Friday, February 17, 2012


How do you choose your health care practitioners? Many people here in Washington DC want "the best." They read the Washingtonian Magazine's list of 100 best internists (for instance), choose from that list. Others are restricted by their insurance companies and must choose from a list of those affiliated with the insurance company. Even if they don't like any of those doctors, they must choose one from the list. What a scam!

Accolades are great, but if you ask me, rapport is far more important in terms of creating a productive relationship. People say, "My orthopedist is a jerk, but he's the best." Then they shrug their shoulders. I'm talking about people who are coming to see me because they're in pain either prior to or following orthopedic surgery. I know that expertise is crucial, but it shouldn't be the bottom line. I wish it wasn't the bottom line.

The best health care practitioner is the one who honestly cares about your health, no matter his or her credentials. Of course in order for your doctor to care, they have to actually know who you are, be in relationship with you. That situation is very rare. I know that the era of the doctor who paid families visits at home, who was the family doctor from childhood to adulthood, who delivered all the children, that era is done now. How sad. Those guys had context to work with when diagnosing a problem. Relationships maintained over a long period of time deepen, including those with health care practitioners.

One of the millions of problems with the health care industry in the U.S. (and it IS an industry) is that when you go see the doctor, there are many ways in which both of you must start from scratch, a process that takes time and costs a bundle. No matter what anyone says, a list of conditions you've suffered in the past is no more than an arrow pointing in the direction of your history, temperament, habit and lifestyle, all of which have a profound impact on health and how best to treat illness. The doctor has to mostly guess what's wrong, and will have no idea what kind of treatment would work best for you. It's no wonder so many people suffer through a million heinous medical tests, to "rule out" various possibilities. What that means is the doctor can't be sure of anything since he or she doesn't know jack about you. Maybe they know your name, that's about it.

Even if I don't truly love every one of my health care practitioners, I have tremendous respect for them. They are curious about my condition. When I describe my symptoms, you can see little lightbulbs flashing above their heads. They are engaged and invested in the best possible course of action. None of my doctors are glazed over automatons who see a patient every seven minutes. No thank you! That is not a healer, that is no better than Web M.D. Stay away from both, please!

Honestly I didn't mean for this to be a rant, but it turned into one. Oops. Be well, no matter how you choose your doctors. You know best, you're in charge! Shalom.


jeanette from everton terrace said...

Oh Reya, if you even had an inkling how many tests I've had. How many doctors. Insurance companies are in charge. I'm very lucky right now to have a great one but still, I dread a new doctor.
I'm thinking you are here talking about health and I'm having a chocolate giveaway - whoopsie :)

jeanette from everton terrace said...

PS - my verification words were LORD and FUDGE - thought that was funny.

Reya Mellicker said...

Lord Fudge! What a great exclamation.

You're doing a chocolate giveaway? I must hurry over asap!

Kerry said...

The word verifications are so hard to read that I give this comment only a 30% chance of making it!! Seriously, where did blogger get these crazy old fonts? From 18th century German bibles?

uhhh, what was I going to say. Oh. When we moved here to Oregon, I was so cynical about health care that I just chose the nearest provider. There was really no better way; isn't that sad? I tried calling around, but the "best" docs weren't taking new patients. I decided I didn't care because we were all "in good health" anyway. I chose the newest clinic, loaded with renegade old docs, and a passel of greenies. It turned out okay, but I know it could be so much better.

Angela said...

In Germany, we have taken a different step. Costs were getting much too high, every medical specialist wanted to (had to) use his expensive x-ray machines, and the health insurance companies refused to pay everything double or threefold. So it became a law that people have to FIRST see their own house doctor (who were upgraded this way), who THEN must decide to what branch of specialist (not the person) the patient was to be sent, getting all the basic informations along.
This way the good old family doctors have increased again, which is wonderful.