August 15, 2003

Physician, Cure Thyself

You should know that at 1 p.m. today, I had a routine dental appointment.

Now, the dreaded visit to the dentist's office actually went great. I was pleasantly surprised to find that the practice to which I went -- it was my first time -- was above-par in all regards. The hygenist was pleasant and the dentist was businesslike, both attributes which I like; and both were extremely competent in providing care.

At the end of the visit, though, I was rather amazed to find that I might have to pay the entire $220 bill for services upfront. As I have a reputable insurance provider and I know my own benefits package, my initial reaction was not dissimilar to my reaction were I to drink a glass of spoilt milk. True, we were able to come to an agreeable solution (I paid $15 then, and would be billed for any overage) and I certainly understood where they were coming from. But the whole experience was rather off-putting.

The end result is that I am not in a generous mood towards the medical profession at present.

This mood was not helped, I might add, by the wailing and gnashing-of-teeth which I read here. I was meaning to blog about it some time back, but got caught up in other things; but when I read it again, I about choked on my own bile.

You should know that one Jean Schoonover, a physician in Maryland, is not at all happy with what she sees as the devaluing of her profession. Dr Schoonover, who is married to another physician, complains in The Washington Post that she and her husband can't make it financially. But this is not the least of her complaints, as we shall see:

Something is wrong with our nation's outlook on health care these days. I have come to name this phenomenon the "Devaluation of the Doctor." As I hear grumbling about Congress's making more Medicare cuts and my patients' complaints about $10 co-payments while they dig $300 cell phones out of their Gucci bags, I am getting just the slightest bit bitter.

Somewhere along the way, as we sat back and let insurance companies turn caring for the sick into an industry, we lost sight of the importance of medical care and those individuals who sacrifice their entire twenties to learn how to save lives and keep us healthy. HMOs have bred a population more interested in paying for a cellular phone plan than a physical. It saddens me to meet a new patient who is "transferring his care" to me (after sticking loyally to the same doctor for 40 years) just because "Doc So-and-So stopped taking Mamsi."

I'm suppose I'm feeling just the slightest bit bitter myself. I don't personally see how the insurance companies are to blame for all of this, and I can certainly understand why average citizens would rather have someone else pay for their health care. What I can't understand is why Dr Schoonover thinks that because she's a doctor, and she's spent rather a lot of time in training, that she's entitled to an upper-class lifestyle right off the bat.

Posted by Benjamin Kepple at August 15, 2003 05:02 PM | TrackBack

Jonathan blogged about this as well:

And his follow-up:

Basically, he explains that Dr. Schoonover is using the flawed "Labor Theory of Value," which holds that value is derived from work done or level of training completed.

But $220 for a routine cleaning!

Posted by: Kevin White at August 15, 2003 09:11 PM

Well, to be fair it DID include X-rays and other dental work. Just the cleaning itself was $65.

Posted by: Benjamin Kepple at August 15, 2003 10:16 PM

But then again X-rays are kind of standard when one goes for a cleaning, aren't they?

Posted by: Benjamin Kepple at August 15, 2003 10:17 PM

$65 just for cleaning? Ouch. In Taiwan, it's 200 NT--about $6. And that's if you _don't_ use national health insurance (for which you pay $90 of taxes a month for a family of four.)

Posted by: Michelle Y. at August 16, 2003 01:04 AM

$65 sounds more like it. That's a fair sum for something you do twice a year. It's worth $65 to me. Although I wonder if I couldn't do just as well for my teeth on my own.

X-rays standard? Err, I don't think so.

Posted by: Kevin White at August 16, 2003 05:19 AM

Well, as someone who spent a lot of time and money preparing for a professional career, I can understand at least desiring a slightly above-average income, insofar as I have invested an above average amount of time, and spent an above average amount of money to learn a profession that requires most skills that the average person does not have. And I'm just a lawyer. Unless I end up doing death penalty work, people aren't likely going to have their lives in my hands. Doctors spend even more time, and more money, learning skills that the average person is less likely to possess than the skills I possess, and I can see why they'd be bitter. Most of the doctors I know are not "living the good life" according to the widely held stereotypes. And I actually share the dismay that Dr. Schnoover demonstrated -- I am consistently shocked at the number of people who are willing to spend tons of money on things like cell phones and designer clothes while balking at relatively reasonable health care costs. My dental hygenist told me about a kid whose oral health was terrible, almost to the point of threatening his overall health, and his mother said she couldn't afford for his dental visits. Yet she had the gucci bag, had her nails done, her hair done, the designer clothes, etc.

Part of the problem *IS* that people have screwy priorities.

Posted by: Geoff Brown at August 19, 2003 10:34 PM