My friend Ted Czukor sent me this essay and I am pleased to pass it on to you:
WHO GETS HELP AND WHO DOESN’T?
By Ted CzukorI’d like to take a poll of all readers over the age of 30. How many of you think that life is going to unfold the way you had envisioned? It certainly hasn’t been like that for me! I’m 65 now, and on the one hand I’ve had some wonderful experiences that I never could have predicted, while on the other hand some experiences have been the sheerest crap; but very seldom in my life has my planning brought about the exact result to which I had looked forward.
One of the more disturbing surprises I’ve had recently is that finally getting Medicare health insurance is not necessarily a guarantee of receiving proper medical attention—because healthcare providers are sometimes slow to order medical tests. I say “sometimes” because it’s a very mixed bag. Sometimes our doctor may send us immediately to the lab for something that he feels is necessary, but other times we may have to come back to his office for multiple appointments over several months with the same persistent complaint before he will decide that the quickly-written prescription isn’t doing anything, and we really do need to have a tube stuck down our throat or a picture taken of our brain or joints to see what the hell is actually going on.
It’s hard to predict when our doctors will jump on a test immediately or delay one for several months—but it seems clear from the national discussion on TV that some tests are being delayed due to concerns about cost. Our healthcare system is losing money, and some patients are guilty of what the insurance industry calls “over-utilization of services”—which makes it damned hard on those of us who legitimately need the testing.
On the Today Show on Wednesday morning, August 28th 2012, Dr. Nancy Snyderman actually suggested that any medical test will come up with something treatable, so therefore people in their 90′s should hold off on such tests so that younger people with longer-expected life spans can benefit from the treatments instead! We like and respect Dr. Nancy, and we never expected her to take such a cold-blooded stance on the subject. It sounds logical and fiscally responsible on the surface, but how low on the age scale should we set the cutoff point? Age 80? 70? What about people over the age of 60? Shouldn’t other factors besides age be considered in such a decision?
Such a stance is easy to support, so long as the older people in question are generic groups whom you have never met. But when that older person is suddenly a personal friend or a member of your own family—or when, God forbid, it’s actually you—then you will probably take a second look and decide that in this case, at least, an exception should be made!
Another unexpected and recent surprise has been that we have to do our own diagnosing. More accurately, we have to research our symptoms on the Internet and take our questions about possible causes to our doctor, to get him to look into them and determine whether we are barking up the wrong tree—or not. Only our doctors and their labs can diagnose for certain, but we have to tell them what to look for! This is doubtless due to the overwhelming number of patients they see every day, with the result that even the most conscientious physician can only pay full attention to the patient who is right in front of him. As soon as that patient has left and a new one has come in, the first one better receive proper follow-up from the doctor’s staff, because the doctor himself will have forgotten about him until their next scheduled appointment.
In the last three years my wife and I have been successfully treated for degenerated hips and shoulders, melanoma and allergic reactions to various medications—but in every case we were the ones who had to self-diagnose the condition and then go to the proper specialist to have it verified! Until we did that, we were simply given prescriptions for pain or infection in an attempt to mask symptoms. It was never suggested that surgery might be needed, or that a medication should be discontinued because it might be messing us up. Suggestions of that nature had to be put forward by us.
I have two reasons for writing this essay and sharing it with others. For those in the medical profession, I want you to know that educated patients understand your dilemmas concerning healthcare costs and the limited time you are allowed to spend with each of us—but we insist that attention be paid to us as individuals, rather than as generic members of a certain age group. For my contemporaries who are experiencing the same frustrations that I am, I want to encourage you to Keep Doing Your Searches on WebMD, and Keep Asking Questions. Don’t take a doctor’s “I don’t know” for an answer. Get your facts lined up, and insist on getting tested for anything that alarms you and that your doctor isn’t completely sure doesn’t need a test.
For those of you who aren’t wealthy and are under 65 without health insurance, I empathize. I went without insurance for two years before finally making it to Medicare age. The best advice I can give is to do whatever you feel is necessary to maintain your functionality, until you can finally get coverage to see doctors again. The trick is to just stay alive. But remember that getting the insurance won’t be enough. You will have to be an active advocate for your own health and for the health of your spouse and parents.
