In my first post, I wrote I would elaborate on some of my experiences with the medical system: including having Medicare as my insurance, state medical assistance, doctor visits, and my medical treatments. I also want to describe my personal history as one diagnosed with uterine cancer, and offer my perspective detailing what a person on a limited income with limited health insurance encounters in the United States. Keep in mind, each state in the US differs in how they execute state medical assistance programs.
Let me describe some of my recent medical experiences.
A few months ago, I requested a switch from a male to female primary (these are generally internists). The clinic I go to…the OU Schusterman clinic in Tulsa; has yet to grant the request. The state informed me I could change my primary as long it was in their network. Even hospitals openly disclose the genders of physicians; so patients may elect whom they feel more comfortable with. I almost feel like my request is being equated to some kind of Freudian complex (… she must be a hypochondriac…). I am more comfortable in disclosing certain information to women, and data indicates women are typically better listeners. In the years I had “regular” insurance, I have always elected women as my primary. No problem. Yet as a poor woman; powerless and desperate– why give a rip she desires a female primary? After all, is she not on state assistance? I may be a bit facetious here, yet there is relevant truth to my remarks.
I once had to assert three times in ONE visit that I do NOT drink to my male primary; who implicitly suggested by repeated questioning I was lying about alcohol! Talk about a lack of rapport and stereotyping! The clinic’s conveyor belt of aching bodies lurches on in a formulated fashion—pivoted along to various departments for an occasional stamp and medicinal poke.
In a previous blog entry written last month; I posted a very interesting article from a doctor discussing complexities of the current medical system. He also wrote about the current trend of medical students electing to go into specialized medicine rather than primary care. However, he asserts as women increasingly enter medicine; a significant number has gone into primary care. Click here if you wish to read this insightful article.
When you are down and out, you become relegated to a different standard. In all fairness, I think a variety of dynamics are at play. The type of insurance you have, whether you are receiving state or federal assistance, and of course, the medical establishment you go to. Where I go to, a revolving door method is utilized regarding primary physicians so their students may be trained. I find this very understandable—students have to be trained somewhere. What I do not find understandable is some of the now expected rudeness I have encountered from employees, the discounting of physical symptoms or side effects from medicines, and the delays in being seen, tested, and treated. On the average, it takes at least 6 to 8 weeks for me to be seen—yet sometimes longer at the clinic. Attempts to get referrals seem to be dissuaded or met with resistance. Whether such facilities are attempting to appease government constraints, practicing bureaucratic protocols, or implementing suggested guidelines to minimize costs—inevitably, it negatively impacts the patient.
Yet, how many times have you read accounts of people having great insurance, going to an established reputable medical institution and getting lousy treatment? As I mentioned before, I think there are a lot of variables at play.
Specialized medicine has good points as well as bad points. I will use myself as an example to this. Recently I developed a lot of pain manifesting at various places in my body. I expressed this concern to one of the internists (essentially what I thought was my new female primary). She suggested seeing my endocrinologist about it. A month before that, my neurosurgeon who a performed a craniotomy upon me in January 2009, suggested I see my primary about it. I called for the primary (who I thought was my primary at the time—turns out she was not) and requested to be seen as the pain was increasing. After 8 days of receiving no call back from the clinic, I called my oncologist to request blood work and expressed my concerns. He informed me through his nurse that this was my primary’s duty. And so the merry-go-round goes. Eventually the oncologist’s nurse had to call somewhere in the clinic, and a different internist (a male) met with me a week later. I had to make a follow up to discuss the blood work–it will be six weeks after the lab when this occurs. Not very comforting to someone who recently had an endocrinologist suggest I might be dealing with thyroid cancer. He saw me early December and has yet to get back with me along with my regular endocrinologist. If this was a true concern, why the delay and no return of my phone calls? He suggested surgery, as he felt it was “a big mess”. No, this merry-go-round is “a bigger mess”. Who wants people who could care less operating on you? And besides, if he really felt cancer was at play, why have I not heard anything from them?
Anyway, these are some of the issues I will be writing about in the future. I guess I am inclined to take on a sociological perspective, as well as a personal one. Yet as I wrote in a previous entry, I have met some caring doctors. Perhaps there is hope out there.
