Then, just as you are fully engrossed in learning about the prospects for the Mets in the coming 2002 season, a nurse flings open an unmarked door, bellows your name and briskly leads you to a very public hallway scale where you are weighed, despite the fact that you are fully clothed, are carrying a coat and toting either a purse or a laptop; nurse clucking and scowling ensue. Then, you are taken to a small, chilly room, your blood pressure taken (more clucking and scowling) asked to disrobe, don a paper gown, not to be confused with anything Halston would design, and told, “The doctor will be right in”. This is the medical equivalent of the phrase, “Of course I will respect you in the morning.”
You spend enough time alone in this chilly room, in your non-insulated paper gown to discover and read more not-too-recently issued magazines–usually vintage 2003 to 2006 — and to have various parts of your body react to the chill; depending on your gender, either perkiness or shrinkage.
Then, just as you are absorbed in an investigative Newsweek report about Dick Cheney accidentally shooting a fellow quail hunter in the face, the doctor comes in, looking confident but somewhat harried. There is brief small talk, a question or two, a quick look down your throat and into your ears and tah-dah, you’re done. “What, what, wait; I forgot to ask about that burning sensation when I pee.” Too late. You peek out the door, one way then the other, clutching the paper gown so as to keep your dignity, but the doctor is gone and, in that gown, there never was any dignity.
The nurse returns and tells you that the burning sensation is “very common in people your age” and to try “cutting out spicy food.” The total time at the doctor’s office, two hours and twenty minutes; portion of that time with the doctor, twelve minutes.
One critical way to change aging for the better is to radically alter the way in which doctors are compensated so that your visit is a real doctor-patient interaction, not an assembly-line model of efficiency. And besides, I already know how the Mets did in 2002.
Actually it is very hard to sue a doctor; you have to get other doc to testify that he or she didn’t follow procedures. Doctors have little accountability.
One problem is that we are hyped on the benefits of annual checkups. In my city doctors are so busy with checkups on well people they refer anyone with symptoms to the ER or an Urgent Care clinic of dubious quality. I don’t do checkups so some doctors refuse to see me.
As for getting weighed, I regularly refuse because BMI is not an indicator of health in the absence of other conditions. I also refuse blood pressure checks if I’ve been sitting in a waiting room. My normal bp is something like 120/78…but not when I’ve been waiting with a noisy television set.
I’ve found that you can get past the system if you’re willing to take strong action and often that means using four-letter words. It works.
the wait in the waiting room can be very long these days and sometimes there are no magazines…bring your own and the wait in the little room can be equally long. no one tells you anything unless you ask. i don’t even get to pretend there is a real examination with those horrible little robes. i don’t think they want to spend the money. actually, i don’t think this treatment is reserved for us old people and i think we all should be quite vocal about it to everyone within earshot. some of us old people have gotten over being shy about expressing our opinions…so they think i’m a grumpy, crazy old woman…they know i’m right!
i love my dentist. they have interesting magazines, but i never have a chance to look at them or to sit and stare at the walls. only once were they a few minutes behind schedule and three people apologized and while one is waiting for the numbness to set in, we get to watch the birds and squirrels at the feeders right outside the window.
Yes, indeed this is the experience of the medical system. No doubt funding issues have a lot to do with this, but I believe it has also to do with the hierarchical system where the doctor, as god, swans in, does his thing while his minions clean up after him. Indeed some of these “minions” are the ones who actually give you the real and practical advice. Specialists in hospitals particularly are never part of the team and beholden to no one. The other problem is that relationships are not part of medical care. If a doctor cuts off the wrong leg, he can be sued. If he disregards you, cuts at your spirit, he can never be sued!
It’s bad enough for us young-old, but recently I was talking to a 95 year old, for whom the multiple visits and engagement with the medical system is just adding to the many stresses she has with a sick husband.
Good stuff, Bruce, but I have to say that this isn’t only an aging issue. We’ve all been subjected to this “treatment” ever since we were old enough to be in the examining room without Mom. However, I do agree with your larger point about time with the doctor.