Do you remember this song?
http://www.youtube.com/watch?v=JPR108kwNo4
“Where Have All The Cowboys Gone?” By Paula Cole. That is a blast from the past!
I pose this question? After twenty years on this journey with this ‘condition’, fibromyalgia/ Chronic Fatigue Syndrome, where have all the good, caring Doctors gone?
Of course we see “Greys Anatomy” on television and all want the renegades. We want the “McDreamys” and the “Greys”….. the Doctors with tireless vigor and passion who went to medical school because of their unquenchable thirst for medicine, not because they lust for the almighty dollar.
When I was a little girl my Doctor, Dr. Ray Owens, North Of The River, in Bakersfield (Oildale), California, was the same Doctor that delivered me, cared for my Mom throughout her pregnancy and cared for my Mom from the time she came to Bakersfield at the age of six years old. Dr. Owens never changed. He had silver hair, however, his face was not that of an old man. His silver hair was always in a military ‘buzz cut’ and he wore one of those old time scopes on his head with the light on it Doctors of old used to wear. He would always greet me with a firm but affectionate grasp of my face and plant a firm kiss on my forehead. This was well before the days Doctors could get a law suit for doing ‘such a thing’. He cared. He was the first human being to literally touch me. I was a bit sluggish when I came out, according to my Mom, and Dr. Owens spanked my bottom and got me wailing. So he also gave me a wallop, 😉 something also now that could be seen as ‘politically incorrect’ I suppose. I am glad he did, for if it were not for that first ‘spanking’, I could have been in trouble! He nursed every case of tonsillitis I had (at least twice a year) and the only ‘specialist’ I was ever referred out to was the Ears/Nose/Throat surgeon that finally removed those pesky tonsils of mine, Easter break, when I was in fifth grade. Of course our parents did that to all of us kids so we would not have to miss school. As a parent I now understand the thinking, as a child, I saw it as my Easter vacation being ruined. Dr. Owens splinted my pinky finger when I broke it (twice), bandaged me, soothed me and literally saw me through every illness, bump, bruise and sprain until my High School physical when I was fourteen years old. I have had a few come close; one Physicians Assistant almost dead on (M. Collette Carver formerly of Parkway Physicians in Vinton, VA and has now moved to the east coast of VA 🙁 ). However, no Doctor I have seen has ever been able to completely fill those shoes. They simply, do not exist anymore. If they do exist, they are very rare and I certainly have not come across any such Doctors.
Why the change in the way Doctors conduct their practice? I have some theories:
- HMO’S: There are good things and bad things about HMO’s and PPO’s. It is nice to have a set co-pay for your Doctor visit with no hidden surprises. Though many things such as CAT Scans and MRI’S have to get prior authorization, I can attest to the fact that when it is a life or death situation, that all goes out the window. I went to Lewis Gale Emergency Room on July 1, 2011 with severe abdominal pain. I had to wait a few hours, but once in back and CAT scanned, they hit the ground running. I was CAT scanned at just after 3 AM on July 2nd and in an OR by 5 AM with a perforated intestine due to a bad duodenal ulcer where my bypassed intestine was connected to my pouch. They tell post RNY patients not to take NSAIDS for a reason. I found out the hard way. I was in ICU for three days with an NG tube for five days (the most miserable thing I have ever had in my life) and hospital for a week. The bill? $80,000. But the now retired Dr. Reif Kessler saved my life and I appreciate ever nurse, NA, orderly and volunteer that assisted me. These men and women are truly in their field as a labor of love. HMO’s/ PPO’s however, have greatly limited Doctors. There are so many restrictions and rules that they must abide by, it makes it difficult, if not impossible, for them to step or even think outside the box. It is my opinion that for this reason, it is easier to maintain a very business like relationship with their patients.
- The “God Syndrome”: I think everyone has seen more than their fair share of Doctors that have “The God Syndrome”. I also call it the “Shut up and listen”; “What you are saying is irrelevant”; “You did not go to medical school, so what could you possibly know?…. Even though you have lived in your body _____ years and know it better than anyone.”; “I don’t care to hear what you think.” and the ‘rush in… listen as …as then can *breathe real fast*…. write a rx… and I am outta here to the next room in five mins*. Do any or all of these ring any bells or hit any nerves? Sadly, such as in my case with a few of my Doctors I have seen along the way. Some I refuse to ever see again and others, I am sorta ‘stuck’ with them. Now, I have a LOT of Doctors and I am NOT naming names. Some are GOOD, some totally have the God syndrome, some fall somewhere in between and some, God bless them, I believe do their best but are just so overwhelmed.
- Specialties: Our insurance has a lower copay for seeing a primary provider than a ‘specialist’. The problem today, unlike when I was a child and save for my tonsil surgery, Dr. Owens was a ‘one stop shop’, most every medical condition requires you see a ‘specialist’. For my Hashimotos Disease it is a Endocrinologist (though my newest primary care has agreed to take over my thyroid care, THANK YOU!), a Pain Management for the management of your pain in fibromyalgia and a surgeon for the tangible problems of the neck that are going to require ACDF surgery at some point in the near future. Then there is the gynecologist for the ‘yearly’ though he does do surgery as he did my ‘partial’ a few years ago. There is a specialist for everything; for us, requiring a $50 copay at each visit! Back in the day one Doctor did all these things unless you were very sick. Going to a ‘specialist’ back when I was young meant serious business. If you have psychological help, you even see a counselor and a psychiatrist: one to ‘listen’, one to treat you for your medications. You see so many Doctors today, if you have health issues, it is difficult to form a bond with many of them. They see so many patients, they know you but are so frazzled, they cannot form that bond we long for when we pine for those Doctors we see championing for their patients on “Grey’s Anatomy”.
