Monday, October 19, 2009

what happened?

Friday I got a notice from my gastroenterologist to remind me that one of those "procedures' is due. In order to get the whole thing rolling, I was to contact the office voice mail, leave my name addy and DOB. Eventually they will send me a packet of information and someone very soon after that (oh boy ohboy) will contact me and set up the date. The letter, which was dated October 6th, arrived on the 16th. Only ten days. Not bad, for a town 20 miles away.

In all of this I will apparently have no contact with anyone involved for any reason at all until they call me, and no contact whatsoever with anyone physically until the driveby surgery, where the Gastro guy comes by says hi, I'm your surgeon, and twenty minutes later Im wheeled out of the operating room, jiggled awake, bundled into the car, and sent home. This is not what I call a fuzzy warm moment.

I had a regular physician type doctor for ten years or more, never met him. I did all my doctor stuff with his PA, and she has been around for so long on many papers she is referred to as MD. Two years ago the doctor I have never met left the practice, (I found out through a third party), and a new doctor has taken his place. I still havent met him, and I still work with the same PA.

At least I see the dentist face to face.

When did doctors start doing this? Im not sure I like it, but it does pave the way for robotics in the future, when you never seen any live folks at all, just robotic arms and scalpels and hypodermics. Press one for yes and two for no. Leave your name, number and DOB at the sound of the beep and one of our AI assistants will contact you.


  1. I see a Nurse Practioner, Occasionally I see a DR, but most of the time a NP. She sewed my thumb up 3 weeks ago, she writes prescriptions for me, but every 4 months I see a real DR. What disgusts me is it costs the same whether I see the DR or the NP. This started about 10 years ago here in Missouri. In all truthfulness, they seem to do me about as much good as the DR.

  2. The dehumanization of medicine began with the superspecialization first encouraged in the 70s and afterwards become a plague. You can make more money as a procedureologist than a diagnostician, when a good diagnostician has always been the gold standard for quality of medicine. This involves a personal relationship with the sufferer, or "patient."

    Some PAs I have supervised are actually better than some doctors. This is well-known but we live in a sheepskin society.

    My suggestion? Make all residencies concentrate on primary care for two years; graduate those who choose primary care, let the wannabe specialists toil another three or four years.

    PAs are great as long as they are supervised by better doctors--though it's proven that they spend much more on lab and X-rays in their practices, confirming their fears of ignorance--when doctors perhaps know 5-10% more but empathy and attentiveness generally triumph over knowledge.

    Usually, if not incompetent, a doctor's quality is inversely proportional to the amount of tests he orders to confirm his hypothesis.

    Obviously I'm from the old school. And can you believe I made a new blog post a few days ago on Leonard Cohen and the Global Economy? I've been slacking, thanks for listing me as a link.



  3. actually i get more feedback from the PA, on a personal basis, than I ever did when I actually saw an MD. Most of the time they never looked up from the chart except to make sure I was still there.
    With the PA we are more equally balanced, and I can actually talk to her without feeling that I am, as my mother used to put it, "wasting the doctor's time".

    The one good thing about that is, I no longer depend utterly on the doctor for advice. Being relatively intelligent, if I find a med. doesnt suit me, she and I work to find one that does. I know too many women my age who are still in the Doctor as God mode, and will take a medication that is turning them into blankets of goo, but it must be okay, because the doctor said it was...sigh.

    I know it's whistling at the moon, but I do long for the days when doctors made housecalls, and kept office hours so that you could deal with someone who knew you, rather than heading out to the emergency room and being at the mercy of whichever doctor is on call at that moment.

    yes, I saw your new post and am still digesting it. I check every day.

    Harvey, I feel about the same way you do. Since I never did get to see my 'regular' doctor in ten years, I find that what the PA and I work on together suits me just fine.