I just learned something very interesting about the nature of healthcare in this country.
You are not supposed to know a damn thing about your own health.
OK, that may be a bit of hyperbole. I’m prone to it. Let me be more specific.
You cannot request any kind of medical testing done without an order from a doctor. It is illegal to perform a test without a doctor’s order. So, if your health care provider says “we’ve been reviewing records, and you are due for some routine bloodwork,” you can call for an appointment and have it done. But, if you say “does that test include an A1C?” and the answer is “no,” then they cannot add that to the list of things to check in your blood.
The reasoning makes sense enough. If they run bloodwork and give me the test results, but I don’t have any kind of visit with a medical professional, they are liable for damage I do to myself. I think. That seems to be the way the law can be read, and apparently is read by many, if not most.
So I have to give props to the very nice understanding person at Family Practice who walked me through this whole dilemma. Basically, since I am going to see an endocrinologist in March, I want to have blood results before that visit. Logical right? So I need them to order it. Problem is, I have never seen them before, and I’m not even in the Geisinger system. (Well, they had me at 243 Broadway so I must have been there as a child.) I am not confident that I will be able to call them and get an order sent over in a timely manner.
So, I am seeing the PA on Friday, who is allowed by law to order me an A1C. I know it would look to an outside observer that I am trying to avoid doctors visits, and maybe subconsciously I am, but really I want to get as much info as possible in hand before I go to this specialist consult.
In the end, it’s all working out. I will be seen, and I’ll get the testing done. I will likely have it in hand in time for the specialist visit. But what it illustrates to me, is that there is a lot of time wasted in healthcare on repeat visits. I always wonder why it is that the people on my “shut-in” list are never home. They’re always at the doctor.
It’s also like “consult your doctor before beginning any exercise program.” In the history of medicine, has any doctor ever said “no no, what you need to do is sit around all day and not move?” I can see some sort of consultation when doing something radical. Even I aknowledged that when I went to the orthopaedist about my old injury, so I could run now. But to take that warning to the extreme, I would call up the doctor to say “I am thinking of walking more than I used to. Is it medically advisable?”
I don’t envy the medical professional at all. The time in direct patient care is eclipsed by medicare reimbursement paperwork, redundancies and stubborn people who just want their dan pill already. Meg once saw a local GP for a winter bug. The lab result showed it was viral. He was going to prescribe antibiotics anyway. She resisted. He was shocked. All he had were patients who wanted to leave with a fix in a bottle.
In a democracy, people get exactly the kind of government they deserve. Well, in an affluent techonogically advanced civilization with every possible way to live well, or poorly, we get exactly the system we deserve. And it is not reflecting well on us.