- Legal Issues: Today in a “Law Suit Happy” society, Doctors walk on the never ending path of “medical egg shells”. In a society where you can sue a fast food company for having hot coffee, lawyers are just as money hungry in many instances and pounce on the opportunity to get the almighty buck. Doctors tread lightly. Many are afraid to “push the envelope” for fear of a malpractice suit. I know myself for every scan, test and poke I have, it seems I have to sign and initial a series of pages as if I were buying a major appliance. Just days ago my knees needed x-rayed to check how advanced the arthritis in them has become. I had to sign in two places and initial twice for x-rays that took five minutes. Most of the time we do not even know what we are signing. I can see both sides here: I feel bad for the rare Doctor who wants to have the freedom to practice medicine the way he/she sees fit. However, people that have had a slew of mishaps like we have with our dentist here in Roanoke and are truly looking into seeking legal action have their side. I think here it is a happy medium situation. We definitely have a law suit happy society but we also have Doctors that are frozen in their tracks, afraid to try anything new innovative.
I see a lot of Doctors. I have a *wonderful* gynecologist and he is probably closest to the “Dr Owens” of my childhood that any of my Doctors have come. M. Collette Carver LNP is a jewel! I am so very sad we lost her here in the Roanoke Valley but cannot fault her wanting to move to the coast. I would if I could! If you know me well, you know I am quite vocal about most of my regular Doctors. I have ‘issues’ with some but for the most part have the best of what I can get in the area. I feel ‘over-talked’ and rushed. I feel my fibromyalgia is being ‘managed’ but do not feel my Doctor GETS IT when I say there is just no money at the end of the month for warm pool or other alternate therapies. I would love to go into the warm pool…. trust me…. however, the food bill, gas bill, electric bill, Doctor bills, Copays, and other bills (no credit cards!) come first and there is just nothing left. Is that difficult for a six figure earning Doctor of Medicine to understand? Maybe. However, unless he/she was on a full ride in medical school surely they can think back to a time, long, long ago, in a land far away called “Pre-Med” and “Medical” school when beans and ramen noodles were substance and money was as scarce as fairies. What do you do? If you are in an area with limited numbers in a certain specialty and if you are in a comfort zone with your treatment, there is little you can do unless you want to travel to UVA, two hours north or Duke/Chapel Hill, two hours south. As a footnote, the average Doctor in Roanoke, VA earns $156,423.00 a year.
http://swz.salary.com/salarywizard/Physician-Generalist-Salary-Details-Roanoke-VA.aspx
Now I am not naming names, nor will I. However, I hope enough Doctors might see this and just think. We appreciate you! We do! However, we want to be treated like people with 1/2 a brain and people that know what we can and cannot do either by limitations of our own physical capabilities or our own finances. I recently procured a new Rheumatologist. I did this for a second opinion and to get answers as to why my hands are ‘pins and needles’ numb all the time and as to why I have been taking falls since about November. Bear in mind, I picked this person after careful studying and ratings research. I was quite happy with my choice. His picture showed that he had ‘kind eyes’. He was ‘nice enough’ but he looked at me like I had two heads. “Exactly why are you here?”, I said, “To get answers.”…. long pause….. “Well if Dr ______ is ready to proceed with the ACDF surgery……”. I have reasons for waiting. Most are quite personal. I will say, however, only ONE Doctor in this area of about 300,000 and two teaching hospitals will take my neck surgery. I am very happy with the surgeon, his expertise and his bedside manner so waiting has nothing to do with him. I explained and it made a little more sense. His take: the severe stenosis I have. WOW! I researched it.
http://www.webmd.com/a-to-z-guides/cervical-spinal-stenosis-topic-overview
Indeed cervical stenosis can and does cause the constant numbness I now live with and the falls I have been taking (jello leg) on a fairly regular basis. Why couldn’t the first Doctor have just answered that for me. It was all right there in front of him in the CAT Scan and MRI reports. He did not have the time and barked, “Get in the hot pool!”, “I think it is arthritis!”
I think what these Doctors do not understand is simple: We are NOT looking for another pill. We do not expect them to wave their magic stethoscope and ‘make it all better’. We, as intelligent human beings, do want answers. I have numb hands 24 hours a day, 7 days a week. Why? This is not normal. A middle aged woman should not be averaging three to five falls a month. That is not right. I know nothing short of intense therapy and/or surgery is going to ‘fix it’, however, at least knowing why these things are happening help to some degree.
Where have all the Doctors gone? Probably Los Angeles, San Francisco, New York, Miami, etc. I have many friends in chronic pain groups online and the ones who have found ‘gems’ or ‘diamonds in the rough’ have all done so after much hunting. It is safe to assume the best of the best can afford to go to the most influential and popular locations. Also the ‘best of the best’ are human. They are going to follow the money. I would, no matter how passionate I felt about my work.
If you watch NONE of the other videos I put on, you must watch this one. For USA people who do not know who this is, Robbie Williams is very big in the UK and also is the original singer and co-writer of the song, “Angels” which has been covered numerous times. I about did a spit-take (won’t say when) when he says, “But not St Johns Wort, cuz I can get that at Boooooots.” Boots is the UK’s equivalent to CVS/ Walgreens, etc. Thank you Robbie Williams for including nicotine as a drug, because it is! A very addictive drug! I found this video by accident but had to include it because it is just too FUNNY!. Enjoy! Until next time, K.
http://www.youtube.com/watch?v=EH1VaQ0MAtU