Monday, June 1, 2020

Dealing with doctors in the Covid era

(Editor's note. I really wasn't intending to publish a post today but then I got caught up making a longer-than-usual comment in the comments section on the post about unsuccessfuly trying to get her ear syringed over at Rachel Dubois neé Phillips's blog or Rachel Phillips neé Dubois's blog or whatever it is and decided to make it a post on my own blog as well. I do apologize (British, apologise) for the long, rambling stream-of-consciousness writing; it's more like Billy Ray Barnwell's style than mine, and if you don't know who Billy Ray Barnwell is, there's a link to him over there in the sidebar. --RWP)

I'm 79 and had a heart attack 24 years ago. Ever since, I've had semi-annual check-ups with the cardiologist, always preceded by a trip to the lab for blood work. Usually my check-up appointments are routine but three years ago I suddenly had to go into hospital and have five stents inserted into my coronary arteries, so the appointments do serve a purpose.

My most recent semi-annual was to have been in early April, but when I called a few days in advance like I always do to make sure the order for blood work was in the computer (the lab people get miffed if it isn't), the cardiologist's office said that since I had had blood work done in October I didn't need it in April as they require it only yearly, and would I like to schedule a virtual or telephone appointment instead? and when I asked is the doctor going to stick the stethoscope through the telephone to listen to my heart and lungs? the woman on the phone got downright snippy. I canceled the appointment altogether and made another one for October. Recently the covid situation has lightened up somewhat around here so when my local pharmacy wouldn't fill my medicines, medicines that one is not supposed to stop taking suddenly, I called the doctor's office again and pulled up the October appointment to late May. An NP (nurse practitioner) saw me instead of the cardiologist. When I mentioned about the blood work she said no, it's every six months, not once a year. So she put in an order and I had the blood work done the day after the actual appointment instead. Very strange way to do business if you ask me, but everything is hunky-dory as the results are available on the computer anyway.

This is a long way of saying I feel your pain, or non-pain, as the case may be.

The world has gone cuckoo, if you ask me.

(Editor's note #2. As further proof the world is going or has gone cuckoo, it has now been one year exactly as of yesterday since Frances Garrood posted anything, and it has been more than 18 months since Kate Steeds has, and the world is definitely not a better place for it. --RWP)

20 comments:

  1. Today's post made me laugh out loud. You're an artful fellow. The laughing came about when, out of curiosity, I read your comment in response to the post.
    I then discovered you lifted the comment and with a few embellishments - hey presto - a new blog post.
    How good is that?
    I think there should be more of this - long comments should be converted to blog posts.
    Oh, wait. Should this be a post and not a comment?
    Alphie

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    1. Alphie Soup, your comment should definitely not be a post. It should remain a comment. It pleased me no end, though, to know that my post made you laugh out loud. I hope you didn't disturb others around you.

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  2. I have a doctor's appointment for next month. I need refills on prescriptions I have been taking for almost 55 years. I am hoping the doctor will simply renew the prescriptions for now.

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    1. Emma Springfield, our primary care provider (GP) usually wants us to come in to see him before he will renew prescriptions, but my cardiologist will usually renew prescriptions if he receives a phone call from the pharmacist.

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  3. Glad your checkup went well!!
    And I agree, the world has gone cuckoo.

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    1. Kathy, I don't know which is worse, the cuckoo types or the ostrich (with head in the sand) types.

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  4. Bob. Just seen your note about Frances and Kate. Frances's husband died a few weeks ago. I'll send you a full email about Hate and Frances if your email address is on your profile.

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  5. Graham, It is. I'm looking forward to receiving your email, and I'm hoping fervently that you mean Kate and not Hate.

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  6. I should add that I've had absolutely no problem with the NHS/Doctor/Hospitals consultations/visits/treatment during the Covid-19 lockdown. So far as prescription requests are concerned they are on line anyway. The Pharmacy delivers it to my door.

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    1. Graham, pardon me for saying so, but from what others re saying (including the aforementioned Rachel Dubois), you must be the exception that proves the rule.

