Redline Doc

Jun 1, 2009 - 3 minute read - Medicine

Failed health, failed heathcare.

I write this entry as a physician working with in the system, having been in it for more than 30 years and watching the steady transfer of medical decision making away from the hands of physicians and into the hands of the payors, not the patients.

I’ve written elsewhere about this but a recent episode brings the inadequacy and hopelessness of the current system home.

A friend (not patient) develops some urinary bleeding. He calls. I suggest, doctor (and give him some names). There is a bit of a glitch. He’s a retailer but doesn’t have enough employees (small store) to qualify for group insurance and his individual rate is enormous. He waits.

He goes to the emergency rooms. They give him antibiotics and painkillers. They tell him ‘see his doctor’.

He waits.

He goes back to the emergency room. A note here. Emergency rooms are wonderful places for stopped hearts, lots of bleeding, run over by a bus. Emergency rooms are inappropriate places for continuity of care. He has no doctor. He pays out of pocket. He sleeps in the bath tub while the insurer waits 60 days from initiation. We protect our insurers, their stockholders.

It is now 15 months since the first symptoms.

Sadly,  my friend has a bladder tumor, which at first appears to be non-malignant, but on closer examination is. No problem. These things are radiation sensitive. He goes for radio therapy and 6 weeks after discovery of the primary tumor (and excision) he falls, rushed to the hospital for a much larger spinal (neck) mass which has eaten at his spine. This too is radio-chemo sensitive.

Alas the removal of this tumor unleashes a string of others… and now there is no friend. He is waiting to die.

So, who done it?  I’m not sure that early detection or regular physician visits would have altered this outcome; however in his early 50′s his chances would have been much improved. There is no primary care physician involved, it’s all specialists. As a sub specialist I realize my narrow view screen, my imperfect mirror for my patients; however, I do implore them to find a primary care physician (rapidly becoming a rare specie) to help them navigate the tricky flumes and waterways of our so-called system.

I do know that I have lost a friend. The community has lost a resource, and we are all, in Dunne’s words – ‘send no one to know for whom the bell tolls; it tolls for thee” lesser for this.

As a trained physician I know we all have our time, yet all of us in the healing arts fight death.  I feel that the unseen co-conspirator here was an uncaring, blovinated system. By denying coverage to some we diminish us all.

Whats with Tzars?

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