Is Our Medical System Causing More Trauma Than It's Resolving?
My first question is, how stressed does this waiting room image make you? Does this give you reassurance that you will receive individualized, attentive care in a timely manner? How often in the last year have you been sitting in an emergency room waiting room and for how many hours?
I want to start by saying that my primary care physician is one of the most caring, dedicated people I know to both his profession and the people that rely on him. He is incredibly open-minded, intelligent, funny and sincere. It’s a joy to see him.
There are many physicians like him, however the medical system within which they have to work has been changing for years and making the true work of physicians much more difficult. They are now overseen by people in front of computers who are not physicians, telling them what they should and shouldn’t do for and with a patient. Their income is almost completely dependent on the bureaucracy of the insurance industry whether they like it or not. They are told when they have to see a patient whether they feel it is necessary or not. They are restricted in what they can tell a patient, what they can suggest to a patient, how much time they can spend with a patient and even how many patients they can have in their practice.
In other words our system is being run by computers and algorithms more than it is being run by human kindness and caring. Our medical system has evolved away from that, removing the human element because that cannot be incorporated into a “system” of care. It has been becoming more and more like a conveyor-belt system of care with a standardized step by step approach to every symptom, condition and disease. And we expect all the people that work tirelessly within the system to act like good little cogs and simply move the conveyor belt forward without exception. Just how many people do you know in the medical care system that have burned out, lost their joy and enthusiasm for helping people and broken down under the strain of this impersonal process?
But what is the cost to the patient? And I’m not talking about the financial cost, although that is often steeper than Erebor. I’d like to tell you just two of my stories from a number of years ago while traveling the world photographing …. let’s begin in the South of Spain. I was in Sevilla for Semana Santa and because I was photographing the processions 24 hours a day, the smoke, the incense, the humidity just brought on a respiratory issue for me which turned into an infection. I was running a fever and went to the emergency room at the hospital because I did not have any insurance. It was a plain, but very clean building. Receptionists with whom you checked in, filled out a form and were given a number by, were pleasant, kind and seemed very calm. You waited for a short time until your number came up on the screen and you went to the indicated room number. There you had a doctor and nurse who in my case examined me, gave me an herbal breathing treatment, handed me an antibiotic to take over the next two days and a packet of herbs to steam with at home. Total time was one hour and the total cost at checkout was $85.00 USD.
Thailand … I was in an outdoor market at night (it always seems to be at night!) and after a few hours, I felt feverish and was coughing a bit. By the next day I had a high fever and really was coughing up mucous. I was staying in a hotel in Bangkok and called the front desk to inquire about my options for care. Within one hour a Swiss physician and his nurse came to my room and, similar to my experience in Spain, gave me an herbal breathing treatment, a small box of acetominophen and a two day antibiotic. They also had room service bring me fresh orange juice every hour to my door (now that’s service!). Total time was 45 minutes and the total cost at checkout was $125.00 USD.
So what is my point here?
Our medical system used to believe that seeing a patient at home was the best. It was calmer, the patient was exposed to less people and less opportunistic infection and they were making use of the best healing mechanism, rest. But now our medical system forced all the community hospitals out, forced people and ambulances to go to just a gargantuan central hospital and now realizing the stupidity of this approach and the 5-10 hour waits lying in ER hallways (which by the way are still billed to the insurance company as a “room fee”) have opened walk in clinics, urgent care centers and ambulatory surgery centers to replace all the wonderful community hospitals we used to have. So now you have to go to multiple places, have multiple visits, all to get an “answer” to your symptoms.
Our current medical system relies exclusively on tests as opposed to a doctor’s experience, making patients wait for days or even weeks to get results. During this time the patient experiences so much worry and stress that any condition will worsen.
Because the “system of care” is already set in stone for a patient once diagnosed, there is no need for discussion, the patient is expected to simply agree and go forward without any time for evaluating the plan, looking for other options or even trying to place this unexpected challenge into their current life. There is no room for questions regarding their family, their job, their responsibilities or their fears!
Why is our medical system so expensive, our medical costs so prohibitive to even trying to live without medical insurance? We have created a system where people must have insurance because even one unexpected injury or surgery would bankrupt them. Why do we need marble walls in our hospitals, the newest of everything, huge medical facilities that are too much for any reasonable elderly person to be able to walk through? We expect people to all use wheelchairs.
Why are physicians encouraged to become part of a group practice that becomes larger and larger until it is absorbed by a corporate medical entity? What happened to small individual practices? Why does our system discourage and even prevent physicians from having their own office? This also forces physicians to abide by rules and restrictions of the group within which they are practicing, often being discouraged or forbidden to advocate for anything that is not FDA approved, i.e. holistic, natural or even complementary. I’ve even had a physician that is my patient tell me that he can’t recommend me to his patients because what would the other physicians in his practice think.
Why do we put physicians in the role of prescriber when they have not had the training that pharmacists have had? Why do we treat our pharmacists as though they are simply secretaries to doctors instead of the highly trained professionals that they are? Who better to understand our individual needs and allergies and all the pharmaceutical options, than a pharmacist? When does a physician have time to learn all about medications? Usually only when the pharmaceutical sales reps come by. We are one of the only countries in the world that does this bum-backwards method of prescribing.
All of this bureaucracy creates so much stress, so much financial burden and provides so little true care that we really need to start saying “Wait a minute!”. We need to start saying no, to realize that just because our insurance company is telling us what it thinks we need or should do, that we need to assert our individual needs. We need to step off the train and not allow ourselves to be herded through the gates like goats. Take a minute, take a breath and take back control of your medical care.