Friday, February 27, 2009

Duh!

Now here’s a novel idea that recently cropped up in the Times—paying doctors to keep us healthy! When I was studying t’ai chi with Master Koo, he told us that in ancient China, people paid their doctors only when they were well. I’ve noticed that the biggest difference between holistic and conventional Western medicine is not so much the form of treatment but the fact that holistic practitioners ask questions and credit your knowledge of your own body. Accustomed to the former, I recently consulted a Lyme specialist at the Berkshire Medical Center and when I attempted to describe my symptoms she asked tersely, “Why are you telling me this?” I have a friend right now who’s being treated for sleep apnea, which I think is hilarious because his 30-year-old mattress is—literally—like trying to sleep on a pile of rocks. He’d rather get treatment (covered by insurance) than shell out for a new bed, although might feel obligated to if his doctor had asked him about it. Another friend was on Prozac, and when I inquired about his dietary habits, he told me he drank 12 cups of coffee a day. He thought it was normal. I also know someone who is getting disability, cannot work due to depression, yet his Dunkin’ Donut habit and addiction to diet Dr. Pepper have yet to be revealed to his doctor. Everyone always says that it’s hard to get people to make lifestyle changes. I bet that if doctors’ incomes depended on it, they’d figure out a way.

So, I began to think, in what other profession do we reward practitioners when they fail? Well, okay, maybe in the financial sector. But, unlike medicine, where they study sick people to try to figure out how to be healthy, at least in finance we don’t study the habits of poor people to learn out how to be rich.

5 comments:

birdspot said...

I have to play devil's advocate here: most of the scenarios you described are actually errors on the side of the patient - a doctor can not successfully treat someone who is not giving them the whole picture.

I agree with you in general, and I do agree that many doctors make it difficult to give them comprehensive descriptions of symptoms, but doctors have to deal with extensive lists of non-relevant things that need weeding through. A patient who is hiding or not recognizing pertinent info is doing everyone a disservice.

deb said...

having grown up in England, a country with socialized medicine, the whole American system seems absurd to me.... the idea of profiting from someones ill health is deeply wrong. The ethics of capitalist consumption and healing the sick seems so diametrically opposed to one another. The idea that you cannot be treated unless you can pay also seems in opposition to the Hippocratic oath doctors take. Insurance companies and lawyers further complicate the economic equation here. I am lucky to be treated by a nurse practioner who is interested in my whole life, not just the parts of me that are sick, but as you observe most are not so lucky... It is a HUGE problem, I wish the new president the best of luck trying to fix it!

Martha Miller said...

have you seen michael moore's film sicko yet? it's terrific. speaks about this topic...

Martha Miller said...

oh ~ and i have a friend whose husband was experiencing double vision. he thought he had some neurological disease and was going blind. he went to see a doctor and it was revealed that he was living on twinkies and 10 - 12 cups of coffee a day!
as they say, you are what you eat...

Carol Diehl said...

Well, dear Birdspot, we finally disagree on something! I believe it's part of a physician's task to inquire about a patient's nutrition--particularly when dealing with depression, which can have much to do with blood sugar levels and allergies (for instance, just one beer--alcoholic or non-alcoholic--and the next day I want to throw myself under a bus! Literally. I have learned not to drink beer...which, of course, I love). As long as his doctor doesn't ask, my neighbor with the Dr. Pepper addiction (which he knows isn't good for him but he doesn't want to give up--it really is an addiction) can say to himself it's okay. And my friend who was drinking 12 cups of coffee, thought it was normal--if not, why would they have a coffee maker in the office? My experience (cited) is that most conventional MDs are not interested in the information you offer--especially if it doesn't fit into their set list of expectations. For instance my Lyme rash didn't look like what the MD was looking for in a Lyme rash, so she discounted it, whereas my naturopath not only took me seriously when I said I felt it was related, but began to look out for it in other patients with possible Lyme.