Saturday, September 29, 2007

The "Practice" of Medicine

I promised, when I verbally abused the legal profession, that I would do the same for the medical profession. Taking my word seriously (It may be in fact, about the only thing that I take seriously) I am therefore happy to present the following: Like most people my age (yeah, yeah I know, older than dirt), I am dealing with the fact that my body does not function the way that it used to, that I expect it to, or that I would like it to. I don't feel the need to be terribly concerned; but much like proper auto care, preventative maintenance is the best way to keep the old heap around, so I attempt to make the effort that is required. It sometimes seems to me however, that the actions of the medical professionals that I have placed in charge of my health could be what ultimately causes my demise. The methods to extend an existence which I am sure some people think has already lasted too long is causing me to agree with these critics. Like the medicine commercials that you often see on TV, the side effects of the treatment appear to be worse than the disease itself. Perhaps this is just the nature of managed health care as we know it today. Health care professionals I suppose, in an effort to treat as many and as much as they can, appear to be experimenting on us most of the time (it is called a practice after all). Treatment consists mostly in the taking of tests and medications that can then be adjusted to reach an baseline established by a bunch of medical researchers who probably have no lives themselves. Add a little this, take a little of that away, and pretty soon you get where they want you to be. This is a great way to make chili (and I gotta tell you that I have learned to make great chili this way over the years), but I'm not sure about using it to make a great ... me, and I have a few problems with it:
  • It makes me feel like a backyard pool whose chemicals you adjust every time you take a water sample. Why can't I just take a medicine (or combination of them) and feel better? Why is it necessary to adjust the combinations and doses endlessly?
  • Second, adding and subtracting these chemicals costs MONEY! Even with health insurance, the cost of these medications is more than I would like to be spending in the hopes that some day my numbers will look good on somebody's chart. (In fact, the amount is enough to lease a really nice car, and is fast approaching a house payment.)  
  • None of this ever seems to be designed in order to make me feel any better. Instead, all it appears to do is make my personal numbers closer to the accepted guidelines. (Maybe it would be easier for them to treat the chart instead of me.)
  • All of this experimenting has what the professionals call "side effects". Drug interactions, drug resistance, and (the big one) negative reactions during this seeming never-ending process have profound effect on quality of the life that I am supposedly taking these medications to achieve.
  • Failures in the proscribed treatments are not failures on my part. The fact that the guesses being made on my behalf are not working is not because I have done something wrong, or that I don't want my numbers to get better ... so stop trying to make me feel guilty about your failed predictions.
  • Finally, that having achieved a certain momentum in the path of life that I have been following, I am not all that willing to make drastic changes in order to ahieve little more than making these health care professionals happy. Beyond a certain age, all of us resist and resent change, no matter how altruistic or beneficial the motives.

Our health professionals need to start realizing that the patient is a person and a customer to be served, not a servant to be ordered about; and certainly not an experiment to be successfully completed. I am willing to be counselled and guided, but not to be scolded and ordered. They need to understand that most of the things being done in the hopes of keeping us healthy make us feel pretty lousy and are keeping us in the poor house (which makes us feel even worse). They also need to realize that the charts that they are asking us to conform to are only the latest in a series of numbers that the researchers change more often than they change their clothes. The Quality of a Life should be as important as any concern in this process; and that information won't be found on any chart, nor discovered by any test. I therefore ask that they keep in mind a bit of wisdom that at the very least, is becoming a meaningful part of my life these days:

"Having given up everything that I need to in order live longer, I now find that I no longer wish to..." 

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