American Pie: Doctor, Please Do Little
...A gentleman, whose name I can’t recall, wrote a book about the psychology of medicine. In it, he stated that the problem with doctors is that they are compulsive healers. The first doctor I went to in America, after having told him that I was perfectly healthy, gave me a thorough medical exam, finally announcing triumphantly that he had found a problem. “You have a pelvic deformity,” he said with glee....
John Merchant focuses his healthy good sense on the task of choosing a new doctor or dentist in the United States.
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No matter how pleasurable moving to a new community might be, there are certain inevitabilities that I’d just as soon not have to deal with. Changing addresses, having mail forwarded; finding someone who can cut my hair without leaving me looking like I’d just escaped from somewhere (as my mother would remark), and so on. But the tasks that fill me with the most apprehension are finding a new doctor and dentist.
Our relationships with doctors and dentists are so much more intimate than those we have with other providers, and demand a level of compatibility that you can’t determine just by looking at their credentials. Even ethnicity is a consideration. Despite the fact that all doctors and dentists are required to adhere to the same standards of professionalism, cultural differences seep through, and can erode the comfort level.
As an example, I have found that doctors who originate from underdeveloped countries often have an arrogance that stems from their elevated positions in the societies of their native countries. In America, medical doctors, thank heaven, don’t enjoy a privileged position in society just by virtue of their medical degree, and have to earn the right to be high-handed, though the very best ones don’t avail themselves of that opportunity.
Strictly speaking, I hardly need a doctor, but the mouthful of technology I have acquired over the years demands that I do have a dentist on tap. So what am I looking for in my D.D.S, Doctor of Dental Surgery to you? Well, first of all, in the USA, there is no such thing as a dentist anymore. Someone you could go to that would pull teeth, do root canal work, install some bridgework, and in a last resort, fit you with false teeth.
Just like the medical profession, dentistry now is broken down into miniscule sub-specialties. The guy that pulls the teeth doesn’t do root canals, and the guy that does root canals doesn’t do implants – you get the picture. Yet withal, there are still practitioners around who will service most, if not all your needs, and those are the ones for me. It’s bad enough having to go to the dentist, sorry D.D.S., at all, but to have to run all over town to get the job done is more than flesh and blood can stand.
After I get past that hurdle, the rest of my criteria can only be tested by actually sitting in the chair. My main man, or woman, needs to have small hands, since they are going to be stuffed in my mouth for a good part of our time together. The fingers also must be strong, because fumbling and dropping instruments is not re-assuring.
Conversationally, I prefer not to be asked questions when my mouth is full, but I do like to be talked to, so keep the chat to non-controversial comments that don’t demand a response from me, other than an “aha” or some other retort that doesn’t involve my lips or tongue. Please don’t get into emotional exchanges with the attending dental nurse, and under no circumstances watch TV while you’re working on me, even if you’re only waiting for the cement to set.
Having found my all singing, all dancing D.D.S., I still have to get me a doctor. Just the plain old garden variety will do. As I mentioned earlier, I don’t really need a doctor at all, other than having to renew a prescription periodically, and get my blood checked for the same complaint. But that’s not so easy these days. Almost all family practitioners have a specialty, and they just can’t resist the temptation to check you out for it.
A gentleman, whose name I can’t recall, wrote a book about the psychology of medicine. In it, he stated that the problem with doctors is that they are compulsive healers. The first doctor I went to in America, after having told him that I was perfectly healthy, gave me a thorough medical exam, finally announcing triumphantly that he had found a problem. “You have a pelvic deformity,” he said with glee. Asked if the fact that my left leg is over an inch longer than my right would contribute to the lack of symmetry he grudgingly agreed.
My favorite doctor; other than Dr. Wrench who brought me into the world and tended to my childish ailments into adulthood, would sit at his desk, leaning back in his chair with his feet up. He was always smiling and occasionally would laugh out loud as I described my symptoms. His method for dealing with my mysterious aches and pains was to suggest some investigative procedure that he, and I, knew full well would be painful. My complaint would quickly cure its self.
But in the years since then I have not been so fortunate with my choice of physicians, and each time I changed I knew I would be faced with a battle of wills over my refusal to submit to the x-rays, colonoscopies, stress tests and EKG’s that most doctors insist their new patients take. Just sitting in the waiting room anticipating the confrontation sends my blood pressure up and my heart to racing, thus providing the doctor with evidence that I need to be tested.
Three doctors, Gilbert Welch, Lisa Schwartz and Steven Woloshin recently published an essay in the New York Times titled “What’s Making us Sick Is an Epidemic of Diagnoses.” The thrust of the essay is that the biggest danger to the health of Americans is the health-care system, and the technology that allows microscopic examination of almost any component of our bodies. Thus every ache, pain or state of mind is diagnosable, and therefore treatable.
This climate of over-testing is analogous to a period in my working life when metallurgical analysis technology was rapidly advancing. After generations of successfully producing steel for bridges, battleships, tanks and railroads, suddenly it was becoming difficult or impossible to meet the quality standards. The only thing that had changed was the ability to perform tests in real time as opposed to days or weeks in the laboratory.
It’s a source of great relief to me that I have just found the doctor of my dreams. On my first visit he asked what he could do for me. Good start. I said I needed a prescription and he immediately reached for his pad. He then listened to my chest and palpated my abdomen, during which procedure we conversed pleasantly about inconsequential things. Then, while I was still braced for the inevitable instruction to take a stress test etc., he handed me the prescription, shook my hand, wished me a good day and said he’d see me in 6 months. I sincerely hope he lives a long life.
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