Wednesday, January 20, 2010

Meet Harry

This is my new doctor, Dr. Harry Shriver. He was quoted in a couple articles regarding healthcare, or rather the healthcare debate.

Here he is in The New York Times. And, again in USA Today.

He seemed alright but 30 minutes was hardly enough time to size each other up. It wasn't even enough time to do the physical exam in the time allotted. He was aware of my concerns already since some of my complaints were recorded "in my file"when I fired my previous doctor. He wasn't simply aware of them, he seemed to understand them.

Group Health's local reputation isn't as good as these articles suggest. It's known locally as Group Death. Often, if I am complaining of my most recent healthcare woes, all I have to do is mention my healthcare provider and that's all my listener needs to know to understand what the problem is.

My husband and his kids have received very good care from Group Health. The doctors there detected and removed cancer from my husband's arm a few years ago and they diagnosed a very rare blood disease in one of the kids many, many years ago. I'm just saying it's not all bad at Group Health. It's not always been bad for me either. On the other hand, I've never been sick before so I never really needed it. (But I've been paying the premiums for the last twenty years, goddammit, so I want my money's worth!)

Group Health is spending a lot of money on their information infrastructure. Medical records are available to all doctors in the system by logging on to their network. X-ray and MRI images are there, all doctor reports and appointment summaries, medications, lab results. Much of that information is available to the patient as well. I can view or cancel upcoming appointments, I can schedule appointments (although this is a new feature that hasn't had all the bugs worked out). I can view my lab results and order most prescription refills which can be delivered (free) by mail. (They won't mail the hard stuff.) I can communicate with my doctor by e-mail or by phone appointment. This means fewer patients need to come in which is how they can reduce their patient caseload. All of this is good.

What they haven't figured out yet is how to keep the relationship personal. Usually, whoever I see (including my last doctor) doesn't face me when talking to me. They face the computer. They're typing notes or filling out some on-screen form. Not all of it is in English either so sometimes there's a pause in the conversation, if that's what you want to call it, because they have to figure out what code to use to abbreviate some condition, diagnosis, or procedure. It takes them longer to figure out what the abbreviated code is than it would have taken for them to type it in English or medical jargon.

The experience has become so impersonal that I am emotionally moved when someone breaks the mold and makes eye contact. And for just one moment, even, gives the perception that they care. I'm serious. That's enough to make me cry right there on the spot. (To be honest my eyes are leaking just a little bit right now just thinking of it.)

I went with a friend to one her doctor's appointments recently when that very phenomenon happened. She finally got a referral to a pain clinic two years after her symptoms started. (It's a slow process, this healthcare.) We met a charming gentleman who reviewed her file (on paper) - let me just pause right here. HE READ HER FILE, ladies and gentlemen. I hate to inform you but usually they don't! They only rely on their own experiences with the patient rather than try to understand the patient's past trials and failures. Incredible. And by taking the time to do this he was able to find multiple errors in her written file. How crazy, not to mention irresponsible, is that?

And then, here's the totally amazing part, he summarized her case history, without having taken notes or referring to her file. He quite succinctly boiled it all down, with accuracy, and with eye contact. He understood. You don't know what this means to us. To be heard. I don't know yet if he can help her but he scored major points for being compassionate. Seriously, huge moment but one hates to get hopeful as we've been disappointed so many times before.

Yes, we want to be healed. But we also want to be heard. (Cared for, would be nice too.)

I hope it works out for Harry and me. We'll see.

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