Another short week – ha!

So another short week, I took Wednesday off to go with Mike to his independent medical exam; he got hit by a tractor trailer in 2006 and has had some continuing health concerns since. As he is a painter, the fact that his neck was whipsawed around the car and his hands now go numb is more than a little of a nuisance.  He has constant pain in his back and neck and has to rely on medications to sleep, stand and etc. He has a law suit pending against the truck firm, who’s driver was talking on his cell phone at the time of the accident, and was ticketed for an unsafe lane change ( he crashed the lane mike was in and totaled his car). The lawsuit has been pending since the accident and now they cannot even find the driver but Liberty Mutual – you know the “what’s your policy” people won’t settle.  I was told by his lawyer that I could not go into the IME with him and they sent one of their law clerks to go in with him.

It was a neurologic exam and it was amazing to me the edifice they have built with insurance money. These doctor offices are the most beautifully architecturally and aesthetically structured, and incredibly staffed by 20-something little girls.   What is really sad is that now instead of just having a practice and helping people, there are many doctors that hire themselves out like whores for insurance company IMEs. People think that they are more reputable because they are local and not flown in like they used to do and like the state currently still does to determine if people are eligible for disability and workman’s comp.  In those IMEs the doctors are usually those who have had to end their regular practice because of being sued multiple times for negligence, so they hire themselves out to the insurance companies who probably were involved in suing them to begin with.

So after the four pages of paper work that needed to be filled out complete with diagrams etc, and waiting for 45 minutes for him to be called into the office, he sat in the waiting room in back for another hour and a quarter. The appointment was for 10am, he didn’t go back until 1045, and even though he had the paperwork filled out at 10am, he was not seen until 12 noon for a brief 20 minute exam.  So , the upshot of all of this is that both he and I were exposed to someone with a cold and we now both have the sniffles. His symptoms are more severe because I take more vitamin C than he does, or at least that is what I think.

So on top of a very stressful Wednesday I got to cram ten pound week into a 5 pound sack. I now have 28 patients in homecare and it has been very stressful as new ones keep coming. They say we can be assigned up to 35, but frankly I don’t think I can manage 30, not and still do what I’m supposed to do. Although lately I will admit that I don’t know what I am supposed to be doing. When you get marching orders that are patently unfair and not well considered it makes it hard to continue to be civil with the “handlers”.

I guess the hard part is trying to figure out how not to be part of the medical establishment that people like myself have come to know and loath. It makes me want to be more consumer oriented and come up with better ideas how to serve people’s needs without leaving that “medical community” feeling. This is not an easy task considering the fact that we are the medical community and I am a medical social worker.  Everyone knows the stereotype of social worker – we take your babies and place your granny.  So I have to fight the image of that, and after working with me most people are pleasantly surprised.  But how could it be better?

Well to begin with the nurses could start with some social skills, which would be nice. They range in their disability to connect with people from fair to really dysfunctional.  I think that it is because it is the one field where they are the case managers and boy does it goes straight to their heads. Hospice work is like a magnet for any nurse who wants to be the Dr.  The irony of it is that they are worse than the most controlling doctor because they are allowed to be in Hospice care. It is encouraged by the director of services.  The very power they deplore being subjected to when they work with doctors is the power they wield with patients and their families.  If the patient or family gets a recommendation that they don’t agree with or don’t want to follow certain recommendations the nurses then have such a hissy that they want to have them discharged because they are not willing to follow the plan of care.  What is worse is that they don’t do the dirty work themselves; they make the social worker go out and make the family tow the line. This is the nonsense I got tied up with on Thursday.  I think that every time the nurses get frustrated with doctors offices and verbalize their frustration (they often do), I will comment on  it in terms of relating to their  relationship  with their patients and families.

Getting back to the medical community and my concerns.  The cost of medical care in this country is outrageous. I still don’t have the bill for my recent emergency room situation, but I know it is going to be costly. The company I work for has provided me with health care coverage not unlike many other companies who have felt the pinch and scaled back.  I have a $2,500 deductible that starts over every January –I will have to make payments through-out the year on this one. Last year I only saw my doctor twice, because to do so otherwise would have been prohibitive. They say that they pay for yearly testing and screenings but the one person who did that ended up paying an overage because her doctor did not accept univera payment as payment in full. So much for the free screenings.  My medications are covered by Walgreens because somehow they can afford to offer a prescription program for $5 per year that gives me and 80% discount on medications – this was better than my old Independent Health coverage.  I know why they do it, it’s because they have figured out that I spend other money there and it evens out.

The problem is that many employees are struggling when illness hits with pseudo insurance, but the doctor offices and medical multiplexes are getting bigger and bigger. I guess they figure that if you’re sitting in the opulence you won’t mind the fact that they are raping the health care system.  Everyone is afraid of socialized medicine but the fact of the matter is that they should be afraid of medical capitalism that feeds on those who can least afford it. The sad truth is that even though it is horrible –  I am better off than most.

Well, back to work.

Peace from the weary empath.