Where did the doctors go?

I don't know if it bothers my children. It’s not something that seems to bother my parents. But I don't understand where my doctor went.

Remember those medical practitioners who did your check-up? When you went to their office they nearly always provided you with one stop shopping. "Take off your shirt and pants the doctor will be right in". The nurse (I do mean Registered Nurse) actually means to say: after you begin to turn blue with hypothermia the doctor will be in. I've stopped complaining, because when the doctor arrived they did an examination. Remember cold stethoscopes, palpitations, prodding and poking? Diagnosis? Each new physician as long as I can remember would discover that my liver is not quite where most people keep theirs. Long ago I learned to wait for them to reach that point below my ribs and then tell them I knew what was concerning them. It had become my personal lie down comedy routine.

I don’t understand where the doctors went.

Today I take a parent to the doctor. We're taken to the exam room by an assistant, it's still chilly, but now we keep our coats on. The exam seems to be primarily talk therapy: how do you feel, have you been taking your meds, are you changing your behavior? I wonder sometimes if we're at a psychologists’ office. No. This is the modern doctor, a provider who spends more time doing data entry than touching. Patient care is determined by tests which are administered off-site. This is one of the joys of modern medicine; art is only used as a defense to explain errors. Medicine is a statistical study. In California doctors are required to examine patients prior to treatment. This is supposed to provide the patient with better care, and it seems to be the most reasonable of arguments until an insurance company or Medicare become involved. Those agencies seem to be the exception. In both cases they are apparently able to determine the appropriate type and duration of treatment without patient contact.

Dad uses a wheel chair (please excuse for being indelicate here) and he has sores on his butt. Medicare and insurance will pay for a pad to prevent the sores, but only if they’re already severe. The doctor has recommended the pad, in the hope of preventing deterioration and infection of Dad’s butt. However insurance only pays for it if his butt becomes worse. Those determinations are made by a person that I'm sure has never even seen my Dad, with his pants on or off.

Do we need to change health care in America?

Of course we do, we need to find the doctors again; physicians who are trained in patient care, who are doctors rather than corporations, doctors who can diagnose and judge, doctors with the desire and ability to make contact with their patients.

My parents are totally opposed to a single payer system, they love Medicare. Sure they’re a little confused, but they grew up in another age. Do we need to change how we get treated? Yes. We need to stop letting statisticians that are doing cost benefit analyses control our treatment.

But first we have to find where the doctors have gone.