When I was a teenager, I was hospitalized for anorexia. I remember, as if in a fog, the 6 weeks of so-called 'treatment'. My treatment mostly consisted of a psychiatrist who could not seem to get it out of his head that I was abused by someone I wasn't abused by. Mostly, it consisted of being watched while eating and threatened if I didn't. I remember being watched continually, strange group therapy sessions, and being moved down to 'level 1' because I would not participate in a movie discussion. When I knew my insurance was done paying, I told the nurse the night before that I would rather die than end up in another mental hospital. She reported me as being suicidal. I called my parents and told them what happened. The psychiatrists could use this so-called suicidal ideation to get an extension through my parent's insurance company. But, my parents knew this place was not helping me. They actually listened. After the hospital, I did not get better right away but was able to find some alternative types of therapy that actually started to help a little. These mental hospital experiences gave me a lifetime mistrust of doctors and helping professionals in general. At 16, I could see that the so-called treatment I was getting was really not based on who I was and offered me little in healing my underlying issues.
When I was 19, my foot was ruined by a podiatrist who insisted I needed bunion surgery when I had little pain, just some bunion deformity. For many years after the surgery, I struggled with pain. I could no longer run and it was difficult to cross country ski.(2 things that I had loved for years) As the years went on, I became unable to dance, another love of mine. Finally, I was told that the initial surgeon set the bone wrong. 20 years later, I had another bunion surgery to re-set the bone with the promise it would take away my chronic pain. It didn't work. I was told recently that having 2 surgeries on that joint have actually exacerbated pain in my other toe joints. When my other big toe gradually became extremely painful, I was told by a doctor to wear Birkenstocks for a year and it would cure the pain. Two years later, I was told the joint was so deteriorated by arthritis that the only option was joint fusion.(apparently, Birkenstocks didn't work-surprise!) The interesting part about my foot story is the first doctor was most likely motivated by the money he would get for an unnecessary surgery and did not look at trying non-surgical options first; whereas, the second doctor did not listen at all to how much pain I was in but instead gave me cursory advice in his quick visit before moving on to his next patient.
Perhaps the most frustrating recent experience with doctors has been my experience with medical advocacy with a close loved one and my dad. In my dads case, I repeatedly told his doctor that his medication was causing agitation and the doctor basically ignored my concerns. This medication was known to have this type of side effect in the elderly, but she dismissed me repeatedly. In my loved one's case, I see doctor's leap to crazy conclusions about her condition based on tiny parts of things she says. (I won't go into detail, but I will say it is laughably ludicrous) They continue to look at symptoms instead of taking a careful and thoughtful history to determine the best course of action. Perhaps most importantly, I see them continue to throw meds at her with often less than 15 minutes spent talking with her. These medications have had devastating effects on her life and may have done more harm than good. There are still no answers for this loved one and the last visit with a so-called specialist was one of the most demeaning and patronizing appointments I have ever witnessed. In both cases, I have seen doctors baffled by conditions that are not easily 'fit' in a box with no quick fix in sight. This bafflement, I believe, creates a bit of hostility towards a patient that does not respond well to traditional interventions. Instead of being open to non-medication interventions in both cases, doctors just throw up their hands and keep falling back on the same old prescription playbook that clearly is not working.
And finally, my experience working with people with disabilities punctuates my experiences with the medical system with heart wrenching tragedy. Countless clients have struggled with chronic conditions, with very little compassion and great frustration when quick fix treatments don't work. With certain insurance, like Medicaid, clients were not even able to get second opinions because of the lack of providers that take Medicaid. I can think of at least 2 clients who are dead because the symptoms they reported to doctors were not taken seriously and they died of aggressive terminal illnesses. Clients fought for years with a healthcare system just to be heard, just to get some kind of treatment that was meaningful. Some died, some deteriorated and some walked around with an extreme sense of grief and hopelessness feeling like there were no answers. These experiences are not unique and many with disabling conditions are left feeling powerless in a system that is supposed to be designed to help them.
Our fee for service health care system has made health care a business where doctors are paid by treatment, not outcome. Doctors are conditioned by insurance companies to throw people into simple 'boxes' so they can be paid. Prescription drug companies have become like car salesman, creating pretty ads, aggressively courting doctors to promote and prescribe their drugs and passing advertising costs on to the patient by increasing prices for medication. With the costs associated with dealing with health insurance, primary doctors and specialists are often forced to book short appointments. There is little time to look at the 'whole' picture in this system. We fail people with chronic conditions in a world that is centered around billing, symptom treatment, and prescription drugs. Instead of looking at a person as someone with a complex health history who needs equally complex and thoughtful treatment, doctors are forced to look at separate symptoms, throw some meds at the person, and move on to the next patient. As referenced before, the results of all these things leave patients feeling completely powerless and often, sicker.
Incredibly, in this system there are still 'good' doctors that thoroughly examine and take careful histories of clients. In the past year, I was blessed to have one of those doctors for my youngest daughter. This experience surprised me, and it shouldn't have. This type of doctor should be the 'norm' not the exception in the medical field. In my personal experience as a care provider for loved ones and my own personal experience, I know the devastating feeling of waiting months for a doctor only to have them completely dismiss your issues. For some, this dismissal could be deadly as some get tired of fighting and give up. As patients and caregivers, we complain about these issues. We complain and complain, but then we run from the idea of 'socialized' medicine as if it is a demon. I honestly cannot a imagine a bigger devil than the fiasco that is our current healthcare model. We need to open our minds and demand better.
Excellent. So much truth in here.
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