Wednesday, April 13, 2011

The Other Side of the Question

I've been taken to task for the past two posts, perhaps deserved. Any time one has very strong opinions, those opinions should be challenged, and I welcome any opportunity to more clearly state my opinions, even if it's just to be sure that that's how I really believe.

When it comes to corporate medicine, I feel very strongly that we are being cheated - perhaps not by some conspiratorial source, but defintely by a system that is more interested in stopping us from "feeling" than it is in really "curing" any of our illnesses. As I pointed out, the number one killer in the US is heart disease and the top selling prescription drug in the US is Lipitor, a heart medication.

Perhaps that makes sense, but it seems to me if we're being given a very costly drug to fix a problem that there wouldn't be so many people still dying from it.

But that's an aside, and I'm saying it kind of stream-of-consciousness. Don't feel obligated to comment on anything above this sentence ;).

What I do really wish to comment on, however, is the amazing medical care I have received in my lifetime. In 2000, I found that I was pregnant with my fourth child. My first child was born via c-section. My second was VBAC, a term I didn't learn until many, many years after my daughter was born. My third child was born in an Army hospital and delivered by a mid-wife, again VBAC, and again, I didn't learn that term until later.

For this fourth birth experience, I wanted something other than a hospital, but our insurance wouldn't cover a homebirth, and so I hoped to do the next best thing - a birthing center. It was at that point that I discovered more than I ever wanted to know about how the medical world works. In my experience it was the worst "good-old-boy" network I'd ever encountered. In short, due to insurance restrictions, the birthing center could not take me as a client, because the delivery would be a VBAC (pronounced vee-back). It means vaginal birth after c-section, and apparently, that one little thing made me a high risk for delivery, never mind that I had already, successfully delivered two children VBAC. It didn't matter, and the head of the hospital that provided back-up service to the birthing center made it clear that having me there would be a liability to them.

I was devastated, incredibly frustrated, and completely disappointed. I had one appointment with my local OB/GYN, who, when I presented him with my birth plan backed as far away from me as the walls in the exam would allow him to get, and told me, basically, that he would consider my requests, but that, ultimately, he was in charge ... of MY body and MY birth experience.

I decided I didn't like that answer, and I found a new doctor. She was a family doctor in a small practice, who had trained with an Amish midwife in prenatal care and delivery. She was the most amazing doctor, and I loved her. She took me as a patient well into my second-trimester, took me through my pregnancy, and listened to me when I told her that I did not want to be induced, even though I was two weeks beyond the date the calendar said I should have delivered.

When I found that I was pregnant with my fifth child, I was told that my beloved doctor would not be given priveleges at the hospital to deliver my baby there. The hospital chief, who was an OB, decided that it was too much of a risk to have a family doctor, not trained in surgical obstetrics, be the physician in charge of a VBAC - for a woman who was having her FIFTH child, FOURTH VBAC. My wonderful, incredible doctor sent me to an OB with a private practice, whom she believed would have more freedom to listen to my needs. Two visits with him and I knew that he was one of the good-old-boys. He never said as much, but what he did say was, "Why aren't you doing a homebirth?"

So, at the advice of my doctor, Deus Ex Machina and I hired a homebirth midwife to oversee the prenatal care and delivery of our last child. She missed the magic moment, and some how, inspite of the fact that I was a VBAC (for the fourth time), I managed to survive delivering a baby with only the assistance of my amazing husband. In fact, we both survived, and that fifth baby is standing in the dining room playing rock-paper-scissors now as I type this.

There are exceptions to every rule.

Unfortunately, my beloved family doctor moved, and we had to find a new primary care physician. It took a long time to find someone that we liked and trusted would not treat us like we were mindless sheep who needed to be herded in the direction they thought would be best for us, but we did.

We found a private practice. They don't just have doctors, though. There are other, non-traditional health care providers. Their clinic philosophy is one of treating the whole patient rather than just symptoms, and the likelihood of being prescribed a medication just to get you out of the exam room is pretty slim. In fact, the typical initial evaluation is an hour and a half, and not an hour sitting in the cold exam room waiting for the doctor with a nurse or PA occasionally coming into the room with a stethoscope or needle. It's an hour and a half with the physician in the room going over the medical history and discussing any problems or concerns.

So different.

But these guys *can* be different, because they don't take insurance. They don't take insurance, and so they are not limited by what an insurance company will allow them to do for their patients. They charge an hourly rate, which their patients pay at the time of service, and if the patient wishes, he/she can send the claim to the insurance company for reimbursement.

It's a warm and nurturing environment, and I wanted to share this experience, because I wanted to be clear that I don't hate doctors, I just think that by the time most of them finish their training enough that they can enter a private practice, they've become so jaded by the system that they no longer care. It's like the difference between a first year teacher and a tenured classroom veteran.

Our medical system is as broken as our educational system. It got too big and too complicated, and now everything, even the common cold ... even pregnancy ... is treated like an emergency. Nothing is treated anymore by a better diet or more exercise or just being aware of one's body and what one's body is saying. Doctors don't encourage us to listen. Indeed, they don't even give us the benefit of the doubt to know what's going on. They'll tell us. We just need to shut up, sit still, and allow them to do their jobs.

That's not good enough for me. It's my body. I've been in this body for more than forty years, and my body and I have been through a lot together. I know what things make my body feel wonky, and what things make my body feel good, and if I tell the EMT that I need to push when I'm giving birth, he'd better listen, but when he tells me to push, and I know I don't need to, I will (and did) tell him to be patient.

