Spider-web---Medical Care

My plan was to was write about the Ryan Romney Budget and how to explain it to the Citizenry. Instead I got caught in the “go see the doctor routine.” Like an old Model T Ford parts of me continue to wear out. Natural as I slouch to 95. Through much of my adult life I have had Hyper Tension.( High Blood Pressure.) That sent me on regular doctor visits. It was in those I observed that more than one purpose was being served by people going to see “the doctor.” Through questioning people in waiting rooms I began to observe some patterns. (This was in the early days of a New York City Insurance, H.I.P. started by Mayor LaGuardia back in the 1940s. Now of course it includes Medicare and lots of other insurance plans.)

A number of older patients literally had nothing to do this day so they decide to “go see the doctor.” It is often possible to get a conversation going in a medical waiting room as people seem anxious to tell their own medical stories while listening to others. In a sense it’s a medical, can you top this one. What began to strike me was the doctor visits might very well be a “social call” for the lonesome. Many years ago I suggested to New York Hospital that they have a Social Worker in the waiting room area for the patients to talk with. That might have eliminated the need to talk with the doctor.

This “social calling” for want of a better phrase raises difficult issue for the doctors. This is particularly true for those dealing primarily with Medicare people. On any number of occasions in doctors offices I experienced the following. My advanced age often leads to a discussion of Genes. “I’d sure take your genes any-day.” Often a “Blessing goes with it. (Those I tend to bank. As I screw up I give up a blessing but keep track of the ones I still have, Never have found the “bank” empty of Blessings. Hence my long life.) This is what follows.

There is a weird compulsion on the part of doctors to do something for the patient. Soon after WW2 friends who through the GI Bill had become doctors would complain about patients who insisted on a prescription or a specialist referral or something in return for their office visit. Our friend Arnold said he was writing placebo prescriptions, sugar, salt, aspirin anything that made the patient feel like they had a worthwhile trip to the doctor. There have been occasions when I wanted to say to the doctor all you need to tell me is “look for your age all your signs indicate your doing just fine. so keep doing what your doing and I’ll see you in six months.” I have been told, for most patients that simply doesn’t work.

I do believe this social needs of the elderly is at least part of what drives up the Medicare costs. Unnecessary doctor visits plus unnecessary doctor referrals and procedures to satisfy the patients desire “TO DO SOMETHING.” It also feeds the need for the next appointment that assures some social contact. I had hoped that at least some of this problem would have been solved with the advent of the social media. The number of people seeing doctors are overwhelmingly seniors who grew up without IPad, Facebook, Twitter, Linkdin, Meet Me.etc. This is a real problem facing the folks who are trying to rain in the rising costs of medical care. Educating the consumer can help but I believe it’s gonna take a lot more than that like some tough discipline on the doctors part.

As to my attendance at the Doctors. We are waiting for specialist reports. Then we’ll see.