had other questions or concerns.

Now, I know this is hard to do. Physicians are overbooked. They have no time. So to be calm and unrushed during an appointment is a true gift.

But I think that you can cultivate this type of treatment from your doctor.

First of all, when you make an appointment, have one specific reason for doing so. Don’t postpone appointments until 10 things are wrong.

If you tend to “save up” all your ailments and concerns and then unleash them all at once on your doctor… and if you do this every time you see her… then I’m guessing it will be harder to get the unhurried “I have all the time in the world” treatment.

Yes, I know it’s more expensive this way. And believe me – I hate going to the doctor and dealing with insurance just as much as the next guy.

But I truly believe this will help your physician do a better job… and it will help you get the best care she can possibly provide.

Now, if you do everything right and your doctor still tends to be more of the “rush rush rush” personality type, you may have to coach her a little to respond to your needs.

According to a New York Times article called “Contentious Relationships Between Doctors and Patients,” communicating your needs is key:

“Go to a doctor’s visit with written questions so you don’t forget to ask what’s important to you. If a doctor starts to rush out of the room, stop him or her by saying, ‘Doctor, I still have some questions.’ Patients who are open with their doctors about their feelings and fears will often get the same level of openness in return.”

I also highly recommend – whenever possible – taking an advocate with you to your appointments. This could be your mom, your spouse, your sister, your best friend. Someone who can listen in to what your doctor is saying… ask questions that you may not think of… and recall the doctor’s comments/suggestions once the appointment has ended.

When something scary is going on, my brain tends to freeze up. So I’ve found that having my husband with me ensures that I get all the right information.

If this is impossible, bring a notepad with you. Write down key information. Ask your doctor to repeat things and spell things for you. See if your doctor has any pamphlets or articles on your problem that you can take home.

When it comes down to it, your health is your responsibility. So make sure you don’t let a hurried physician prevent you from getting all the information you need.

What say you, Internet? Any advice about making sure you get everything you need from your doctor during an appointment?

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We were at my cousin’s baptism, greeting guests after the church service.

A tall gentleman* walked up and shook my father’s hand heartily.

“So good to see you doc!” he said. “It’s been way too long!”

“It sure has been a long time,” my dad said, smiling.

“Yeah, I think it was about two years ago I came into see you about my hemorrhoids. Man, they were bad. I couldn’t sit down for about two months. But thanks to that cream you gave me, I feel much better.”

“Oh, glad to hear it,” said my dad.

“But I’ve been meaning to come back and see you, doc,” the man went on. “I have this big festering boil on my lower back. It’s been there for about two weeks now. It hurts and it’s full of puss and…”

About this time, I left my dad to fend for himself. I’d heard enough!

The thing is, once you’re a doctor, people seem to think that they can bend your ear about their medical problems anytime, anywhere.

I know this drives my mother crazy. And while my husband hasn’t really had to deal with it (outside of advice requests from his sister and parents), I am sure I’ll grow to hate this aspect of his profession as well.

When you’re a doctor, you have so much power. People automatically seem to trust you more. To feel okay opening up to you, sharing with you the most personal aspects of their lives.

I’m sure it happens with other professions. Lawyers must get requests for instant legal advice in grocery store lines… Accountants must get questions about tax season from fellow church goers… Plumbers must get asked to look at a variety of toilets and sinks while at dinner parties.

But I’ve seen it happen ten jillion times. And every time, it surprises me, bemuses me, and perplexes me more than a little.

This is one of those unreasonable expectations that a lot of patients seem to have when it comes to doctors.

I don’t know all the legal technicalities, but I can’t imagine that it’s a good idea for a physician to give you any sort of medical advice outside the confines of the hospital or doctor’s office.

Plus, why would YOU want to share something as personal as your health with someone you may not know very well? In a public place, no less? (Okay, okay… as a blogger, maybe this one is more understandable than most.)