I realize that not everyone is like me, and that's fine. What a boring world it would be if we all were the same.

But I am like me, and I want a doctor who will respect *me*, as an intelligent, well read, and thoughtful human being. I may be wrong, and the doctor can tell me I'm wrong, after he's figured out the right answer, but to automatically assume I'm wrong without having listened to me or done any tests is insulting.

It's possible that the medical profession (doctors, nurses, hospitals, big pharma, etc.) is not in any conspiracy to make us sick so that they can keep getting paid the big bucks, but it has been my long and varied experience that they don't have a great deal of interest in helping me stay well by giving me sound advice and direction. Nope. Slap a bandaid on it. Give me a pill. Do some quick surgery.

That's not good enough for me, and I'm not willing to support a system that is so apathetic to my needs. In my opinion, no one else should be either ... but that's just my opinion.

The very bottom line is that medical care in this country is too expensive and too complicated, and unless we can find some doctors who know how to treat without big fancy machines and expensive medication, we're going to be in some trouble in the not too distant future.

I'm confident that my doctor will be able to treat me, even without drugs and x-ray machines. Are you as confident about yours?


  1. here is what I know: my mother, my father, and both my grandmothers were actively killed by medical interventions. My MIL was actually awake but couldn't move a few months ago (they thought stroke initially) and it turned out to be a horrendous drug they'd prescribed for, get this, restless leg syndrome. Quinine works for her for restless leg syndrome (which is not something I particularly believe needs treated except with lifestyle changes myself) but big pharma got quinine taken off the market because three people had bad reactions to it. Seriously. Ridiculous.

    The something very wrong with medicine is that there is way too much of it.

  2. Just wanted to make sure you don't think I was one of 'em getting my dander up over the last couple posts. That was not my intention.

    I get what your saying, and I agree. On just about every point.

    I also see the other side. Folks who got into medicine because they want to help people. They want to change the world, one person at a time.

    *sigh* I can't wait for TEOTWAWKI, cuz all this is too messed up for my poor little brain. I don't see why we need a pill for every disease, and a disease for every pill. I don't understand why someone would go into a profession that takes so much if they weren't passionate about it. I don't understand why folks head off to the doc for every little ache and pain, wanting relief from symptoms instead of a fix for the real problem.

    I tell ya, life as a hermit sounds better and better every day ;)

  3. Hi - I found your blog, and I love it and have just come across the acronymn TEOTWAWKI, life can't go on as it is, it's not sustainable. Sorry to hear about your birth experiences, midwives are the answer, we need lots of them, lots more of them, when the men turn up they bring a mechanical or medical answer, when women do it themselves they bring soft hands and reassurance, your medical system in corrupt - IMO as it's just about profit, the UK system ain't brilliant as it's about doing as much a possible as cheaply as possible on our taxes, so more and more women have their second and subsequent babies at home, i had both of mine at home, on the living room floor with no medical intervention at all and the midwife stayed for breakfast, i knew her, she lived locally, her kids grew up with my kids locally, they all went to the same school, i hope our medical system stays state funded. It's not good, we have to wait for some treatment, you get what you need and not what you want, sometimes they get it wrong and hospitals are not perfect and they are staffed by people on very low pay but it's not about profit just trying to help the sick and pregnancy is not treated as a sickness here, its a local helping caring service. again, sorry it wasn't good for you but wow, you have a big brood and that's got to be worth it all - love frogal queen xxxxx

  4. Wendy, one of these years one of our families will have to take a vacation and visit the other...I suspect we could talk through the night around a fire, and again the next day about issues we are passionate about.

    Ralph and I feel as strongly as you about the medical system, albeit we have some things different here above the 49th parallel...Still, we need to assert that it is OUR bodies and OUR health... and THAT is a two-sided coin - it means that we don't have to agree with everything a medical professional will tell us, but also, that we need to take responsibility for our health and our wellbeing - something many people don't even give a second thought.

    Keep up the good fight, girl. I respect you for bravely voicing your beliefs, even at the risk of offending some. For the record, you have our support!

  5. Hi
    I'm new to your blog and have to say it is a breath of fresh air. Terrific post, well thought out and insightful. Keep it up :)

  6. I'm going to respond only with an anecdote: a long-ago boss was married to a guy who did sales for Siemens Medical. He referred to the doctors as "M.Deities." Of course, being a salesdude, he had to bow & worship…

    The verification word was "treatric" — I guess Ric has some ailment he's going to the doctor's for!

  7. Coming late to this post thanks to crummy internet... Have you read the book *Complications* by Atul Gawande? He is a MD (surgeon no less) who discusses similar topics from his point of view. Very interesting.

  8. I agree totally about the medical system in this country. We spend the most money in the world....the whole world on health care in this, how come so many people can't afford to see the doctor? I have to pay before I walk through the door to see a doctor at my local clinic. I have been going there my whole life, have never had a bill that was late or unpaid, but, I do not have insurance, and, I am not on the welfare system, so, I have to pay first. Lovely, just lovely, and people thing everything is hunky dory with this? I think at this point that too many people with lots of money are in positions of power, and those of us not on welfare or who can't afford insurance can not....just die, that's all...just die. Simple. Sorry, this is a touchy subject for me and my friends in the same boat.