I want to begin within the context of enormous gratitude for competent and caring physicians, nurses and technicians from so many medical practices and hospitals. These dedicated practitioners serve their patients and communities with high level, quality service. That said I want also to register concern about medical practitioners being held hostage by insurance companies who dictate UCR (usual, customary and reasonable) fees which doctors and hospitals agree to either accept or negotiate.
As someone who has worked in a hospital setting training 3rd year residents in family medicine, I have a little knowledge (dangerous) from behind the scenes of what I call factory medicine with a mechanical, assembly line approach. This is when we, as patients, begin to feel that we have become caught up in a system where standardized procedures take precedence over any creative, innovative approaches to diagnosis, treatment and prognosis. And it’s when it seems like our bodies are divided up into parts and pieces and a practitioner focuses solely on the presenting problem and not necessarily the patient as a whole person.
I know that the old days of the general practitioner are long gone when the family doctor who was qualified in internal medicine, minor orthopedics, pediatrics, gerontology and general surgery provided excellent patient care and even made house calls. We moved into an era of specialization that includes over 62 medical and surgical specialties and 22 sub-specialties under surgery alone. Within that category there are 127 different “ectomies” most of which involve the removal of something that may be interfering with high-level functioning. It’s a little like taking your car to a mechanic because something is getting in the way of its quality performance. Or it could be a plumber or electrician depending upon the system, urology or neurology. Don’t push this analogy too far.
One of my sons and I exchange photos of vintage cars that we see on the streets, he on the west coast and I in the southwest. I wrote to him recently about a couple of health issues I am dealing with personally and here’s what he wrote back, seeing me as his vintage Dad: “As many of my “Car of the day” posts can attest, as any vehicle ages (including our very own) it is important to maintain all the components of all the various systems in order to keep it moving down road. Sounds like you’ve got some good mechanics and they’ll be using factory original parts for the jobs. Always the best! Many happy miles ahead and as it is St. Patrick’s day, “May the road rise up to meet you.”
I see four different doctors, submit to a variety of tests and monitor four or five different medications. I find it both amusing and annoying given my previous health history that was excellent until a couple of years ago. Then, given things like age, condition, genetics and a few other variables some parts began to decline with wear and tear. That’s about the time I got caught up in the medical machinery that continues to grind away. And very often the medical systems do not communicate very well with each other. I had a surgical procedure today (3/28/17) in a local, regional hospital. It was put on the schedule two weeks ago. Then Sunday night I had a cardio-vascoular episode that sent me to the E.R. and the good folks here got that resolved sufficiently yesterday so we could proceed today. Everything went fine with the involvement of 15 people, numerous medical and surgical procedures, telemetry, monitors and a change of plans at the last moment dealing with the anesthesia. That was the last thing I remember before waking up in recovery and slowly coming back to a conscious, thinking clearly state of mind.
I want to take care of everything, be professional about it and get on with my life. I have several things on hold waiting for my attention and involvement. I am confident that my caretakers know what they are doing and I am, as I said at the beginning, grateful for their interest in the best possible diagnosis, treatment and recovery. As a patient, I know I can be a difficult pain in the ass by asking a lot of questions and looking for alternative solutions. I also have a bit of a warped sense of humor that some appreciate and others do not. I have another surgery coming up, as soon as I am sufficiently recovered from this one. I get it, I really do, one step at a time. It just feels like my body is an object on a conveyor belt, waiting for the next person to deal with whatever part is their expertise. I’m set to go home tomorrow and move on down the road
What is most important is that we do what we can to keep ourselves healthy and understand that the best medicine is prevention. Our bodies, along with our minds, change over time and it is up to us to keep them functioning at an optimum level as long as we can consciously choose to do that. Benjamin Franklin is credited with the saying that “an ounce of prevention is worth a pound of cure” and that seems to still hold true. For all of us the question is what do you want the quality of your life to be whatever the conditions are? “I am still in fairly good shape for the condition I’m in.” And I am enormously grateful to be exactly where I am, doing what I can with what I have.