Patient or Widget? One Person’s Experience with Today’s Healthcare System
When was your last visit to your Primary Care Provider (PCP) or specialist? Mine including an emergency room visit occurred within the past two months. How much time did the medical provider spend with you face-to-face versus having their face in a computer taking notes?
Twenty three years ago, when I had my accident, I recalled both my primary care and specialist spending from 30 minutes to an hour with me. I felt seen and heard, and the medical staff communicated with one another. Yes, the specialist, PCP or nurse practitioner took notes, yet I felt I was a person, not a widget on an assembly line.
Now I’m greeted by a person who takes my weight and blood pressure, followed by a physican’s assistant (PA) and possibly a nurse practitioner (NP) who will spend 15 minutes with me while looking over a laptop as they type in the information. I’m offered medication that is contradictory to my medical history or told to take another blood test or imaging test.
Now I want to make it clear I have patients who are PAs, NPs and medical doctors (MDs). I know the extensive training of both PAs and NPs, and what they need to do to hold these titles. I have respect for both.
However, when you have a medical history as I have, I do not believe they have the training or experience of a medical doctor, and even some of the medical doctors do not have the training to understand and treat brain injury and contradiction of medications related to brain injury.
In my earlier post Beware of Medication That Can Affect Your Brain I mentioned going to an emergency room and being there for three hours, only to have the MD spend 15 minutes with me and tell me I had a rash (which was obvious) and to take a steroid, Predisone. I then pointed out my history of brain injury and he agreed I shouldn’t be taking that medication.
In April, I had severe pain in my side. I was seen by a PA for 15 minutes and was told to take Vicodin. Once again, I pointed out my medical history, and upon viewing it she agreed I should not have this medication.
Recently I had my yearly cardiology examination. I’m fine, yet I have a family history and there was some injury to my heart during my accident in 1990. So, since then I have a yearly visit. On this visit, my blood pressure and weight was done by an assistant. I sat in a waiting room for twenty minutes. Then I was escorted into a room where my cardiologist, who I respect and like, asked how my year was going while I gave a laundry list of stressful situations including the fear of my brain tumor growing and possible brain surgery. I said other than that I was feeling fine. He looked over his laptop and continued to type. He listened to my heart and chest. He never listened to my carotid arteries nor did he do an EKG. The appointment lasted 15 minutes. I was told I was fine and to come back in a year.
The next day I realized he hadn’t listened to the carotid arteries or the EKG. I phoned the office and was told, I had an EKG in April. I’m fine and as for the listening to my carotids this can be done when I see my PCP at the end of July. I felt like a widget again.
Yesterday, a plumber was working in the patient bathroom. He stated he had a bad migraine. I went over his symptoms with him, suggested Feverfew for his migraines and also magnesium. It had been extremely hot and he’d been sweating a lot. I then took the time to show him why Feverfew works for migraines and showed him Chapter 8 in my book, Coping with Concussion and Mild Traumatic Brain Injury.
We went over the list of foods that could possibly affect his migraines. He was shocked because he had eaten many of them. I suggested trying an elimination diet for 1to 2 weeks, then adding one food back each day to see what foods might be contributing to his migraine headaches.
He made a point to me that I had spent more time listening to his needs, educating him and helping him out than any of the medical doctors he has seen in years. He said that he has complained about his headaches and does not want to take medications because of side effects, and he wanted to be educated to know how to prevent them. He said I had done this for him.
If he had been my patient, I would have done the same things, except I would have done a more thorough history check based on my 5 Prong Approach. I strongly believe what I do should be the norm for all people, not only for people who pay for concierge medicine, which I see nothing wrong with, yet why can’t a person with a brain injury get more than 15 minutes if we need it.
In the Boston Globe August 8, 2013, Alex Beam, wrote, “I’m paying about $10,000 a year for a family health plan, and like most Americans, I see my doctor about twice a year. My insurance company can’t keep decent doctors around for me to consult with? What’s going on here?”
In my previous post, A Call for Better Healthcare, I reference my 1996 healthcare proposal. I strongly believe that every individual is entitled to quality healthcare and that if a person only needs 15 minutes, fine. However, when you have a complicated history as I do, and medication directly affects your condition and the other 2 million people with brain injury, we are entitled to more than 15 minutes by a PA, NP or MD. We need someone who understands brain injury and has had the training. We need compassion and an understanding of what medication we can and can’t take.
Only when all the various sides of brain injury, be it individuals with acquired (autism, stroke, MS, Parkinson Disease) or traumatic brain injury, unite as a single voice are we ever going to obtain the proper medical training and treatment we deserve to regain our lives.