      Thank you for the information about Kate Steeds and Frances Garrood, by the way. Your email arrived earlier today.

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    2. I'm not sure why you need me to pardon you but I'm quite happy to do so 😂 😇. After all there are 70 million people in the UK and those of us who have commented are a very small sample. On the whole I have found, as well, that people tend to comment about things that go wrong rather than things that go right.

      Well I have to be honest and say that the friends in Scotland that I have spoken to have all had perfectly okay experiences with their medical practices. My experience is not just on the Island either: I had a letter from my Consultant Surgeon at Ayr hospital about my treatment (I have a kidney stent) and both phone and email conversations with the head of nursing at the Beatson (West of Scotland's Cancer Centre in Glasgow) who deal with the drugs trial I'm on for my cancer. They couriered all my drugs up to me and got my medical practice here to do all the blood tests, ECG, BP etc that they would usually do.

      Our dental practice is still dealing with emergencies as well.

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    3. Graham, you are certainly right about the smallness of the sample in comparison to the total population. Maybe we should all move to Scotland.

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  7. I am sure that if my need had been a medical emergency I would have been seen/spoken to by a doctor and not left. I think Graham is over reacting in his defence of the NHS as is often the case, one is not allowed to utter one tiny word of dissent. I accepted that my waxed up ears were non urgent, the receptionist was only doing her job, and the COVID reaction to the NHS is one that is judged correct by many. I was perfectly capable of seeking private treatment for my ears and did so. Whilst the NHS is held up on a pedastal and untouchable it will never change of fit the current population size, one of which it was never designed for and it is no good merely chucking more money at it year after year without proper management of the said money which it does not get at the moment.

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    1. Rachel, is it Phillips or DuBois? Inquiring minds want to know. We do not have an NHS over here and I am often quite glad in spite of continuing attempts to achieve the same end through what is called "single-payer health care".

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  8. Pardon my denseness if denseness it be, but why wouldn't your pharmacy fill your prescription? I've gotten used to plexiglas screens, and I always favored outside windows--especially during cold and flu season--but for a pharmacy to simply say, no, we're not going to fill one/some/all(?) of your prescriptions makes no sense at all to me unless the problem wasn't on their end, but rather on the doctor's end for not authorizing the refill, in which case I can understand your objection that an online appt wouldn't be optimal, but surely it would be preferable to no appt.

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    1. Snowbrush, it is gratifying to see the comments section of this post still going strong after two weeks. I take pleasure in small successes. As for the reason for your comment, you are of course correct. It was not the pharmacy that refused but the doctor's office that refused to renew my prescriptions without being seen by said doctor. And when I did go in (a 50-mile round trip, by the way), I was not seen by the doctor but by a nurse practioner whom I last saw about three years ago. They have you, or rather me, by the short hairs to do their bidding since we were told repeatedly during cardiac rehab sessions not to stop taking our medicines suddenly.

      Everything in this life seems designed to make yours truly become as gentle as a lamb, no opposition, mp arguing, come along quietly, please. It's all in your best interest. I'm sure people at Auschwitz were told the same thing before their showers.

      My, you must have touched a nerve. Try not to do that again. It's not good for my blood pressure. Maybe I am over-reacting to what is, after al, merely a slight inconvenience.

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    2. "Everything in this life seems designed to make yours truly become as gentle as a lamb, no opposition, mp arguing, come along quietly, please."

      As Edward Abbey worded it: "What incredible s___ we put up with!" Now, if you will kindly allow me to go on for a while...