But above all, why would you put a doctor in that position? She’s at the grocery store/golf course/gym/birthday party on her time off. She needs to relax and unwind as much as you do. She may not be able to leave all aspects of her job at work, but she certainly doesn’t want to be “on call” 24/7. Especially when she’s technically out of the office. She doesn’t need another patient – let alone one who’s asking for FREE advice – to deal with when she’s thinking about her tennis serve or trying to pick up pizza for dinner or watching her kid play at the playground.

Listen, doctors – for the most part – really, genuinely want to help people. They may have a hard time telling you to back off if you’ve crossed a line. So don’t put them in that position.

If you want free medical advice, marry a doctor. Otherwise, make an appointment.

* While this is a real experience, I’ve changed any identifying details to protect the innocent.

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Take a second to imagine that you – or maybe your child or your parent or your spouse – are really sick.

You don’t know what’s wrong. All you know is that you’re terrified. That you’re in severe pain. That you could – for all intents and purposes – be dying.

So you head to the hospital, to see a physician. A doctor with years of education and training and – if he doesn’t have years of experience – dozens of colleagues with hundreds of years of experience among them. A physician who is concerned solely with diagnosing your problem and finding out the best possible way to resolve it.

Now, let me ask you this…

Do you want that physician to decide what tests to perform? What prescriptions to offer you? What treatment to order?

Or would you rather hand over those responsibilities to a few men and women in another state, who’ve never met you, who have (probably) no medical education or experience, who don’t know your particular problem, who’ve never met your doctor or even (probably) set foot in your hospital or doctor’s office?

Think about that for a second.

Then read this excerpt from an article by Senator Ted Kennedy and co-author Bob Shrum:

We also need to move from a system that rewards doctors for the sheer volume of tests and treatments they prescribe to one that rewards quality and positive outcomes. For example, in Medicare today, 18 percent of patients discharged from a hospital are readmitted within 30 days–at a cost of more than $15 billion in 2005. Most of these readmissions are unnecessary, but we don’t reward hospitals and doctors for preventing them. By changing that, we’ll save billions of dollars while improving the quality of care for patients.

In an editorial for the Washington Examiner, William Kristol addresses Senator Kennedy’s statement above.

I think his response it succinct. It’s clear. And it gets to the bottom of what Kennedy is saying.

Here’s part of what Kristol had to say (you can read the full article here):

…the most important implication of the Kennedy-Shrum claim–“Most of these readmissions are unnecessary, but we don’t reward hospitals and doctors for preventing them. By changing that, we’ll save billions of dollars.”–is this: The government is going to decide–ahead of time, obviously, since deciding after the fact wouldn’t save any money; and based on certain general criteria, since the government isn’t going to review each individual case–what kinds of hospital readmissions for the elderly are “unnecessary” and what kinds aren’t. And it’s going to set up a system “to reward hospitals and doctors for preventing” the unnecessary ones. That is, the government will reward hospitals and doctors for denying care they now provide, care the government will now deem “unnecessary.”

Indeed, this understates the case. For in reality the government isn’t going simply to reward “good” and penalize “bad” admissions. It’s going to prevent insurance companies from paying for “unnecessary” admissions and procedures, if those companies want to participate in the government system. In other words, government bureaucrats are going to deem entire categories of treatment inefficient for all or certain categories of patients, and put those treatments out of bounds for doctors and hospitals.

***

Listen, I really don’t like politics. Nor do I “have a mind” for politics, either. But Kennedy’s words and the whole healthcare tumult that’s occurring right now have freaked me out enough that I thought it would be pertinent to at least post these paragraphs here… to get anyone who’s reading this to at least consider the implications of letting our government get too involved in our healthcare system.

And I KNOW that our existing healthcare system is seriously effed up. It needs to be reformed. But I happen to think that allowing the government to dictate who gets what kind of healthcare… and when and where and how… is not the way to go about making a healthy change.

Healthcare is a very personal thing. This is your life, or the life of people you care about. Why would you want the government to have the final word?

If you have any objections, contact your senator, your congressman… whomever you can. Before it’s too late.

I’ll leave you with the immortal words of Thomas Jefferson: “A government big enough to give you everything you want, is strong enough to take everything you have.”

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