Paging Marcus Welby, MD to our health care system

August 4, 2014

healthcare_moneyWhere do I even begin? I’m certain every one of you has their own family health care horror story and many actually horrific rather than annoying, as mine was. I mean, I feel lucky.

300px-Marcus_Welby_Intro_ScreenQuality health care a thing of the past

Here’s my problem. My father was one of those pediatricians who made house calls well into the 1990s. I’m not going to pretend he was Marcus Welby, M.D., that beloved, kindly TV doctor played by Robert Young between 1969 and 1976. Because my father had a short fuse to irritation.

But he did take his profession seriously and was like a dog with a bone when he faced any tough diagnosis. Since he treated little people who often couldn’t tell him about  symptoms, that was often.  I was raised with a model of health care that no longer exists in most places and that colors how I view my own health care.

Living down the freeway from Stanford Medical Center we have access to (arguably) some of the best health care in the world. Or so we’re told.  And years ago we made the decision to engage with a concierge medical practice centered at Stanford. Our rationale was that we were aging; should anything bad crop up we wanted a good quarterback on our medical team.  And we have one who has access to some of the best specialists in their field. When I needed a retinologist immediately, I got to see one of the top young retina surgeons in the world. M’s cardiologist is excellent. No complaint there.

It’s just that the overall system here is very strange. 

For example, let’s take the eye practice I go to.  It’s a beautiful facility with all the latest high tech equipment and fantastic specialists. Upon your first step into the well-appointed waiting room you are greeted by someone who is there to be sure you are checked in immediately. There are at least four receptionists doing the check in, plus a greeter. All are beautiful and beautifully attired. Ahhh-customer service.  There’s hardly ever a long wait.  This is the best of what Stanford has to offer.

Not too long ago I woke up with a small, itchy swelling under my right eye. Small.  A bite? A boil? I wasn’t sure what it was, so I shot a selfie off to my internist. She prescribed an antibiotic ointment and told me to ice it and check back with her the next day.  The ice did nothing. I shot another email photo off and she told me to use warm compresses and keep up the ointment. The following day, after another photo showing no change (not better, not worse), she suggested I hard boil an egg, wrap it in cloth and use that. And she told me it was  “sty” and that I should see an opthomologist to have it drained.

Here’s the problem. Over at my eye practice, I have no regular ophthalmologist. I have a retinologist. I have an optometrist. But the good ole general eye doctor is nowhere to be found. Following my internist’s instructions, I called the Big Eye Practice  and explained what I needed.

Untitled“The triage nurse will call you back…” was the answer. This was Thursday.  No call on Friday, so I called them.  “Our protocol is to call back within 24 hours. She got your message late and will call soon.”

Nope.  Monday, they called.

“We’d like to schedule you with an ophthalmic plastic surgeon.”

I was taken aback. Seriously? It was a tiny sty. That, by the way, disappeared over the weekend after the application of a hot hard boiled egg. But I played along.

“But all I need is to have it drained,” I said. “Wouldn’t it just be a needle to withdraw fluid? Isn’t that what a regular ophthalmologist would do? Wouldn’t bringing in plastic surgeon be like trying to kill a mosquito with a .357 magnum?”

“We don’t have a general ophthalmologist,” Big Eye Practice said. “All of our doctors are specialists.”

short+history+of+medicine+webSo, let me get this straight I go to a Big Modern Eye Practice and can not get regular, garden variety eye care. It’s not even an option. So, to avoid having to pay surgical rates for a simple “lancing”, I would have to engage a different practice. That is, find a regular eye doctor.

Now, Big Modern Eye Practice DOES run an afternoon “clinic” for problems like mine and each of the specialists takes turns staffing it. But it’s unreliable, because shit happens and the doctors can’t make it.   I know this because I met with the practice manager after a different eye debacle and he told me. Apologetically.

So, of course, I am on the hunt for a regular, local eye doctor for those garden variety issues that crop up beyond the capability of my concierge internist.

