Thursday, March 8, 2012

Why Doctors are Gangsters

As I often do, I like to write about the absurd things that happen in life.  Some things are blatantly absurd like bath salts, Rick Santorum, and internet trolls but other issues and scenarios in life are covered under the guise of reasonable and accepted practice when in all reality, when you start to put the pieces together, they are just as ridiculous as Michelle Bachmann’s husband claims of being heterosexual.  One of the most absurd, vile, widely practiced and accepted issues we have here in our country is the whole healthcare system.  I know that healthcare is vitally important to us all.  We have to have someone take care of us when we get cancer or need our leg amputated.  We need trained, well-studied, experienced doctors to diagnose our ills and prescribe the proper medicine to make us all better.  I accept these truths but after a lot of careful observation and contemplation lately I’ve found that these truths also make the healthcare system one of the largest organized “legal” criminal institutions (only second to the government) in our nation.  The entire set-up is just about as gangster as it gets.  From hospitals to doctors to insurance to radiology to clinics all across the board, they are all in a way scamming you and milking you for every dollar that they possibly can.  I don’t necessarily believe that every healthcare worker is in on it and I feel that some really have no choice or voice in the matter; they are just another cog in the giant wheel of obscene money.  I can say this because my wife is a nurse and she really has no voice in what goes on, sure she takes the information about the patient and tells the doctor what is going on and then takes care of the patient but she can’t really determine the path of treatment and what all it will entail; she is a cog in the machine. 

The best and most recent example that really got me thinking about this was based around a family member of mine who has gone through some extensive back issues.  Since I don’t want to actually use her name in the fear that her doctors might possibly read this and in turn treat her even worse, I will call her “Beulah” and leave it at that.  So Beulah has had a history of back problems over the past 4 to 5 years.  She has had 3 ruptured discs, sciatica, degenerative disc disease, back surgery, and most recently a small spinal fracture (don’t worry she isn’t paralyzed or anything but it causes a great deal of pain).  Back pain is a broad subject and often easily dismissed by doctors until there is absolute proof showing an injury.  Try going to the ER and telling them you have “back pain” or “back spasms” and notice that you’ll get a look of doubt and/or suspicion.  It’s understandable to a point why there is skepticism when someone makes that claim because of all the stupid “seekers”.  Seekers is the affectionate name bestowed upon people who go to the ER or multiple doctors claiming pain and simply wanting a good shot of morphine and a script of Loratabs but have no real pain or issues to speak of.  Seekers screw up so much for the rest of the people with actual issues.  But I digress, Beulah has many noted back problems and thus has to undergo many tests, see many specialists, and the newest escapade, she went to a pain clinic. 

Here is the first part of the entire medical scam:  When Beulah’s back first started giving her problems common sense dictated to her that she needed to see a doctor.  The problem with this is you cannot use your God given logic and just make yourself an appointment with a back specialists or a neurosurgeon, no, you have to go to your primary care doctor who then has to refer you to a specialist.  So already you are looking at two different doctors’ bills right off the bat.  The primary care doctor is fairly helpless in helping Beulah and can only give her some highly addictive pain medication to deal with the crippling discomfort of her jagged back.  The primary care doctor could maybe order an MRI but she’d probably rather pass that along to the specialist that will take at least another week to get in with.  So now you have a good week to be dependent on these new narcotics while awaiting the specialist.  Every day Beulah and millions of others have to deal with this.  It’s comparable to putting a Band Aid on hollow point bullet wound, sure it will stop some of the bleeding but ultimately it’s still going to bleed and not fix anything.   So assuming that the primary care doctor didn’t order an MRI (which would also be billed separately through another medical group, bill #3 if you’re keeping count), Beulah arrives at the specialist and the doctor is able to ask some questions, feel around on the back, see what the reflexes are like, and check the range of motion but says, “Well, it looks like you have some issues but we can’t really tell anything until we see an MRI or CT scan so let me order that and we’ll schedule you a follow up appointment with our office.”  Now wouldn’t it be convenient if inside of an office that requires almost 99% of its patients to have and MRI, that it actually had an MRI machine?  Of course it would!!!  But that’s not where the money is at and here is where some more of the “gangster” stuff happens.