      Given that you feel this way anyway, you would positively loathe trying to get refill prescriptions for controlled substances because they would require that you make frequent, expensive, degrading, and time consuming trips to your pain specialist FOR NO OTHER REASON WHATSOEVER than to get a refill prescription, plus, at any time, you can be required to go to a lab within 24-hours for a urine screen or to bring in that month's remaining pills for a pill count. If you should argue or otherwise say a "discouraging word" to anyone about any of these things, they will assume that you are an addict and cut you off entirely. So it is that the system is designed to make non-addicts act and think like addicts for fear of being cut-off, the result being that one's doctor becomes one's enemy. For instance, if it should happen that you're not in a lot of pain during your actual doctor's visit (my pain level ranges from horrendous to not terribly bad), you have ask yourself whether you should lie and try to look like you are hurting (being careful not to overdo it) for fear of being cut-off. Likewise, you might really need more pain relief, but you're afraid to ask for fear of being cut-off, so you instead throw out little hints. This isn't all the doctor's fault, because just as his opioid patients fear him, he fears his mega-business employer and the DEA, and both patients and doctors worry over what might be the DEA's next move. For the patient's part, he can never trust his doctor because he knows his doctor is under pressure to prescribe fewer narcotics. For instance, as though in casual conversation, my doctor asked me recently--while his stenographer was typing away--if I ever run out of narcotics between prescriptions, and I immediately had to ask myself how many of his patients are stupid enough to tell the truth.

      One more thought, it seems to me that when that scheduler got snippy with you, it was in response to you being snippy with her. I always try to remember that the people who receive the lion's share of abuse in doctors' offices are young women who are underpaid, under appreciated, and powerless, both in their jobs and in regard to what the patient is unhappy about. I use to remonstrate quite a lot with Peggy about her tendency to yell at such people, telling her that her words weren't only unkind, disrespectful, and misdirected--in my view--they might inspire the person being yelled at to do everything she could to make Peggy even more unhappy than she already was.

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    3. Snowbrush, well, I can say (1) it sounds like no fun to be you and (2) I'm glad I don't have a prescription for controlled substances. A few years back when I came down with shingles and also had some gastroenterological problems, I was on gabapentin for a time and also hydrocodone. I don't think I took them at the same time. They both helped the pain so much that I could have really learned to like them, but my brain and my better self kept me on the straight and narrow pain-relief-wise.

      I don't think I was being "snippy" to the woman on the phone (and it wasn't a low-paid receptionist, it was a registered nurse). I merely asked her if the doctor was going to put the stethoscope through the telephone to listen to my heart. Granted, she could have interpreted it as being "snippy" so you are saying it was my own fault then, are you? Thanks a lot, old friend, old buddy, old pal. I am not one to yell and shout and certainly not to curse. Kill 'em with kindness, that's my motto. But can I help it if where I spit, grass never grows again?

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    4. "you are saying it was my own fault then, are you?"

      I will only say this once, so please listen carefully. To the extent that your question was bearish, bilious, cantankerous, cross-grained, curmudgeonly, disagreeable, dyspeptic, ill-humored, ill-natured, ill-tempered, ornery, querulous, snarly, surly, argumentative, bellicose, belligerent, combative, contentious, disputatious, fractious, fretful, pugnacious, quarrelsome, scrappy, truculent, huffy, pouty, sensitive, short, sulky, sullen, tetchy, thin-skinned, and/or touchy (https://www.merriam-webster.com/thesaurus/snippy) you were being snippy (I personally--but this is just me--interpreted your question as a passive-aggression rebellion against your doctor's violation of what you regard as your rights as his patient). If, on the other hand, you acted in all innocence because you truly needed your doctor's nurse to confirm or deny that your doctor could put a stethoscope through the phone, then you were not being snippy. You were instead acting in such a way that, if you do it often enough, will inspire your wife to consider it her sad but necessary duty to have you committed to a "home."

      "But can I help it if where I spit, grass never grows again?"

      Such spitting strikes me as the kind of thing that the Biblical deity might be expected to do (in which case the spit would leave a smoldering spot on my lawn), but that aside, if you must spit, I would ask that you spare my innocent grass and spit upon my wicked clover, my grass having enough problems already.

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  9. L.T. (may I call you L.T.?), and if not, Snowy, you succeeded in making me laugh not once, not twice, not even three, but four times with your comment. It made my day, definitely brightened my mood. Thank you very large.

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I will be laboring (<i>British,</i> labouring) under a handicap for the next couple of weeks (<i>British,</i> fortnight)

More about that below. First, though, I want to add an addendum (what else would you do with an addendum?) to my previous post about phone...