Tuesday, May 31, 2011

I swear by Apollo, the healer, Asclepius, Hygieia, and Panacea...

The door of the examining room opens, and the young doctor walks in, carrying an open laptop computer. He mumbles an apology for the delay, saying he wanted to take some time to review my records. On the computer.

He is a nice young man, with a young family, a local boy made good. This isn't really his practice, though. It's actually owned by a business which runs several clinics, and he works for them.

He continues to look at his laptop computer, as he reviews the results of my latest routine tests. "Uh-huh, uh-huh," he mutters to himself, in a standard physician-like manner.

Finally he looks up from the computer and asks me, "Now, if you come here, because you are having a heart attack, do you want us to revive you?

"I beg your pardon," I wasn't sure that I understood him. Why would he be asking something like that?

"Well, you know. Would you want us to shock you with an electric defribillator?"

"Paddles?" I ask. "Hell, yes! Why would anybody say no to that?"

"Well, some people, say they're 75 or older, take into consideration the quality of life after defribillation, and specify 'no resuscitation.'"

I will apply dietic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice. --Oath of Hippocrates

"Then this is something you need to ask me again when I'm 75." I'm reasonable healthy, and nowhere near 75. Clickety-click, he enters some unseen information into his laptop computer. The "examination" is now over.

Then my famous paranoia kicks in. In the first place I don't like the idea of having all my health records online and in someone's computer. I know that those records are available to everyone in that office.

What I may see or hear in the course of treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep myself holding such things shameful to be spoken about. --Oath of Hippocrates

And realistically they are also available to every enterprising snoop who wants to see them, be it the town gossip, a potential employer, or an insurance company.

And in the second place, how many people are being asked about this "no resuscitation" notation? Is this part of the current administration's initiative to get everyone's medical records online in order to economize on paperwork?

And with the obvious need to cut costs in Medicare and Medicaid is this part of another initiative to reduce expenses once an individual reaches a certain age? And what is that age--40, 50, 60?

So what can or should we do about it? If you are 40 or over, the best thing to do is to start eating and exercising sensibly, to get and stay with the best doctor you can find and plan on having enough money to pay him (or her). We seem to have turned our health system over to for-profit businesses.

Chances are that "your" physician is making decisions about your health based not on his inner intuition and experience, but on dictates and guidelines handed down to him by a faceless bean-counter in a faraway office.

Americans may yet find a way out of our current medical morass, but by all indications things are going to get much, much, worse before they get better. When I get these kinds of paranoid feelings I have never been wrong, never, not even once.