The specialist knows that they have no MRI machine there in the office but they will have to send Beulah to a radiologist group which they are affiliated with.  We can call it profit sharing, or as I like to call it monopolizing.  Neither Beulah nor you can tell the doctor, “Hey, I’d like to go to this place to have it done.  It’d be more convenient for me.”  The special doctor has worked out a deal through his office to use the services of this other radiologist office exclusively.  Of course getting that all important MRI scheduled is going to take at least another week to get in and then 3 or 4 days to get the results sent back to the specialist who will then call Beulah and schedule another appointment to discuss these results in another 3 or 4 days.  So now she is up to bill #4 because of the follow up.  The follow up doesn’t go so well, it shows some new disc protrusions and ruptures and fractures.  The option of surgery is once again presented which could take 2 or 3 more weeks to schedule. So in the meantime, Beulah is given more powerful narcotics to ease her pain until this surgery is done.  Beulah complains that she would like some more timely results; she has already waited 4 weeks since this whole fiasco started.  So the specialist refers her to another specialist, a doctor at a pain clinic which can see her in a matter of a 3 more days.

So another bill, #5 I think, is going to be racked up by Beulah.  The pain clinic is a very diligent, methodical, cold place where caring and giving a damn are pretty low on the priorities totem pole.  They have very strict rules about filling out paper work, timing, and other miscellaneous tedious tasks to do before even coming into their office.  Beulah’s original appointment was set at 2 pm and was told to arrive 15 minutes early because of paper work but preferably an hour if possible.  Why can the information not be sent from doctor to doctor?  Couldn’t the previous specialist just send all of the paper work filled out for their office onto the pain clinic?  Of course it could, but that would involve caring, logic, and convenience which as we are slowly learning is completely out of the question.  Unfortunately for Beulah she gets a little lost trying to find this pain clinic because it is not clearly marked on the building, I guess because it just doesn’t sound that appealing, and arrive right at 2 pm.  Beulah explains the issue to the receptionist and apologizes but alas it doesn’t matter.  She is told that not only will she not be seen because of the inadequate time to fill out paper work but she will also be charged for “wasting their time slot”.  Now, I’ve been to my fair share of doctors and I know with more certainty than death and taxes that no one ever gets seen at their appointed time.  No one in the history of man or medicine has any patient walked through the door at their appointed time and not had to wait.  And I’m not even talking about just the waiting in the lobby but the waiting once the patient is back in the examination room too.  As a patient you are looking at 30 minutes bare minimum worth of waiting at each appointment.  I went with Beulah to this particular appointment, as any good friend would do, and I pointed that out to the receptionist after Beulah walked away out of pure anger.  I said, “Come on, she was here at the time and we both know that the doctor wasn’t going to fly in at 2:01 and start checking her out.  She could spend all of that waiting time filling the stuff out.  Wouldn’t that work?”  All I got out of the robot woman was a “No, sorry we can’t do that”.  I hate hearing that phrase because we know a lot of things that can and can’t be done.  Like I know that I can’t sprout wings and start to fly around and sing the love ballads of Barry White because that is actually impossible.  But in a situation like Beulah was in, it was obvious that I had found a practical solution where everyone could be happy.  Unfortunately we don’t live in a “grey” society or a society that allows a little leeway in the rules.  Everything is “this is the way it is and that’s that”.  People are too scared to think outside of their retarded box that was built by their boss.  She couldn’t just concede that I had just made sense and let Beulah be seen.  So of course she has to reschedule.

