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The 5 Things I Hate About American Healthcare

by Chris Poindexter

As you get older you develop a love/hate relationship with the medical profession. There is love because, at some point, they’re going to save your life. The hate comes from the casual abrasions of your dignity, regular affronts to your pocketbook, and constant interruptions to your normal routine that accompany a trip to the doctors office.

The difficult dance with the medical profession is one of the reasons my interactions with them tend to go in streaks, with long periods of neglect by both sides in between. During my last long interaction with medical science, I was finally able to articulate just what really bothered me about the whole experience. I learned that it’s not big things keeping people away from the doctor, it’s little things. There are 206 bones in the human body, but here are the five bones I pick with the medical profession.

You Treat Me Like My Time Is Worth Nothing

Depending on his or her profession, the average doctor is clearing around a quarter-million a year. Okay, I don’t make that much, but that’s no reason to let me cool my heels in your waiting room like I have nothing better to do. For many of us out there if we’re not working, we’re not getting paid. Sick time is a relic from the past, like pensions and retirement. Freelancers like myself can actually hear their billing going down the drain during the hours we’re wasting in waiting rooms.

While We’re on the Subject — Waiting Rooms Suck

Medical people don’t place a high value on waiting rooms because they don’t spend any time in them. Many feature cramped, uncomfortable furniture that needed to be replaced 10 years ago. There’s nothing like being stuck elbow-to-elbow next to someone with a chronic cough, who is also sneezing and blowing their nose. I’ve also only been in a handful that had Wi-Fi, so at least I could get a little work done while I was waiting. Buy some new and comfortable chairs, lower the noise level, spring for the $50 a month for Wi-Fi, and replace those crappy paintings on the wall with something a little more colorful and alive. Better yet get rid of waiting rooms altogether, and page people to the office by text or phone when it’s their turn.

You Make Me Fill Out the Same Paperwork Over and Over

I know there are good systems out there for management of electronic patient records and online registration systems, because I helped build some of them. Yet every new doctor I see still has the same pages-long medical history forms, HIPAA forms, and financial responsibility forms. Filling those out over and over just invites mistakes and oversights, especially when you think I’m going to list every major disease a close relative has ever had. I don’t have all day, and you don’t have the forms online so I can fill them out in the unhurried privacy of my home. HIPAA gets the blame for not being more up-to-date and not using services like online registration, email, and text messages — but the law is not as big of an obstacle as most medical offices claim. More often the real culprit is the medical profession’s own colonial approach to technology and stubborn indifference toward customer service.

You Don’t Call If You’re Running Late

You expect me to do that if I’m running late for my appointment, but keeping me waiting 90 minutes because some drug rep you think is hot happened to stop by is alright. I’ve adopted a new rule for any doctors appointment; I give them 30 minutes past the appointment time and then reschedule. It doesn’t matter if the procedure requires prep time or advance medication; I’ll leave. It’s unfortunate that has to be, literally in some cases, a death-defying act, but you have to draw the line somewhere. They have their rules, I have mine — and leaving is the only sense of control that I have in that unequal relationship.

You Soft-Sell Side Effects and Potential Complications

I had fairly major surgery last year, and both of my doctors made the procedure sound like it was a piece of cake. I actually thought I’d be in and out of the hospital the same day. Then, in a later conversation, I discovered it would actually be three days. In reality I was in there a week — and only got out then because I insisted on being discharged. Waking up from surgery was an orgy of bloating, pain, and nausea followed by a laundry list of minor complications, none of which I was mentally prepared for because both the referring doctor and the surgeon made the procedure sound like day camp at Disney World. I also ended up with a large ugly scar, which was another highlight that wasn’t in the brochure.

Sure, if you tell people the ugly truth, some are going to opt to not have the procedure done — but that’s their right. If the patient decides that the cure is worse than the disease, it’s their call and people deserve the whole truth.

Right now my opinion of the practice of medicine in the US is that it’s a dysfunctional mess that puts patients between billion dollar corporations trying to chisel each other over for a margin. Everyone involved, including patients, doctors and insurance companies, feels cheated by the process. There’s too much profit margin in the system, sucking unproductive dollars away from patient care and driving costs up for everyone. In new rankings of medical care in 17 wealthy nations, the US ranks dead last.

I know we can do better and we have nowhere to go but up. Virtually anything we do differently will be an improvement.

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