Most interesting is that a home remedy–a hard boiled egg– “fixed” the problem. And I found my most reliable healing this year via Reiki. Which, by the way, my Stanford internist says she doesn’t dismiss.

I don’t know about you, but I’m getting tired of “modern medicine.” Sure, there’s a role for it when things get really bad. But “modern medicine” seems no longer able to handle the sort of things our kindly general practitioner used to handle.

And that’s why I’m paging Dr. Marcus Welby, if not literally, figuratively.

What’s your horror story?

29 comments on “Paging Marcus Welby, MD to our health care system
  1. Ryder Ziebarth says:

    Too many to retell, and not wanting to turn this into a political statement,we pay out of my butt for good health care and a free choice to see whom ever we want. We are lucky. Many, not so.We are trying to get our non-citizened housekeeper an operation for a fibroid cyst removal- with no insurance, she applied to charity care, which covers all hospital costs, but not the doctors fee, which we will cover for her. She is not eligible, as the state sees her as “married”( her husband took off six years ago, refused to help her process a green card application, and cut her out of his union policy-which is illegal). So now we are trying to get her a divorce, under the immigration radar. This woman has been paying U.S. taxes for 20 years and been here for 24. No one will help her. The cost of her operation, which she badly needs, is more than 40K.

    • This IS a political situation, sorry to say. your housekeeper’s situation is awful and medical costs in this country are out of control.

    • Laura says:

      What a good person you are to worry about your employee. if you are in California, have you contacted MedCal? Is she eligible for affordable care via the exchange in your state? Finally, there are fantastic hospitals in Mexico: Cabo San Lucas, Cancun, Mexico City that cater to medical tourism. I’ve been a patient at the hospital in Cancun and it was the best care I’ve had in an ER. Ever.

      • Ryder Ziebarth says:

        Thanks Laura. We live in New Jersey. I couldn’t take her over any border that requires a passport.

  2. Isn’t it amazing how health care has changed so much in our lifetime. It is really scary. After 20 years, our family doctor started charging a $3000 fee just to stay on their patient list. I was devastated…I felt as though a family member had stabbed us in the back. What was surprising is how many stayed just to keep the same physician…I could not justify it for any reason. Now, I am never certain of what I am doing…probably, never will be.

  3. How about that 3,000.00 shot in my sacro for a fractured lumbar bone? From a pain specialist? Who missed the fracture? And insurance didn’t cover it because the problem was in my L4 L5 L6?

    On the other hand, my family doctor is much like Marcus Welby. He doesn’t make house calls but he’s a fantastic doctor who believes in treating the whole person Holistically.

  4. Knock wood!

    I wish things could be simpler, too, when it comes to getting what you need when you need it.

  5. I’m fortunate that one of my best friends is a physician (OB/GYN) who is knowledgeable in so many fields of medicine beyond his own. I can field many of those pesky questions that seem too small to visit a doctor about, which saves a ton of time and money.

    He is my version of the old-fashioned physician!

  6. Where to begin on this one… Had a prolapsed uterus last winter and had to have a hysterectomy. I was told to spend 8 weeks in bed laying “still” I’ve recovered but they forgot to inform me that this would drastically change my hormones. At 65 I’m now on the search for help and I’m not sure I will find it at the Dr. office. Getting old is not for sissing nor is our health care system.

    If I remember right James Brolin was Dr. Welby’s assistant. That would make a fun house call. He could give advise and Barbra could sing 🙂 Have a nice day!

  7. Laura says:

    The system at Stanford is a bit precarious if you aren’t diagnosed with a strange/rare/catastrophic illness but this is true of all university based medical centers I’ve dealt with . Professionally, I deal with the top tier centers across the country and I believe they try to do expert work; however the regulatory systems and insurance regulatory systems in the US give them additional hoops to jump through to the point that compassionate and expert patient care are being left at the wayside. It’s why I left the bedside, I couldn’t practice nursing in it’s purest form because of the regulatoray agencies.

