Essaying the Situation
Thursday, July 14, 2005
Medicine in the Hot Seat
    The good news is, Mom got bounced by yet another physician due to my efforts. Good news? Yeah. I now figure if a physician cannot work with me and resents my efforts to make sure professional health care is appropriate to my mother and worth her insurance doling out money to pay for it, the physician's acknowledgment of this by dismissing my mother as a patient is good news.
    I received the letter today. I didn't expect it. I'd e'd a friend a few days ago, immediately after I Fed-Fedexed my letter, that considering my mother's history with the clinic and all its personnel, the overall productive relationship we've had with everyone except this particular doctor and since this doctor was new, it was our first visit and things could change, I was sure she wouldn't get bounced. Today, though, when I saw the envelope from the doctor that required my signature as recipient, I knew before opening it what it contained and I was relieved. I'd been thinking, over the last few days after having Fedexed my letter of review of the bad appointment on June 23rd, that it might not be a good idea for me to try to work with this doctor. This doctor is a close version of the last doctor who dismissed my mother because of me. One of the bones of contention during the appointment was, as before, scoping.
    Within less then two hours of having received my mother's dismissal we were back with her former PCP who'd left the clinic in November. At that time, in part because the other clinic was so vague about where her former PCP had gone and in part because I trusted the doctor who owned this clinic, I thought it would be best to stay there instead of trying to find her former PCP. I thought this would guarantee continuity of care because her records were there and the owner of the clinic would likely hire personnel who closely matched, in quality and outlook, himself and colleagues who'd gone before. After having our first Post-Former-PCP appointment with The Wondrous FNP I thought I was right. Now I think The Wondrous FNP may have been a fluke; a good fluke for us. The new physician is also a fluke; a bad fluke for us.
    I was up front with my mother's former, now current, PCP's assistant about what had happened; that is, why we'd stayed with his former clinic after he left and why my mother was bounced. I wasn't sure how he would react, since this physician saw us through the first physician dismissal, as well. I reflected, though, that he and I worked hard to develop a productive relationship on behalf of my mother that dignified her Ancienthood and her desires for her own health care. I decided it was worth the risk of the possibility that we may not be accepted. I even suggested to the person who answered the phone that the doctor may want to be asked whether he wanted to reaccept my mother as his patient and be told why I had finally sought out his office.

    I'm going to publish the letter I sent to Shiny New Doctor [heretofore to be referred to as SND]. Some of you may think it rough, tactless. Those of you who are regular readers, though, know from the publication of previous letters written to medical personnel that I can be tactful, complimentary, even effusively complimentary when it is deserved. This letter contains all these elements. I'm publishing it because I want others who may be experiencing similar circumstances with the non-alternative medical system on behalf of their charges to take courage from what I said. Depending on the physician, doing the same may get your care recipient dismissed, but that is not the worst that can happen; that contingency is a relatively easy deal.
    Either way, it is important, and becoming urgent, that patients who manage their own care and caregivers who manage the care of others come forward and speak out, directly, to those medical personnel who need to be corrected. The medical industrial complex is, as a whole, resistant, and, I think, running scared and apt to become even more resistant before patients and patient advocates arise en masse and say, "You exist for us before we exist for you." It appears to be trying very hard (although not necessarily successfully) to use American medical schools to flood the market with young physicians who are not only patient and advocate resistant but don't believe they can work with patients and medical advocates who don't lay down and play "Yes Doctor". I think the medical industrial complex is hoping that if it can graduate a tidal wave of physicians who have been indoctrinated to believe that it is best not to let the patient get in the way of all the latest gadgets and pills and tests and procedures and structures that non-alternative medicine is trying hard to install, medicine can revive The Era of The Physician As God and Healing as Sacred. It's too late, guys. The gig is up. Thus, I think, someone needs to record her trials and her tribulations with the current U.S. medical industrial complex in order to highlight exactly what medicine is trying to resist.
    The importance of making my record public is that, unlike spectacular cases involving rare diseases or horrifically expensive medical treatments that are refused to those who need them, the cases out of which movies are made, nothing about my mother's and my involvement with the medical system is unusual. This is all standard stuff: Ancient woman aging much like millions of other Ancients age; caregiver who is trying hard, in the face of everyday medical odds, to make sure medicine doesn't refuse to respect her mother's wishes and dignity and doesn't run roughshod over her mother's final years in the name of medical advancement in gerontology, just like millions of other caregivers. This is the kind of every day medical stuff people discuss offhand in their coffee klatches, over bridge or mah jong, at their book clubs. Medicine isn't going to change on behalf of the rare and the economically unfair. Medicine will only change when those clients in medical offices struggling to get information and have their opinions weighed in 15 minutes with physicians who are anxious to get on to the next fee or refer to yet another specialist in order to enhance their professional networks speak out about their experiences and their frustration; speak out to their physicians and their society, as well as their friends.
    My letter appears in the post immediately previous exactly as it was sent except for a few corrections of spelling errors and removal of names.
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