09.30.11
Notes as a bystander from the cancer ward
One of the signal failures in US health care is too many doctors.
That’s not meant as a comment on the absolute number.
Instead it refers to the saddling of patients with multiple doctors, their staffs and infrastructures. It’s all part of the long-standing US obsession with hyper-specialization and the expansion of a massive buzzing edifice of health technology.
Even when the doctors are in the same building, or even on the same floor of the same building, there’s friction. And this friction comes at a time when the person getting the services is very unwell.
Even someone with no health problems would find it challenging.
With so many involved you get opinions and interpretations on disease and results that are never all completely on the same page. Outlooks differ.
So one minute you can get a statement that’s very unfavorable. The next, down the hall, something almost opposite, depending on the state of mind of the physician.
It’s incurable, says one. The survival figures are very bad.
Next up: You’re going to be treated. It’s going to work.
Surrounding every doctor is a staff, sometimes shared. Even with everything committed to a computer network, so many people guarantee that data entry and communication is fraught with mistakes.
Daily. Error correction is a constant part of the experience.
The doctor tells a patient, by phone, that a test has been canceled. The next day, at the same facility, a nurse comes along with an appointment for the tests that have been canceled.
No, no, the patient is mistaken. Fifteen minutes later the nurse is back. Turns out, the patient was correct.
Off-site, another series of scans is done. The next day, one of the staffers at the cancer center asks when that new scan, already done, will be done.
This is straightened out on the spot.
There is a request made for the new results to be faxed over. When they arrive, they are either the wrong papers or those of another patient.
Eventually this is sorted, too.
But it all takes time. And it’s a constant reminder that this system of hyper-specialization is not efficient.
It’s not an admirable feature, not something the American health care system can be proud of, yet it is entrenched.
And in Pasadena, CA, it is discovered that all the cancer doctors in questions are hard asses about the use of medical marijuana.
It’s a cognitive disconnect in a state that went out of its way to legitimize the use of the drug because it was thought to be of use to the deathly ill.
Have these people been flustered by the federal government? Do they just not like the mini-industry of potheads and hippies that furnish it from storefronts here? Were they read a secret riot act by someone?
Who knows? Why do they even care to condemn such a small thing while easily handing out prescriptions to much stronger palliatives?