"I need your love but it comes out wrong/I try to live but I don't belong/I close my eyes and I see/Blood and roses." --The Smithereens, Blood and Roses
I'll talk more about good eats and how they affect your health in the next post. I just kind of had to share with you an odd revelation that my father and I had when he took me to the certified nutritionist yesterday. See, I can't really drive by myself safely yet...my right eye doesn't really want to work reliably, so my Dad had to take me to the appointment. My internist/primary care physician prescribed a visit with the certified nutritionist, upon my request, so I could get on an eating program that would boost my immune system. (I'll happily share in future posts the advice; you can benefit...my affliction is your gain, sort of thing).
So...my father came in with me out of curiosity and we both had a MAJOR AHA MOMENT having to do with the standard of medical care. The kind of Aha! moment that you would have only if it happened directly to you. YOU WILL BE SHOCKED! If not, it's because you've already had this epiphany--no fair, cheating!
OK, so after smacking me upside the head with a Food Pyramid and going through my old eating habits, my recently acquired eating habits and a tweak or two (to be shared later), the nutritionist grilled me for awhile about my past medical history, both sides of my family's past medical histories and then began filling out a sheet. "I'll have to fax this over to your primary care physician; you're seeing him on Monday, right?" she asked.
"Yeah. What is that thing you're filling out?"
"Well, it's a list of additional blood tests to run, based upon the data I've collected. We need to check your blood levels for a few things directly related to your suppressed immune system and/or check the blood levels for things connected to possible other medical conditions."
"Uhm, when they took blood in the emergency room, they didn't run these tests?" I asked.
"No."
My father chimed in, "Well, her internist didn't think to order these things?"
"I suppose not; look, I'm only ordering these blood tests based upon what you're telling me. I'm just a stickler," the nutritionist explained.
"But, you would think that the doctors, especially in the hospital with an acute situation on their hands, would run a broad spectrum check to see everything that could be wrong with her. Don't they have the power to do that?" Dad queried.
"Yes, but that's not the standard of care. In fact, if Stacey didn't bring up the possibility for the need to see a nutritionist, and her doctor didn't write the script, she'd never be here right now. That's being an informed medical consumer on her part...and now, I'm trying to augment her care. If you don't ask, you don't get." (LEGALESE ALERT: Standard of care is a diagnostic and treatment process a clinician should follow for a certain type of patient, illness or clinical circumstance. If a clinician does exactly what is prescribed by the standard of care and nothing more, guess what? You can't successfully sue them in terms of medical malpractice. Yes, I am a lawyer, and yes, sickeningly, that's TRUE).
"But you'd have to know in order to ask the right questions in the first place," I objected.
The nutritionist shrugged. "These extra tests will be ordered for you now."
OMG! "Uhm, I'm planning on going to [name of private health care center withheld] in the coming week or two; they warn on their web site that a lot of what they do won't be covered by insurance, but I've heard great things about them. They indicated that they will likely do a broad spectrum blood scan of me to catch anything and everything. What do you think?"
Nutritionist: "They're awesome. I've heard nothing but great things, too. Oh, and sure, they'll catch anything and everything and that's great."
"So, why won't the hospital do it?" Dad asked.
"Because insurance won't cover it. They're afraid they won't otherwise get paid. But if YOU pay for it out of pocket through a private health care center, that's between you and them, and, well, as long as they meet the standard of care, they're fine anyway. You're fine. Everyone's fine."
Well, my father and I walked out of the nutritionist's office in silence. We walked to the car in silence. As soon as the door shut, we looked at each other and began talking excitedly over one another.
"I'll never look at the world of medicine the same way," Dad told me. "That's disturbing. You hear complaints about insurance, but you never, ever think that there's some sheer minimum that, as long as it's met, everything is legally OK. Meanwhile, things could be wrong with you that don't get caught...that could get caught...and if you don't think to ask for the specific test, it won't get ordered!"
"Or, maybe you ask, the doctor says it's not necessary (per the standard of care) and it doesn't get ordered, and you don't have the money to pay for it privately, and something festers inside you that could have been found, could have been eliminated...."
"You'd have to know to ask in the first place!" Dad shook his head. "How would you know if you weren't a doctor or working in the medical field...?"
Now, listen: I love my primary care physician. Anything I ask for, he agrees I should look into it, give it a shot. And he has gone the extra mile for me every time. He cares about me, and I'm not changing doctors over this. The standard of care, as far as I'm concerned, has always been met by him. And if I come to him as an informed consumer (sometimes I certainly have), he'll write a script for whatever is on the other end of that request. Dr. Troll...he just is awful, and I'm never going back.
And I still think the hospital was wonderful, too. As an attorney, I can parse it out in my mind...you meet the standard of care and you're kind while you do it, you are above legal reproach. Insurance basically pays you the bulk of your income as a hospital/doctor/clinician. You need to be paid. People don't necessarily have thousands of dollars to pay for out of the box thinking. Without money, your hospital/private practice/clinic/whatever can't run.
But still, I decry the fact that human life is precious and priceless. Should we not start to become more informed consumers? Should we not engage in preventative medicine so we don't need so much medical intervention as we age anyway? Should we not realize that instead of shopping for that new outfit or buying that new techno-fun gadget that we should put that money aside for the day when what insurance and co-pays won't be able to cover?
Because I don't know about you, but I don't want to live on in ignorance. I want to LIVE and I want to LIVE WELL and for A LONG TIME and seriously, if I have to give up on a vacation or a new car just to find out everything I need to know about the current state of my health, then so be it! Take another look at those lyrics I quote at the opening of this blog post...it's not just a play on words about blood and blood tests for me, personally..."I try to live but I don't belong"...really? You don't belong in this life if you don't take your health seriously...you need to do what you can to live in a healthy manner, and be the informed consumer you need to be in the sad event you're no longer healthy. Learn with me. Avoid my mistakes. Copy my successes. We can make it to 100 and beyond!!!
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