Growing up, even into my 20s and 30s, I remember that seeing a doctor was a relatively simple procedure. You would call his (doctors were still mostly male then) office, and a pleasant woman, known as a receptionist, would sign you up for an appointment. The doctor might spend a good hour with you, listening to your heart, tapping your knee (an obscure practice that seems to have gone out of favor) and listening to your complaints.
Many of us might still carry the memory of the 1960s medical TV shows, like Dr. Kildare, the compassionate and knowledgeable doctor who always had time for his patients. But that’s not the way medicine works anymore. I still believe most doctors are compassionate and knowledgeable. But the infrastructure around them has changed. Instead of talking to a reliable and caring receptionist, we get a phone tree that must be navigated in a sometimes futile effort to connect with our doctors.
I recently had the opportunity to wander into this maze of health care. Only persistence helped me find my way out. After I directly received the results of an MRI from the lab technician, and thus were not massaged by the doctor into something more reassuring or user friendly, I Googled the medical phrase and came up with a scary assessment.
I desperately wanted to talk to my neurologist but was unable to make an appointment with him in the foreseeable future (that is less than three months). Instead, I could write him a message on the HMO’s portal. But when I tried that, his name did not come up on the list of “recipients.” When I called the neurology department, I was told I needed to contact the “webmaster,” who, it turned out, knew less than I did and asked for my suggestions for keywords to find a solution. When that didn’t work, I was told to contact the “appointment line,” which didn’t have a clue and sent me back to the neurology department. There, I finally found a sympathetic human being, whose efforts eventually paid off. I was able to have a video visit with my neurologist, who provided reassurances—something I would have been happy to hear two months ago.
Everyone has their own story of trying to get help by pushing the right buttons on their phones. And I know I’m not the only one who’s having trouble getting medical care. One acquaintance with serious heart issues has been unable to see her cardiologist for months or even talk to his assistant. Another acquaintance left the large HMO for some of the same reasons that annoy me. But she’s exchanged one set of frustrations for another. In her new medical network, she spends a lot of time coordinating her and her husband’s care among many different specialists, as well as retrieving their medical tests and results from the HMO for their new doctors. Because her husband has Parkinson’s, coordinating both their care has become a full-time job.
Partly to blame is the pandemic, which caused medical clinics to shut down except for emergency cases. With the gates open again, people are flooding in for problems that may have been brewing for several months. So there’s a natural backlog.
But now that Dr. Kildare and Dr. Casey have been replaced by megalithic, medical systems that prize efficiency above all, I have to resign myself to managing my own medical care, whether it’s figuring out the phone system or Googling my symptoms (and solutions).
For more than a year I’ve had constant eye pain, but test results show no obvious cause for it. In the medical world, the case is closed, so I’ve had to comb through the Internet and get suggestions from friends. All have provided advice and ideas, which I’ve used to press my doctor: Could it be sinuses? Could it be allergies? I still haven’t found the answer.
I recently saw a new doctor about not being able to sleep at night. Instead of listening to my long story about everything I’ve tried, what has worked and what hasn’t, she peppered me with questions from her check list of possible reasons. Maybe because she was squeezed for time, she wanted simple solutions, but from years of suffering from this condition, I knew there weren’t any easy answers.
No wonder so many people seek out alternative healers, who are willing to consider the whole picture rather than bits and pieces (eyes, sinuses, heart rate, weight). Of course, you have to pay out of pocket, but how many of us (who can afford it) are more than willing to shell out good money to someone we can call directly, without going through the armada of gatekeepers? Someone who might actually listen to us.
Love the contrast with Dr. Kildare!
Best wishes with all that Kathy,
My dad was a doctor and I always felt he was Marcus Welby, MD, both at home and with his patients. But then, an ob/gyn is usually much beloved (and if not, don’t tell me). To this day, I expect that from my doctors, if I can just get to them through all the bureaucracy and phone trees. My primary care doctor always acts as though she has nothing better to do than spend time with me, and does for up to 45 minutes at a time. I don’t get as much time from my oncologist (buried in the bureaucracy that is CUHealth) or my opthalmologist, but both always take as much time as needed to cover all the issues and questions. I feel very lucky to have them.
You are lucky to have good doctors. Some of mine try their best, but I think they’re restricted by the massive health care system they work for, and the limits on how much time they can spend with patients.
I sympathize, Kath. The health care system is more system than care, and we must be our own advocates, willing to keep pushing for help even when it’s exhausting to do so. A couple of years ago, after years of insomnia, I went to see a specialist and when I chose not to do an in-hospital sleep study for apnea, he was done. I don’t have sleep apnea. I read part of an interesting book called Why We Sleep written by a specialist at Berkeley, and I got more help out of that small section of reading than I did with the specialist. I eventually came up with my own solution and am getting sleep finally. I love my doctor, but her solution was to prescribe sleeping pills, and this where our own advocacy comes in. I said no. I hope that you can a solution for your insomnia and for the eye pain. I wish you well.
Thanks, Verna. I think most of my health care providers are irritated with me because I won’t use the Cpap machine, which doesn’t help. So, yes, they’re done with me. I’ll check out “Why We Sleep.” Perhaps it has some answers for me. And I’m glad to hear you’re sleeping better.
So true. Medicine feels like prioritizes profits over patients anymore. Sorry about your eye and your insomnia. I can relate to your experience and frustration on conditions that aren’t easy fixes for tradtional doctors. Alternative medicine has helped me in some cases.
Like you, alternative healers have helped me, at least in giving me the broader picture.
This post has drawn plenty of comments, and with excellent reason. You have to be either very rich or very lucky to find a doctor who’s actually willing to spend any time with you. Here’s one trick I’ve learned, though, at least to bypass the maddening and all-too-familiar phone runaround you describe. When I need to get my doctor’s attention, I write him letters: old-fashioned letters in envelopes with stamps (remember those?), addressed to him personally, that I mail to the clinic. This strategy has yielded excellent results, with both my current and former doctors. I suspect that it surprises them into responding.
Only see my PC at the annual well women’s visit. Takes all the time and listens well. I have the option to go every six months after turned 80 but, at the moment, annually is sufficient. If I need to go throughout the year see the PA as rarely could I get an appointment with PC she is booked solid. I am fortunate that I have few health issues but hear from friends tales exactly like you wrote about. My doctor did not elect to do this but other doctors in the practice did, go the concierge route. You pay so much a year to get “more individual care, tests and attention”. This begs the question what are we receiving now?
I really enjoy your blog Kathy, thank you.
Thanks, Rosemary. I’m glad you have a PC that you like. Yes, the concierge route is an interesting idea, but why, as you ask, should we have to pay more (for those who can afford it) for quality care?
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