12:42 AM - 28.11.04
Prevention
Not a lot to say today. My son's new meds seem to be exactly what he needed. He has been in that deep sleep that often comes with healing. It isn't that we haven't tried to get some help for the problem before. The bullying started in junior high four years ago. By the end of the first year it was obvious something was physically wrong. I was still searching for a new family doctor because our old one had retired so we attended the local "doc in a box" associate clinic - sort of a take off on the US's HMOs. I think the lead actresses comments in "As Good As it Gets" typify what we experience here in Canada. Lack of accountability, a system that is set up to focus on profit and a russian roulette game when it comes to the doctor one is sent to see each visit. Some we met were great - like our family doctor now. Most were too new to the profession to be working without supervision and the others were ones who should have been flunked out of med school. Arrogant and ignorant with one's life in their hands is not a good mix.
One of the worst is one still practicing. He comes from a culture that dismisses women as irrelevant to begin with. When trying to talk with him about symptoms he was always rude and denigrating in his comments. He had very little understanding of presriptions meds - interactions and contraindications - let alone the conditions that patients were describing to him. That didn't stop him though. One day while we were waiting to be seen, it was so busy that we were in the waiting room for three hours. I noticed that all the patients he saw - one of two doctors working - would always return from their consultation carrying a clipboard with a code on them back to reception. With each code it appeared that the patient would receive a certain type of prescription medication. Given that it was impossible not to hear what was said between patient and receptionist it was very clear that often the drug assigned in rotation had nothing to do with helping the person deal with their illness. The nurses tried to intervene a couple of times but were told to back off. Often when I've been standing and waiting at the pharmacy next door for my prescriptions I have heard the pharmacists say that they will have to call that particular doctor because what is prescribed doesn't make sense or is contraindicated for the patient - severe allergies and such.
The other problem is one strictly to do with billing requirements. Our health care system will only pay for one "symptom" or presenting problem per visit. Often patients aren't knowledgeable enough to accurately describe what is going on with them and they are misdiagnosed as a result. Several stories in the news lately where the pateint has died after going to several of these "doc in a boxes" trying to find someone who will take the time necessary to test and eliminate different options until an accurate diagnosis can be determined. Usually the victim is a young adult with small children left behind - now parentless. The other problem for patients is that they may have several problems, each requiring it's own session. If a patient doesn't realize that they have to book a different appointment for each single issue - say heart disease and diabetes for instance - then either one or the other doesn't get treated or the alternative is that a conscienscious doctor will be penalized financially for doing their job properly. Multiply that by several similar patients per work day and that is a substantial hit for being good at one's profession. Too often expedience is the result especially in the associate clinics where the docs are told to spend no more that x minutes with each patient - for billing reasons of course.
The upshot is that if a patient survives the misdiagnoses and incorrect treatments, their health becomes steadily worse. It can often take two or three years before one finally gets all the other potential disorders eliminated and finds a physician who will both listen, check the history and not be bound by the provincial governments draconian decisions with respect to access to health care to actually receive the treatment they need. The patient may lose years of schooling or paid work and become debilitated enough that recovery is either incomplete or takes a very long time to realize the benefits. The taxpayers lose because of all the wasted time and resources ploughed into doing the wrong thing. The whole idea of preventative or early intervention is not even on the radar screen for most Albertans. One of the reasons I have enrolled my youngest in home schooling is because he has too many sick days and finds the long hours of travel to and from the school site too hard on his body. Add in the stress from three years of continuous harassment and it was becoming nearly impossible for him to cope in any other way. How many students in similar circumstances are failing or just dropping out of school as a result. Longitudinal studies in a number of countries have demonstrated that for every dollar spent for prevention or early intervention society saves five dollars in long term social costs for each person affected. Preventive health care is an investment not an expense. End of rant.
On a lighter note this book review for parrotheads Jimmy_Buffett. Happy Birthday Kramer.
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