    Between the government and the outside accrediting agencies mandating what constitutes “patient safety” it’s never been so dangerous to be a patient in a hospital. People are slipping through the cracks because the nurse and the physician are consumed with documenting what they’ve done, not done or are about to do. Things are getting missed. I see this daily in my practice with an insurance company.

    This is why you must have someone in your life who can advocate for you if you are a patient: someone who can speak for you and your wishes if –God forbid–you can’t speak for yourself; someone who can help you navigate the system if you are overwhelmed by a diagnosis so you don’t make a hasty decision out of fear and confusion.

  8. Haralee says:

    I think the every doctor is a specialist approach is similar to every child gets a trophy for showing up. I don’t mean to diminish their expertise but if your aliment doesn’t fall into it the specialists’ discipline they are not comfortable treating you. Hard boiled egg, I like it!

  9. Carol Graham says:

    As a health coach, I could write a book of horror stories but alas, there is no room. I am happy and proud to say that I have not seen a doctor for many years and have no reason to, short of breaking a limb. I enjoyed your post which underscored what I already believe. Thank you.

    I loved Dr. Welby 🙂

    • You are very lucky. And that is what I believe–we luck out in the gene pool and combined with healthy habits, do better than those who don’t. Clearly there are also environmental factors. May you have many more years of good health!

      • Carol Graham says:

        Sorry to disappoint but luck has absolutely nothing to do with it. I was born ill, died when I was 9 months old for a few minutes, was sick my entire childhood, got cancer in my 20’s and told I had 2 years to live, if I was lucky. I was totally crippled with Rheumatoid Arthritis and had ulcers, as well. When I told the doc I would not accept his diagnosis, he told me to go home, suffer and die. I told him I would walk in there pregnant one day — and I did 14 years later. I found my own cure. I became a health coach and that is what I do all day long – teach people how to have strong immune systems. No cancer, no arthritis, a healthy baby and on and on and that was over 40 years ago. I am glad I did not have to depend on the health care system in any form, and their remedies, as I would be 6 feet under – guaranteed.

  10. Lana says:

    I feel that most of our problems have come from insurance companies – when was it decided that they get to rule the world? As a small business owner, my options are so limited. We pay a huge premium every month, and they still cover virtually nothing. Luckily we have all been fairly healthy, but I do worry about the future.

  11. Don’t even get me started on the whole plastic surgery dilemma that occurs if you need breast reconstruction after a bilateral mastectomy. Ay yay yay. It was very eye-opening (pun intended re your story above).

  12. Healthcare is a tricky business. Your situation doesn’t seem too out of the ordinary to me. I have watched my elderly family members receive such extraordinarily pathetic care, that it is sickening. We have to be our own watchdog and our own advocate. Glad you are all better!

  13. After 2 years of Drs. telling me that my pain was all in my head, assuming it was something from a recent car accident, putting me on pain pills, anti-depressents etc. My husband took me to an ER and demanded proper testing
    One simple blood test told them I was mere hours from death and had been bleeding internally for months. Three transfusions, 2 weeks in ICU another 2 weeks in a regular room. This is when I was finally diagnosed with the Felty’s Syndrome. My husband was destroyed thinking that he had let these quacks convince him I was basically crazy and has spent every single day since making it up to me.

  14. bodynsoil says:

    Working in an medical environment I can see how sometimes these new docs can’t see the forest for the trees, they all want the big interesting cases and not the hum drum stuff. I’m hoping that they wanted to do the big case on your just because and not just so they could bill out the large procedure and get that college debt down faster.. So glad a little home grown remedy did the trick and the large procedure wasn’t needed..

  15. Laura Ehlers says:

    I work at one of those ‘TOP 20’ hospitals, according to US News so I have access to some pretty fancy MDs. My family physician, who happens to be one of this facilities top diagnosticians, recommended putting a banana peel on the planter’s wart I had developed. Yup. Banana peel. He was quite embarrassed about the suggestion. I found it perfect fodder for a blogpost. And…it did help a little!

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