Our Wonderfully Efficient Healthcare System

I'll state from the beginning that the title to this posting is sarcastic. And that's putting it mildly.

One of the more eye opening aspects of my ordeal has without question been my experiences with our highly dysfunctional healthcare system. It's something that I hope you all are able to avoid in life, though I suspect over time it is going to prove an impossibility. In my viewpoint, the problems are so deeply systemic that it won't matter what ultimately ails you; you're inevitably gonna experience deep frustration with this system of ours.

Prior to my diagnosis, I considered myself somewhat versed on this subject and I've heard my father-in-law, a radiologist, rail about it for years, but given my lack of involvement and the infrequency in which I saw doctors, I didn't really have a strong point of view.

I sure do now. And I have to say, that if I had to summarize my personal experiences in one word, it would be "Kafka-esque."

Let me be clear, that this isn't an indictment against my doctors, or doctors in general for that matter. For the most part, I'm generally pleased with the level of care I've been receiving. Actually, this isn't true. One doctor in particular is starting to rankle me with his unresponsiveness, but I'm going to bite my tongue for the time being and keep this from getting personal. More on this particular situation later, but only if I am unable to square away some of my fundamental issues.

The problem as I see it is "the system" or the bureacracy or whatever you want to call it. It's beyond broken; it's in an utter state of disrepair. I don't even know where to begin. Here's just sampling of some of the issues that I've experienced:

-- Insurance companies. Whether it is the constant erroneous bills, receiving invoices for services that are supposedly covered, never being able to get a "live" person on the phone, etc. etc. etc., the fun with insurance companies is endless. What really galls me, however, is that there are certain services -- critical services in my opinion -- that insurance companies have eliminated over the past few years due to the associated expense and inconvenience.

The best example: it used to be that years ago, when thyroid cancer patients were given i-131 radiation, they were hospitalized and put in quarantine for 72 hours. This ensured the safety of the patient and their respective families, as 100 plus milicures (around the average dose of RAI) is highly toxic.

Well, it must not have been terribly profitable because most states, including Calfornia, have completely eliminated this element of the treatment. So now, we have to figure out for ourselves what to do/where to go during RAI. Back in September, after much deliberation, I had to send April and the kids to a hotel for a week plus to ensure they weren't exposed to radiation. Nice, huh? If any of the thyca ladies are still with me here, I think they'd back me up that this is a major issue.

-- doctors communicating with fellow doctors. You think this would be an easy one, right? Wrong. It's one of the bigger breakdowns I've experienced. Doctors not speaking with one another, not sending records, not reading records, losing records, not getting back to one another in a timely fashion. For a quasi-control freak like myself, it's maddening, because the fix is so obvious. I'm in the middle of a situation right now related to this and it is beyond frustrating. If I don't get a remedy soon, I'll blog on this; trust me, you won't believe this story.

-- doctor's being too successful for their own good. Sounds a bit incongruous, right? Well, let's call this one Howard's Law. It says there is a direct correlation between how busy a doctor's office is, and the poor level of service you'll likely receive as a result. An active, busy practice might be good for the doctor financially and reputation wise, but it doesn't necessarily translate to a good patient experience. Being too busy leads to all sorts of break downs in communications, response time to important inquiries, the quality of information received, etc. etc. In my personal experience, this has been a very big issue.

-- As a corollary to the above, it's also been my experience that doctors simply don't spend enough time with individual patients, as they are more concerned with keeping up with their schedule and patient flow. While this might not be as big a deal for, say, an internist, who perhaps isn't dealing with life threatening illnesses on a daily basis, it's a lousy approach for doctor's who are dealing with serious issues such as cancer care.

Again, with the exception of perhaps my last point, this isn't really so much an indictment against the doctors, as it is the system. It's ironic, too, given that doctors arguably comprise the brightest and most talented minds our society has to offer, and yet preside over a system/infrastructure that is staggeringly broken.

Am I completely off the reservation on this one? Anyone out there have a differing opinion and/or personal experiences? If so, by all means, let's hear it. Inquiring minds want to know.

Before I conclude, I want to send a shout out to two of my heroes, both of whom are among the nicest and toughest ladies I've ever had the pleasure of getting to know - Nancy Richman and Faith Margolin. Mother-in-law's, grandma's and survivor's in arms. Hope all is well in your world, ladies.

(ps. Best Soprano's of the season last night by far)