Wednesday, August 17, 2011

The Naked Doctor

The naked truth is that we have a for-profit health care system that is not effective for the vast majority of the population it is designed to serve.

Doctors are human beings and don't deserve the status of god-like image accorded to them through the centuries.  There is no mystery, they go to school, they accrue ridiculous debt and graduate into an abysmal system of paperwork and insurance premiums to cover malpractice.

After their internship, they either go into private practice or work for an HMO or hospital.  While working for an HMO or Hospital they may have less paperwork to deal with and less people in the office to manage, which gives them more time with the patients.  This is a wonderful theory that does not pan out most of the time since they have to seek approval for procedures, testing and medically needed equipment from their higher-ups just like a doctor in private practice is at the mercy for approval by each patient's insurance. 

The medical field is a for-profit system in the United States that does not work to deliver effective treatments, preventative care and respond quickly to minimize health declines at the onset of an illness.  Much time is wasted awaiting for approvals and responses.  The out-of-pocket expenses make patients reluctant to seek care until things get worse for them and they have no other alternative.

We all know how broken this system is and how ineffective it is.  Until we manage to get a health care system that covers everyone in the country - just like they do in France and other industrialized countries - we are going to have to manage what we have a little better. 

General Practitioners 

You are a rare breed in most states.  Others with your medical credentials get trained in specialties, not because that is their calling, but because that is where the money is.  A sad state of affairs dictated by insurance company reimbursements.

If you are still a family physician, please do not set  your patients up for more pain and failure because you are getting a kick-back from ancillary services.  Your patients trust you to direct them toward what is best for them, not your bottom-line. (Yes, it is illegal to do so, but it is done - Patients are not always aware and reporting them creates legal hassles a patient has no energy or time for)


The Naked Truth:  You are not GOD. You do make mistakes, you do have fights with your spouse, you do have affairs, you do come in with a hangover and you are human.  So please, do not treat your patients as if they were parts of a machine that needs to be fixed.  Their pain is real, their fears are real and you need to know what is in place to take care of them for months or years on end after you have done your 3 or 4 hour job.

Change things a bit and coordinate your work with social services, a patient advocate and for God's Sake! LISTEN to your patients about their concerns post-op.  Your job is not done with the last suture.


The Naked Truth: Most of you are arrogant, self-centered bastards. Period. 

Some of you may be the salt of the Earth and we have a hard time finding you.  The fact is that the vast majority of you treat everyone as if they are beneath you.  You talk down to patients and it never occurs to you to inquire about their difficulties outside of your office.

There is a reason why they may not be able to have the treatments and therapies you want to charge them for; it cost money they don't have and many of them have already gone that route while you were still in medical school, as recommended by someone who was just like you.  They know it is just a ploy to part the insurance company and the patient from their money.

Your owning a piece, or all, of the physical therapy business next door, does not entitle you so soak the patient's insurance company for all  you can get and put the patient to unnecessary routines that are costly and time consuming.  It is their lives and their time, not yours.

Pain Management

The Naked Truth: Some of you are very good, but some of you are nothing more than legalized drug dealers. 

Your patients are walking around like zombies, you are not doing a good job.  Pumping more medication atop of more medication is a bad protocol that destroys the patient's mind and internal organs and you have no idea, or care, what this is doing to their family life.

Your job is to make sure the source of the pain is addressed properly and use medications to enhance the patient's quality of life and keep them engaged in their lives, jobs, and with their loved ones instead of sitting in a drug-induce stupor for what can amount to decades.  

To all doctors:

Do not keep your patient waiting longer because the pharmaceutical representative showed up and you must talk to him first.  This should be a wake up call for you as to what your priorities are and a wake up call to those in the waiting room.

Do not send your patient to a physical therapist, acupuncturist, or pain management specialist until you are SURE that whatever is causing the pain is not broken or torn.  The patient's injuries will only get worse through manipulation and pressure.  You waste their time, their spouse's time and disrupt their lives even further than they need to be.

When a patient finally comes to your office, they are not doing it as a means of socialization, as a matter of fact, you are not a thought on their mind when they feel well or are completely healthy.  Patients are coming to see you out of desperation and want to be "fixed" so they can go back to normal.

Take the time to get to know your patient.  It is pathetic that the nurses in your office know more about them and their difficulties than you do.  It is not their job, it is yours.

Be honest.  Tell them the truth.  Don't waste their time, and above all else, treat them with respect.  They are not customer, they are patients and no one wants to be a patient.

P.S.  Many reading this post will state that their doctors are wonderful. To that all I have to say is: Good for you, and may you continue to prosper in health - Many across the country will find this post resonates with them based on the quality of services available in their states or cities.  Health care is not equal across the board and it certainly needs a major overhaul for the benefit of all.

Related Articles: The Naked Patient   The Naked Spouse

Image: renjith krishnan /


sandinbrick said...

I have been to many Primary Care Doctors, since moving to the shore. I had one in Elizabeth, NJ. I could call her at any time, and she would listen and help me. That changed. Till this day, I cannot find one that I like. It's true, they don't listen. They want their money, that's it. If you have no insurance, you're out of luck. The greedy bastard forgot their oath of do no harm. If you try and tell them, they say here's some anti-depressants, take this and you will be better. Very important, to know what drugs they give you, the side effects, and whether they are prescribing off label. Thanks Olivia, this is a discussion we need to share.

Leigh Ramsey said...

Way to lay the warped U.S. health care system bare, Olivia! In my area, at least among the progressives, there is a decided move to get the idea of healthcare as a human right going and the pushing of a single-payer system a la Vermont. Wondering what your thoughts are on the latter.

Olivia Emisar said...


You are so right. The prolonged use of medication can cause irreversible damage to otherwise healthy organs.

We need to have this conversation often. Next to Jobs, Health Care is paramount to a decent life.

Oh Leigh!

... If only! I have been hoping, praying and wishing and Vermont has renewed my hopes.

Patients are NOT customers, they should not have to shop around for health care. They are at the most vulnerable they will ever be in their lives and they need support, not schemes and the "run around" - People want to be and stay healthy. They want their "lives back" and go back to "normal". If that is not possible, the doctors need to know what their new "normal" will be and what adjustments need to be made to keep people as comfortable and productive as possible.

It is a human rights and impacts the quality of life tremendously. Quality of care should not be dictated by finances.

Socialized medicine has gotten a lot of bad rep from the pharmaceutical companies and all that profit from the misery of others, but no one in Canada or France, for instance, would trade their health care system for ours.

Mexico is inundated with Americans going across the border to get health care and dentistry. Canada has looked the other way for decades when Americans pretend to be Canadians to get health care.

Americans go to Cuba to get health care. It is reprehensible how we treat our citizens.

Finally, I am embarrassed that we need to donate to Free Clinics so middle class and poor Americans can finally be seen by a doctor. This is like seeing the lines on a third world country lining up for a health check up or vaccine, except that it is happening here.

Thank you for your post. It is encouraging to hear other states are fighting for a better health care system.

PEACE and good luck to us all.

Marie Bagatela said...

Single payer system is the only option...
Bad news is we may don’t live up to see it...
Good news is...Our children will...
Cause it is entering the bottom line of the other sphere of Corporate powers, threaten their bottom line, so our Society has a choice: total Free Market, or going into a single payer system...
Free market is just transferring the payers around...ppl without insurance will jeopardize the health of those who have, they will end in emergency room, and taxpayer will have to pay...
Not very wise if it is wide spread phenomena, witch will be, if the "Free Market" hit the streets...
On the other side we have single payer system who is tree time chipper then the Insurance based HC system...
Wonder who will Corporate America choose in the end...