Aug 20, 2007

Another doctor story

My dear and beloved readers, I promise, I tried my best to not be critical, I wanted this to be my happy post and everything to be good. It is not. I am not unhappy, just sad with the way the world is. So here goes another doctor story.

I have this mild but annoying foot pain since I was pregnant - 20 months ago. It is only annoying when I walk for a long time (like our 10 miles hike from a month ago). It's not that bad, but I figured if I can make it go away why not try.

My doctor very warmly recommends this podiatrist and tells me that all the doctors he recommends are his friends, but his patients actually like this guy. This is big for my doctor.

I call and get a 7PM appointment - hey, appointment at a convenient time, amazing! They send me directions, they call me twice to confirm my appointment with an automatic message. This guy obviously has an EMR system... I am grounded. I loved him even before I met him.

When I get there, it turns out that he doesn't take my insurance, but the first appointment is free. I quit caring about my insurance a while back. The doctors I have the best relationship with are out of network anyway. So this doesn't put me off.

The doctor comes in with a laptop, examines my foot, asks the questions, etc. He finds a spot that hurts and explains what he thinks is wrong. I listen and then tell him: oh, so if I just wear wide shoes it should go away. He says that's not enough and sets me up for a X-ray and U/S. I am presented with a U/S paper where I promise that I pay $50 if my insurance doesn't. Hey $50 is not the end of the world.

The X-ray is perfect, On the U/S he shows me a black area that is supposed to be my infection. Before I know, I get a hydrocortizone injection, a pad on my foot and I am armed with a cream and pads ($24.5). I shyly ask if it might not just go away just by wearing wider shoes. Doctor becomes uncomfortable and hurries out the room. I am set up to have another appointment in a week.

Will my pain go away? Likely. Would it just go away if I wore wider shoes anyway? Probably. Would I go back to the doctor if he just told me that? Likely not, but just because I would feel better.

Why are we so hungry for intervention? Why is this doctor basically a vendor? A very good and courteous one, but at the end of the day just a vendor. That EMR system that he has needs to be paid for...

And BTW, I had to peek at the EMR system and saw his notes: they started with "This 37 yo female patient..." He typed that in... shouldn't that be automatic, generated by the system?

I lost any hope that I am not the most critical freak that ever existed.... Everybody likes this guy, even my doctor, and I don't? What's wrong with me? Can I just be happy?

ETA: Check out the development of this story.


Anonymous said...

In the end, medicine is a business. He does have to pay his bills...but wouldn't it be nice if "free" really meant free? I also think doctors are like mechanics - they see a problem and want to fix it. Letting it heal on its own is against their nature. I'm sorry this happened to you.

Ileana said...

Insurance companies are paying by procedure, lots of patients are unhappy to not get anything (either a referral or a prescription). Therefore the doctors are starting to offer what the market requires and what is valued.

However, we are people and each of us has a different view of what we want. I expect from a good doctor to use their cognitive skills and help me understand what is going on before jumping with any medication.

I will go back and will pay the next visit because they don't take my insurance, but when I'll pay it, I will ask for his opinion rather than an injection.

I did not say to let it heal on its own, it obviously didn't in 20 months, but wearing the right kind of shoe will probably make it better.

I valued this guy a lot, he explained the problem very well, unfortunately it was so well that I could see a different way to fix it.