On the next visit Beulah obviously doesn’t want to go alone because of the way things wound up the previous time and she asks me to go.  We arrived at the standard, carved in stone time of 15 minutes early and avoided the problem with robosecretary.  But guess what, we sat in that stupid lobby for 30 minutes before being taken to a room in which we waited another 20 minutes!!!  I love being right but I hate when I’m right about things that suck.  Beulah spends 20 minutes explaining everything that is going on with her back to this PA (physician’s assistant), she gives every grueling detail to her and the PA pretends she is paying attention and taking notes but probably really just writing out a grocery list.  The PA responds to all the questions and then tells Beulah that she will now report to the doctor what’s going on and that he’ll be in shortly.  So there has now been 15 minutes of paperwork that she has filled out explaining her issues plus 20 minutes explaining the same issues to a PA, and now the doctor walks in and says, “So, you’re having some discomfort in your back?  Why?”  I wanted to scream, “Did you not just look at all that paperwork and listen to your assistant about all the problems or are you too stupid to comprehend simple things that my 10 year old could tell you!!”  Needless to say, she attempted to explain her problems all over again but in the douchy doctor move, he cut her off.  He didn’t want to look at any MRIs or X-rays nor did he want to hear about anything else.  He told her that he wanted to get her a psych exam so that she could start on a regimen of OxyContin and morphine.  That’s the answer?  More drugs that are ten times more dangerous and addictive than what Beulah was already taking?  Awesome!!

Both Beulah and I were livid, well she was more livid and I was more annoyingly amused at the stupidity that he was showing, and she told him that she wasn’t going to take a psych exam nor did she want to take OxyContin or morphine.  “Well, I can’t treat you then” he said and immediately I could see that he shut himself down from any further conversation or rationalizing.  Beulah was asking about immediate things that could be done like an epidural steroid injection or a TENS unit or physical therapy because she already was given narcotics that she didn’t want to take by the other doctors which wasn’t helping her.  He said that he “didn’t like” doing things like that, he preferred the pharmaceutical route and that if she didn’t want to go that way then he couldn’t help her.  This was that “Zen moment of clarity” for me that truly told me what gangsters some of these doctors really are.  OxyContin is a drug that almost immediately creates dependence in the user.  Oftentimes once a patient has been prescribed a drug like that it is almost a guarantee that they will be on it for years to come if not for the rest of their lives.  So the doctor, like a crack dealer, knows that if they can just get you take a little taste that they will have you for life because the patient would have to continue seeing that doctor’s office (which is a new bill each time) plus they will be taking their drug (which these doctors have deals with for selling).  And let’s say that one day a patient decides that they want to get off of OxyContin, that it’s just too bad for them and is ruining their life, well don’t worry Dr. Gangster Drug Dealer has another solution for you!!  The doctor would then send their victim to a methadone clinic which “helps” people come off of drugs such as heroin, OxyContin, and other powerful narcotics/opioids.  How crazy is that?  The same thing to get one off of illegal street heroin is the same thing used to get off of legal, doctor prescribed OxyContin.  You might think, “Well, it doesn’t matter.  It’s still a good thing because it’s getting people off of these dangerous drugs” but you’d be wrong.  Methadone is just as addictive and people that go to these clinics pay a fee every week to get their medicine and if they miss a dose they are in horrible withdrawals.  I know a couple of people that have had to drive an hour and a half to the nearest methadone clinic for the last 9 years every week.  What’s the point?

Either way we look at it, the doctors are making money by finding creative revenue streams.  They use specialists, radiologists, surgeons, and worst of all drugs as ways to filter in cash to their giant money hole.  In the long scenario that I just lined out, it was a total of 4 doctors and offices that Beulah had to go to.  If she would have accepted the fate of getting a psych exam plus starting the OxyContin treatment it would’ve been 5 or 6 different doctors, all armed with their own detailed bills.  Please don’t feed me the garbage about insurance and Obamacare or RomneyCare or IDon’tCare because no matter whose plan is in effect you still have to go through way too many flaming hoops to get any issue taken care of.  As it stands today, Beulah still has no scheduled back surgery; she has her original prescription of painkillers, and is going through extreme pain every day.  To me it seems completely unnecessary, the doctors could easily get their heads together and fix problems but they are being dictated by the money lust that has destroyed their logic. 

***Now that I’ve wrote all of this, karma will come back and give me SuperCancer and a spinal fracture that leaves me paralyzed and the doctors will completely ignore me and shoot a giant air bubble into my IV as they walk away laughing.

No comments:

Post a Comment