MAY 2009 - How Long Do We Wait?

Each month this column's readers are offered the opportunity to "chew on this." If you've been "chewing" a while, I humbly ask for feedback this month. Below are several incidents that baffle me about our health care system. If you or a family member or friend have had similar experiences, I sincerely want to know about them. My email address is at the close of this column; snail mail is P. O. Box 34, Millstone, WV, 25261.

1) A 19 year-old college freshman and track athlete experienced a number of sporadic episodes of severe chest pain. While each episode was short lived (less than a minute), the severity and unexpectedness of each attack doubled him over, while he gasped for breath. At his appointment the next day with an alternative health care practitioner, he was advised to get a stress test and have his thyroid gland function checked. A month later his blood work and stress test was administered; although he disclosed his history as a high school and college athlete, he never broke a sweat on the stress test. The doctor reviewing the tests said all was normal, but wrote a prescription for Synthroid and scheduled the young man an appointment with a thyroid specialist -- nine and a half months later.

2) A 71 year-old grandmother was hospitalized for several days with cardiac symptoms. Upon discharge she was given an appointment with a cardiologist -- five and half months later.

3) During an pre-employment physical, a 49 year-old man was diagnosed with high blood pressure and pre-diabetic symptoms. His follow-up appointment with his health care provider resulted in a complete physical, including fasting blood work, EKG, BP, stress test, prostate screening, blood pressure meds prescription, etc., all performed by an MD. All subsequent appointments were with an MD. Not long after, this man's wife suffered from bouts of palpitations and recurring chest pain. She called the same health care provider to request a complete physical and stress test, highlighting the symptoms of chest pain and heart fluttering. She brought a list of symptoms and current meds and supplements to her appointment and was greeted with, "We don't have time to cover this today," by the physician's assistant, waving the symptom list in the air.

4) A 52 year-old woman visited a neurologist, hopeful that tests would be scheduled to identify the cause of a number of baffling symptoms that were increasing in frequency and severity. She described her time with the doctor: "He never made eye contact with me. He touched a stethoscope to my chest in two places, for less than a half a second each time. He opened a drawer, pulled out a blood pressure cuff and put it on my right arm, over my clothing, squeezed the bulb twice, and removed it! With my chart, he opened the door, turned and asked me a question. When I started to answer, he walked out ... without waiting for my response . . ."

What's going on here? The young man in #1 is still having chest pain, more than a year later. The attacks sometimes occur while he is driving. I don't know if the grandmother in #2 has been seen by a cardiologist yet. In #3, the woman and her children have NEVER been seen by anyone other than a PA. And the woman still has not had a stress test. The patient in #4 had a job offer that was exceptional in these days of economic distress, but did not want to accept or decline until she received a diagnosis and a prognosis. Despite her explanation to the medical staff for urgency in test scheduling, her next appointment was more than a month away.

These examples surely cannot be called "health care;" "heath care-less" might be closer. "Disease Management" might be a bit more accurate, or maybe "Disease Mis-management" if one must wait nine months for an appointment. Why? I ask why must anyone, let alone someone with severe chest pains, wait so long for an appointment? Is it the insurance industry? Are doctors and specialists so overrun with patients that it takes nine months to be seen? And why is the male gender seen by the MDs and not his wife and children? These people have used the same insurance and same provider for 12 years. And personally, I think if a health care professional can't take the time to look a patient in the eye, another line of work may be in order.

Have we become so complacent that we've handed over our personal responsibility for our own health and well-being? Is a nine-month wait for an appointment normal? What do you think?

Meanwhile, Chew On This: "The most common way people give up their power is by thinking they don't have any." -- Alice Walker