Monday, August 20, 2012

What Happens When Healthcare Gets Sick? (Thursday, May 10, 2012)

Throughout the past five years during which I've worked at International Galleries, I've had the opportunity to meet and befriend a number of people of note. One of these people, the one to whom I've developed the closest bond, is a retired print-making professor by the name of Dennis Rowan. He counts among his friends not only young framers but also a rowdy bunch of old men who specialized in anything from industrial design to sculpture. Once a week they wreak havoc on some poor, unsuspecting server at a number of different restaurants in town. This group was named by Dennis, The ROMEO Club. (ROMEO stands for Real Old Men Eating Out.)

I had the pleasure of accompanying this prestigious group on one of their outings last year, and although the conversation was lively, the behavior childlike, and the experience unforgettable for a variety of reasons, the thought that remained in my head for the longest time afterward had naught to do with any of the ROMEOs but with another guest Dennis had invited along.

This guest (whose name I do not recall) worked for his father. His father, however, does not own a local business; he owns a corporation that sends out efficiency experts to hospitals and clinics all over the country in order to inform them how they might better be spending their time and money. Efficiency experts?

Yeah, that's what popped into my head too. But here's what amazed me. This was someone who is maybe a year or two older than me, and he seemed somehow already completely wrapped up in the idea that the more money health care can make, the better. It's supposed to take decades of cynicism and greed to acquire a view like that, and yet, here it was.

At the time, I did in fact challenge the idea that health care needed to make more money, but I quickly realized that it was neither the place nor the time for such a discussion. I won't argue against many institutions being generally wasteful, but I feel it is money that more often than not is the cause of such inefficiency. For example: It used to be the expectation that doctors did more than just the required prodding, probing, and punctures of a typical check-up; there was an understanding that they were to both care for and care about their patients. A relationship is required for the latter.

One of the examples provided to me by this efficiency expert was increasing the amount of patients seen by doctors within a given period of time. It's pretty hard to develop a relationship with a patient that you've seen for under ten minutes. By taking more time to know and understand the situation in which a patient is set, money is ultimately saved, because a greater understanding produces a better diagnosis. (Also, if you've developed a relationship with a patient and they consider you a friend, they're not going to want to sue you if something should go wrong.)

If we are to go into a doctor's office and see them for only the amount of time necessary for them to glance at a chart, reaffirm what's already been written down by a nurse, and maybe (maybe) a little small talk, then we might as well not be there at all. Web M.D. can do just as good a job if the patient isn't really being utilized as a context. Sure, there are all the tests they can run at a hospital, but a lot of those wouldn't be necessary if they just took the time to actually be a doctor. Besides, who really needs a doctor to order a test? You want to streamline health care? Send in a vial of blood to be done by a lab without a doctor ever glancing at it. The hypochondriac in all of us will love it. They'll be able to tell us everything that could be potentially wrong with us for just a small fee.

Now for a little honesty; this is all really just an entry venting frustration for the now weeks-long process of getting all of Amanda's paperwork together to send in to the Peace Corps. Anything you can think of on a pretty standard piece of paperwork that a doctor could mess up has happened. Five boxes to date and initial? Just do three or four of them; the others probably aren't important. Did the vision test? No need to write down the results. OK, fine, I do have to write them down? I know, I'll flip which eye needed which prescription. And it goes on and on. The last struggle has been the most absurd of all though.

In addition to the usual physical scheduled with a family practice doctor, Amanda and I both had to have several different specialized doctors for areas where general doctors don't have the expertise for a given area (teeth, eyes, vaginas, et cetera), and that's all cool. That much makes sense. What doesn't make sense is having to make a separate trip back for every single one to have your primary care physician sign off on the results. What makes even less sense is when one of the specialists refuses to fill out and sign a sheet because it requires the signature of your physician, and your physician won't fill it out or sign it because they're not comfortable doing the work of the specialist.

This is the situation Amanda is currently in. Two doctors, two refusals, two weeks trying to figure out a single sheet of paper, even though all of the information is already there. Like I said in a previous post: You really have to want it. So, what happens when health care gets sick? You and I get screwed. I don't think pills are going to help this one; it's time to amputate, starting with the efficiency experts. Sorry, Bob, Bob.

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