Tuesday, November 2, 2010

Doctors, Nurses, Nurse Practitioners, and Other Folks

Australia is moving towards getting people to see nurse practitioners instead of doctors.    No, doctors won't become obsolete.  It's just that the nurse practitioners can free up some of the doctors' time by taking on SOME of the workload.  

My younger sister Melissa is a nurse practitioner.  She went to nursing school, and then she did more school. She worked at a hospital, then a clinic, and now she mostly stays home to take care of her toddler and infant.  She'll very likely go back to medical work in the future.

Anyway, the news item caught my eye because of my sister.  AND I see a nurse practitioner when I go to get my annual pap smear.  It's mostly because it seems getting an appointment with the doctor takes too long.

The medical world seems to be a mess these days.  I am nostalgic for the days I've heard about and never experienced....you know where the doctor made house calls and actually knew your family.

From what I understand, Australia and America have a shortage of doctors and other needed medical people.   I'm sure other countries have these issues as well. 

Yeah.  I just found this article saying that Australia is facing it's worst doctor shortage since World War II. Wow.  

I'll take this opportunity to tell OUR recent doctor story.  

We've been taking Jack to the same office since he was a baby.  We loved his physician.  She was nice and down to earth....easy to talk to.   She totally did not fit my (somewhat negative) stereotypes of doctors.  Then she left, and we got stuck with another doctor. This one was pretty okay, but we didn't like her as much as the first.  Later, we got a letter saying this doctor was leaving as well.    Okay.....

I had reluctantly made an appointment for Jack's well-child check up. We skipped last year because of the swine flu.  I didn't want any of us to pick up germs.  But then my sister said something that made me kind of feel like an irresponsible parent for not taking Jack to his yearly appointment. So I decided I better do that.  

I had my doubts though.  I don't really see the point of these check ups.  So we have about ten minutes once a year to find out if something is wrong?   Wouldn't it be better to just go to the doctor when we're sick or suspicious about a problem; and maybe when we need a lab test or a vaccine?  

They ask all these ridiculous condescending questions that make me feel they must think I'm incredibly ignorant.  Does your child eat vegetables?   Does your child use a booster seat?   Does your child get enough calcium.   Blah, blah, blah.   And I'm thinking.  Hey, you think I'm dumb?   Who sits there and measures and compares infants based on infant formula charts from decades ago.  Huh?  Hello?  

Anyway, I was going to be a dutiful mom and do the appointment anyway.  Besides the long boring wait and condescending conversations, I hate it because of the germ factor!   So many sick kids coughing, and kids touching surfaces with their vomit germed fingers.  Yuck.  Yuck.  Yuck.   And our office....ex-office (as you shall soon see) didn't have a separation of sick and healthy patients.  I also never saw anyone cleaning books or toys. That place is a germ fest.   I feel we're going to go in healthy, and come out sick.  I'm not a total germ-a-phob, but I am at that place.

A few days before the appointment, Tim told me that our insurance wouldn't cover the check up. He asked if we could reschedule. I told him to just cancel the thing.   I decided to go with my feelings that it was all a waste of time. I did want to get Jack a flu vaccine, but I figured we'd do this at the grocery store.

So, Tim calls the office.  They immediately put him on hold.  They didn't ask the nature of his call, and they didn't ask if he minded being on hold.  They just left him standing....waiting.

He was on hold for over five minutes. He says he knows because he saw the timing of the phone on his Blackberry.

When they got on the phone, Tim remarked that they left him on hold for five minutes. Instead of saying something polite like Oh, yes sorry about that, they gave him major attitude.   They were rude and unapologetic.    I personally don't think it's a huge crime to be on hold for five minutes, but it IS decent to apologize to someone for doing that to them.  How difficult is it to say I apologize.  We're really busy right now.

They didn't have the decency to do that. Instead they rudely gave us the attitude of We-can-be-as-rude-as-we-want-because-we're-holier-than-thou-and-we-don't-give-a-crap-about-your-feelings.     Tim got angry, and started fighting with them. He didn't threaten to kill them or anything dramatic like that.  The most dramatic thing he did was use the term God Damn

Tim called up some people and complained. I kind of expected to get an apology over the whole thing.   Instead we got a letter firing us from the office!  Who in the hell gets fired from their doctor's office? 

The thing is they're down one doctor.  They haven't yet replaced the third doctor who left, so now there's only two.  In terms of supply and demand, there's lots of demand and not enough supply.    The office knows they have plenty of patients, and potential patients.  They don't NEED to be polite to parents.  Who cares if they make someone angry?  Who cares if they lose a family or two?

It's really sad that they feel and act this way. They're doctors.  Okay, I've pretty given up the delusion that doctors are guaranteed to be heroes that love helping people.    But maybe a small part of me wished they would act like decent human beings, despite not NEEDING us because they're already overcrowded.  

Our dismissal letter was written (or at least signed) by one of the doctors herself.  She said that since Tim was rude towards her office staff, she'd have to terminate her medical relationship with Jack.   That made me more furious than anything.  She had never been Jack's doctor!  This would have been our first appointment with her.  How the hell could they have had a relationship?  And it made me wonder.   Did she even know that Jack wasn't a patient she had seen before? Does she have so many patients that she doesn't know what kids are her patients, and which are not?

Then I thought about appointments at the office.  They feel so impersonal.   And maybe I'm asking too much in this modern careless world.  Probably.  But it seems like every time we had an appointment, the nurse would ask us if Jack had any allergies.   I understand they can't memorize the medical charts of every patient.   I'm not THAT irrational.   But couldn't they take two minutes to glance over his chart?    Then they could say, I see Jack is allergic to penicillin.   Are there any other recent allergies that we need to add to that? 

So, we're done with them.  We ended up doing what we should have done years ago. We tracked down Jack's original doctor.  She's not too close to our house. It's a little bit inconvenient, but we're hoping it will be worth it.