Thursday, June 19, 2014

Seeing Our GP Tomorrow

I grew up in the 1950's and came of age in the 1960's.  Since Hubby and I are visiting our GP tomorrow (for the last time with Dr. Patel since he is graduating and moving on to his own practice), I've been thinking how much patient treatment has changed throughout my life.

Of course I remember when doctors actually visited your house.  One memorable Christmas my mother got strep throat and the flu, and though she made it through the dinner and the gift giving, Grandmother called the doctor at his home at 5 p.m. and he came to our house to take her temperature and give her a shot.  On Christmas evening.  Into the house, right into the bedroom, and sat with the patient.  Then visited with the family and had a piece of mincemeat pie before he left.

The message, today, of course, is -- if this is an emergency call 911 and go to the hospital immediately.  Our clinic site runs an emergency clinic for walk-ins, because it usually takes five to fifteen days to get an appointment with your assigned doctor.  I made our appointments for tomorrow in May to make sure we would get to see Dr. Patel before he left "our health world" forever.

I don't remember we saw as many specialists, either.  I remember when I broke my elbow when I was 10. I was taken to St. Luke's hospital but both my mother and my grandmother consulted with the GP who then called in Dixon and Dively - the bone specialists of the city.  My arm had to be set under aesthetic because of the severity of the break but I wasn't kept in the hospital overnight.

However when I was 12, my appendix "went bad."  I had had several attacks over the summer but we hadn't recognized what was going wrong.  One Saturday morning in October my dad called upstairs asking why I had been vomiting since before dawn, and when I explained my tummy hurt and I kept throwing up, Mom took my temp and the doctor was called (at home).  Once he heard the symptoms I was again dispatched to St. Lukes and the appendix was removed before nightfall.

I stayed in St. Lukes for five days -- and loved every minute of my time there.  Grandmother and Grandfather paid for a private nurse -- anybody remember them? -- for me for the first two nights.  She was a fascinating creature with blood red nails and the most elaborate nurses cap perched on her long blond hair.  Remember those nurses caps and the starched uniforms?  My room was filled with roses and carnations and she spent most of her time prepping the flowers, because at 12 I mostly slept the nights away.  Finally, she told my grandparents they really didn't need an RN for a kid that really wasn't sick and she was released -- and I cried when she left.

My time in the hospital was filled with backrubs in the afternoon and before bed, ice cream treats in the afternoon and after dinner, and trays filled with food that I got to order myself.  I don't think I had a TV but the room was filled with books and craft materials -- brought in by my grandparents -- and folks waited on me hand and foot.  I was nearly hysterical on having to leave the hospital because I'd never been so pampered in my entire life.  My mother was hugely embarrassed and angry with me, claiming I made her look bad as a caregiver.  The entire nursing staff gathered round to hold my hand and assure me that if I got home and got sick, I could come back.  

Interestingly I don't remember ever having seen a doctor while in the hospital, but I must have.  I have no idea if I had a special surgeon or not; quite possibly the GP performed the surgery.

As a child I had an old fashioned pediatrician, Dr. Coward, well-known in the city.  I went to him until I was 12 -- probably right about the time of the appendectomy.  Then I transferred over to the the family's GP office.  I went to them until I got my first teaching job and my own insurance.

At age 20 I got a gynecologist because I had horrible menstrual cramps -- and the philosophy of the GPs was that once "you have a baby you will no longer experience this pain."  Nobody was ever able to solve the menstrual cramp problem, even when I finally found what I thought was the best gyno in the city -- and that pain got worse as I aged.  Then came the problem of infertility -- and finally we solved the whole shebang by removing the offending organs -- the best decision of my lifetime up until retirement.

I spent a lot of time with Total Health Care from Blue Cross and Blue Shield -- and grew to depend on them for full payment of all my health needs.  My gynecologist became my primary physician and for 18 years he dictated my health care.  I saw him usually every three months, sometimes (like during the infertility treatments) more often.  He managed to see me naked nearly as often as my husband.

When I quit teaching in 1990 I spent some years without "real" health insurance, paying my way through whatever treatments were "desperately" needed.  My gall bladder was removed the hard way -- cutting me in half and leaving a scar that transects my entire body.  I had kidney stones that I managed to pass without invasive treatment -- OHHH the pain!   When in pain I got pills; when in distress I got pills; when depressed I got pills; when the flu fell me I got pills.

During these years doctoring seemed to changeradically.

Now I can't seem to get pills for much of anything, though that said, I'm taking more "holistic" meds than I ever thought reasonable.  My current GP has never seen me undressed.  I can communicate with him personally only through email and then he will call me after a week or so has passed.  I can call his office and talk to his nurse and SHE talks to him and then SHE calls me back.

It's actually an okay system.  I'm not the sick one in our family and Hubby has been taken care of beautifully and on point.  He has never been denied help -- and only once was I thoroughly put off that, as he was going into congestive heart failure, it wasn't identified in the GP's office.

It's the emergency room techs who get the real credit, though.  They are the ones on the front line that handle our emergencies, they diagnosis and admit us to the hospital, they call for the tests -- and then they notify our GP and consult.  They hold my hand when I'm terrified for Hubby and they tell me if I should be worried, terrified, or just "go on about my business."

I'm sure that nurses are much more comfortable without those starched uniforms and caps of my youth -- and they can certainly do a lot more work in pants and scrubs.  I don't really want or need my doctor to make a home visit.  I'm actually delighted that Dr. Patel will not have a memory of a naked Milly on his exam table and since my lady parts are mostly departed and I'm reaching really old age, I'm sure he's as delighted.
I would like it to be easier to get pills to soothe the troubled spirit but I understand why they are not so readily dispensed these days.  It would be nice to get an appointment more quickly or not have to go through the clinic nurses to get info from the doctor, but if the system works for them I'm not bucking it.

Times have changed and we have to go along with the flow.  Your doctor won't smoke a cigarette during your exam or recommend you have a cocktail before dinner and a tranquilizer after. Instead she'll suggest you put flax meal on your rice and lentils. You won't get a script for diet pills but a recommendation for a 30 minute walk after every meal.  The memory of those hospital backrubs and late afternoon treats linger, of course, but hospitals are not for relaxing and resting any longer.  Now you go to the spa for your rubdowns -- and your insurance simply won't cover it.

1 comment:

Margaret said...

Great post--there are definitely positives and negatives to the changes in health care. The specialists kept Patt alive for 2 precious years whereas in the past, he would have probably died within 6 months.