Wednesday, August 24, 2011

Medical Care--or the lack thereof

I'm so angry and scared I can't find the words to say what I feel right now. I keep wondering whether what happened to me is how the American public really wants people to be treated. We have millions of unemployed people who don't have health care, since most health insurance is through people's employment. We have millions more working people who don't have health care because their employers don't offer it. Somehow we have to fix it, but I don't see how and certainly not in time to help me.

I recently had surgery. They diagnosed me with type 2 diabetes. They said I didn't need medication. I need follow-up medical care to try to keep me off medications. They sent me a referral letter and I called. The registration clerk told me the referral was for the classes I already attended. She offered to make an appointment with a pharmacist. I told her I didn't see why I needed to talk with a pharmacist since I don't need medication at this point. She told me they don't offer ongoing care for people who aren't on medication. I can get medical supplies to test my blood sugars and take all the healthy living and education classes they offer and attend the diabetes support group.

She said that I could get a primary care physician to work with me. I got the number from her and called. The clerk who answered that phone told me some garbage that made no sense about them redoing the clinics so no doctors are taking new patients right now. I wondered if I had insurance or cash if that would have been the case, but I saw no reason to ask because she'd say whatever she'd been told to say. Someone on Yelp posted that they got the same story and the post was over a year ago. The clerk said if I go to outside clinics there's no guarantee that they'd take the program I'm on. I got the message. If you don't have outside insurance or the money to pay, you don't get care unless you need something that specifically requires a doctor. In my case, that would be medications that need to be prescribed.

Right now my disease is barely started. My numbers are not in the "You're not diabetic" range, but they're pretty stable and mostly in the lower range of where you'd be diagnosed as diabetic. If I could get individualized help to tweak what I'm doing to try to keep it under control and improve those numbers, I may not need medication for a long time. But what do I do without that help? 

My research is leading me to the same brick wall. At some point, all the book authors, medical web sites, etc, all say to discuss various aspects of your care with your doctor or health care team because they have to be personalized to how your body is responding to your efforts to treat the disease. How do you personalize it when you have to be your own doctor and you don't have the medical degree and medical experience and access to a lab to test your blood regularly?

And back to my original question-Is leaving people to get sicker to make them need medication so they need to see a doctor to prescribe it, rather than helping people stay healthy and off medication, really what we want to do? Apparently, the answer is yes. When you don't have insurance, people ask why didn't you go to the doctor before it got this bad? Or get angry that you went to the emergency room because what you have isn't life-threatening. What else can you do when no doctor will treat you until you get sick enough to need the emergency room or, if the hospital has it, a clinic for immediate needs that aren't life-threatening?