The Doctor Won’t See You Now

Am I being cynical? I’ll leave that up to you to decide. My point of view may be jaded because I’ve lived through changes that have brought us to what is now called Modern Medicine. It’s true that technology has transformed how people are being cured and that is amazing. However, is that all medicine is about?

When I was growing up, a family doctor was almost a part of the family. He or she looked at you while discussing your health. The doctors knew their patients’ first and last names and if you saw each other while out to eat or shopping for groceries, they would say hello. If you were sick, you got an appointment no later than the next day, and if you were too ill to go to the office, the doctor made a house call. Office visits were approximately $5 and house calls were around $7. Yes, I’m talking about the fifties and sixties and prices have gone up since then, but personal service shouldn’t have been kicked to the curb. Let me give you a couple of personal examples.

I was having some abdominal cramping, so I called and made an appointment with my primary care physician. Their title used to be general practitioner. Six weeks later, I was sitting in his office explaining my issue. I liked this guy. We were the same age and had a similar background. Despite being allotted fifteen minutes per corporate medicine rules, he examined me and referred me to radiology for an ultrasound. Joking, I said I didn’t think I was pregnant, but made the appointment anyway.

Several days after the ultrasound, I received a message in my portal. Phone calls are too time-consuming in today’s world. I was being referred to a vascular surgeon for another ultrasound and a consult. The message offered no further explanation. I was more curious than concerned. It took about a month before my belly was once again being rubbed with cool gel, and a tech was taking more pictures of my insides.

The doctor wasn’t available for my consultation, but his assistant graciously found time to explain my problem. He said I had Triple A, so I replied, “Which is?” Abdominal Aortic Aneurysm was his answer. I said, “Please translate that into English.” Simply put, your aorta has a bubble in it, similar to a bike tire's inner tube. The bubble wasn’t very large at the moment, but I would need to monitor it every six months. That’s what I did for almost three years. I asked if they ever healed themselves and was told they didn’t. Once the bulge got to 5 mm, I would need an operation to correct it. The alternative was to let it burst and bleed out internally. If that happened, I’d be dead within five to ten minutes.

During my next six-month physical, I asked my regular doctor why he didn’t simply tell me about the problem as I’m sure he could read the results. He told me he had to refer me to a specialist because corporate rules dictated he must practice “Defensive Medicine”. My doctor explained that if he were a country doctor and there were no specialists in the area, he would be free to explain the diagnosis to me. Since we have specialists close by, he was bound by corporate policy to pass me along. Doing so relieved him and the corporation of all liability should a mistake happen. Their rules also meant that I had to pay for specialist visits that were more expensive.

Several things happened over the next few years. My original GP developed cancer and died, which forced me to choose a new doctor from a list of people I’d never heard of. The new guy entered the examining room with a laptop in one hand, glancing from me to the screen and back during the first part of our visit. During one of my six-month checkups, he asked if I was still monitoring my Triple-A. I told him no, and explained why.

Most of my checks showed the bulge remained the same size. On my second to last visit, it increased by one millimeter. My last visit showed it decreased to the original size. The tech called in a supervisor to double-check her findings, which the supervisor confirmed. Once again, I asked if these things ever healed themselves and was told no. Neither the doctor nor his assistant was available to explain things to me, so I left. The doctor’s office called the house three times to set up a phone call with him, but I was working, and he never tried again. I also never went back to that practice.

When I explained this to my new GP, he suggested I use their in-house radiology department for a follow-up, which I did. They were the first to find the problem, so it made sense. The tech spent an unusual amount of time going over and over the problem area and finally announced, “I can’t find it. From what I can see, you don’t have any sign of an abdominal aortic aneurysm.” Later in the week, I received a message in my portal from my doctor that indeed my issue was gone. Other than the message, no one has actually talked to me about this. I have a six-month appointment with him next month and we will definitely talk about my disappearing Triple A.

I could go on and on about quirky visits. There was a cardiologist that asked me how my pacemaker was making me feel and was thoroughly confused when I told him I didn’t have one. The point of this long tirade is this: doctors need to return to treating people instead of following the dictates of corporate medicine. Personal contact should be mandatory and not left to emails and text messages. In today’s world, the only way to guarantee quick service is to pay for concierge medicine. The medical field needs to go back to First Do No Harm instead of Protect the Company’s Bottom Line First.