When I began this blog I thought I would be posting often on political topics. I haven't at all, as it turns out. Each time I go to write something I feel like I'm just not quite informed enough to say something intelligent. But the one topic that is really making my blood boil this election cycle is health care. We are big health-care consumers in this household, so it's something we've been able to think about quite a lot. Red Cardigan gives an excellent overview of some of the problems plaguing our modern system. To encourage Red, I thought I'd highlight one sign of hope: our family physician.
Our family doctor is, first of all, a family doctor. I certainly believe in specialized medicine and we see many specialists but for run-of-the-mill medical problems, it's much more important to the quality of care that the physician know the patient. I have never personally needed to see our family doctor, but I have taken both of my kids in on several occasions. When I do go to him for some malady, he will already have an established relationship with me
Our doctor is in solo practice and has no staff. He doesn't have any partners, any nurses, any receptionists or any billers. When we need to see this doctor we call or e-mail him, and schedule the appointment with him personally. He always knows who is waiting to see him because he makes all his appointments. I once had to wait five minutes in his waiting room but otherwise we've always gone in on time. Our entire 30- or 60-minute appointment is spent with our actual doctor. We don't answer a dozen questions from a nurse only to spend half of our precious five minutes with the doctor answering all the same questions again. Our doctor weighs babies, gives them their shots and even replaces their cloth diapers after an exam.
Our doctor does not work with any insurance companies. He provides standard "diagnosis" forms for the convenience of his patients who wish to file for reimbursement. He also encourages Health Savings Accounts. Because he does not work with insurance companies he can charge a fair hourly rate instead of an exorbitant rate that is then "negotiated" with a third-party. Our doctor does the negotiating with his patients directly. He does not refuse patients because they can't pay but will work with them to find an acceptable financial arrangement. Because he does all his own billing, he knows exactly what the visit is costing his patient. He knows, for example, that each vaccine costs $30 and that administering five in one day might be a financial burden (as well as a physical burden on the health of the baby).
There are a lot of other things we love about our doctor that have less to do with the current state of health care, but that still buck the current trends of the medical establishment. He trusts the judgment of parents: he asks parents to make informed decisions about vaccinations and he doesn't insist on endless well baby visits. He responds to e-mail and often offers simple solutions and advice this way. And, because his second-floor office does not have an elevator, he has often met me at my car and walked me back out again so he could carry one of my kids.
This is an unusual doctor. There should be more like him. If healthcare in this country become increasingly privatized, I think others will follow his model of practice. If healthcare becomes nationalized, I'm afraid this doctor might be forced to find another line of work--or radically change the way he deals with his patients.