As I recovery from the surgery that repaired my torn quadriceps tendon, I have had the chance to reflect on health care. Although I have been to the doctor in the past, it was generally for minor stuff-sinus infections, checkups and so on. However, my recent experience was far more serious and hence led me to think more about the matter.
First off, health care is expensive. With my insurance, the surgeon charged me about $400 for the operation. My insurance covered 80% of the cost, so the operation itself cost $2,000. The procedure took less than an hour. I have yet to receive the hospital’s bill, which I suspect will be even more than the surgeon’s fee.
Since I have good insurance and a good job, I can afford to pay. However, if I did not have insurance or a good income, that $2,000 alone would be a fairly serious hit. While I have long been for reducing medical costs, I am even more for it now that I have a concrete experience to ground my previously abstract arguments.
Naturally, I have no objection to paying a skilled professional a significant amount of money. As a professor, I get paid fairly well and that is justified because of my education, skill, and experience. Likewise for medical doctors. However, the costs need to be reduced so that people can afford health care. Just how to do this is, of course, the big question.
Second, as a patient you need to be very active in your own health care. The first doctor I went to checked to see if my leg was broken, gave me a prescription and sent me on my way without a referral or any advice beyond icing the knee. The second doctor I saw said that they could not do an MRI because it was not considered an emergency, but I did get a referral after he took a quick look at my leg. I finally got to see a specialist one week after my initial accident. The doctor was very good and diagnosed the injury within a minute. I was scheduled for surgery the next day.
As my example indicates, it is important to always get a second opinion (and a third) when you suspect it might be something serious. If I had simply stuck with the first doctor, it might have been much longer before I got a proper diagnosis.
Third, as a patient you have to educate yourself. I have found that doctors tend to provide very minimal information at best. While some might say that doctors do this to preserve the illusion that they are keepers of a special knowledge beyond the keen of normal mortals, I think that they do this for a much more innocent reason. To be specific, doctors are trained to diagnose and treat illness and injuries rather than to teach.
In contrast, I am trained to teach. So, I provide detailed, clear and (hopefully) interesting explanations, instructions and explications. Naturally, I notice when someone else fails to do this and I notice that doctors and nurses generally fail to do this. To be fair, this is mostly not their fault. They are not trained to be teachers or to clearly convey information to the patients. To show the contrast, my students get a 16 page guide to write a 6-10 page paper in my Modern class while I got two generic bullet lists and a few minutes of instruction about how to deal with three medications (including a blood thinner that would need to be injected) and my knee.
Given that the medical profession is already overloaded, it is unlikely that patient education is going to be a priority in the near future. It is also unlikely that hospitals and clinics will start to widely employ medical educators to teach patients about their medications, treatment, condition and so on.
As such, it is up to the patient to provide self education. Fortunately, there are many sources of information such as the old standby of books (the various Mayo Clinic publications are a good place to start-they tend to be informative, accurate and readable) and, of course, the web. You need to be very careful about the web. While places like WebMD are professional sites, there are plenty of dubious and scam sites out there. Some are just honestly misguided (for example, people who sincerely push copper bracelets as a cure for arthritis) while others are snake-oil-salesmen who sell useless or harmful products. My best advice is to stick with the professional sites and cross check any information you find elsewhere.
If you are up to the challenge, some medical journals are available online (google will find them) and they can be useful. On the downside, they are written by professionals for professionals, so they are often a bit too technical for most folks.
People also tend to rely on anecdotal claims from friends and colleagues. While such advice can be well intentioned and even useful, it is always good to verify any advice that might seem a bit dubious. After all, anecdotal evidence isn’t a fallacy for nothing.
Fourth, I learned that good friends make even a disabling injury bearable. Thanks Florence, Ron, Dave, Kyle, Bridgette, Anna, and everyone else!