Excessive Medical Treatment?

July 25, 2012

Upon reading Tara Parker-Pope‘s article, “Too Much Medical Treatment,” I was moved to compare and contrast my experience at San Francisco Kaiser Medical Center for the same issue: a moderately-severe sprained ankle that occurred on a Sunday. I checked in to the Emergency Room and was  immediately placed in an examining room. A nurse-practitioner promptly obtained medical history and preformed a preliminary exam. She noted and confirmed drug allergies. The E.R. doctor appeared five minutes later and also performed a physical examination. He then sent to me to Radiology for an x-ray. No wait there either. I returned to the exam room and was offered Tylenol or Advil while waiting for results. The radiograph images were available within minutes. The physician studied them and advised R.I.C.E. (rest, ice, elevation, compression and elevation) as well as keeping weight off of my foot until the pain diminished. I was provided a compression wrap and measured for crutches. The doctor was concerned about the level of pain and offered stronger medication, such as Vicodin, if my discomfort increased.

I scheduled a follow-up exam with an orthopedic specialist the following day. This physician reviewed the x-ray, examined my injury and provided a second, better-adapted compression wrap. He asked to follow up in two weeks absent any increasing discomfort or other symptoms of worsening. I was offered physical therapy.

I never saw a bill other than the $100 co-pay I had to supply at admission. The total time spent in the E.R. was approximately one hour.

Four months later I’m almost entirely healed; there is just a bit of very occasional residual pain.

As a patient advocate, I actively watch and intervene for errors and oversights. There were very few and they were quickly resolved without any rancor from the staff. By the way, everyone washed their hands or used cleaning gel without being asked.

I give Kaiser an A+ for efficiency, quality and effectiveness.

The Department of Health & Human Services did review Kaiser’s system as a model for a nationalized health care system. We could certainly do worse.

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4 Responses to Excessive Medical Treatment?

  1. Betty Curtis on July 27, 2012 at 10:46 pm

    Greetings —

    I just want to offer some generalities I’ve learned in my own aging
    experience. Maybe somewhere in your files you will find a place for
    the info to help aging patients.

    Generalities re: Ageing and Medications

    I am not presenting this as a medical thesis by a professional,
    medically trained individual. I am offering it as some things
    I have learned as an 84 year old experiencing aging limits.
    Individual differences will always be involved in aging.
    Please just consider it for whatever it may prove of worth to
    Physician and Patient, in their mutual concern for what works.
    Regard these as “personal observations” on the road of aging.

    I have gradually come to follow a pattern regarding my own use
    of both prescription medications, and OTC medications. I read
    the info re possible side effects, and interactions with other drugs.
    I don’t refuse just because of these issues, but I do assess whether
    my individual history makes me vulnerable to them. Many allergy
    remedies will need 2nd dose after wear-off of original. Sometimes
    the resurgence will be more intense than the original flare-up. The
    side effects warning is of the very thing the original was supposed
    to be aiding. I have learned that at 84 this resurgence can be more
    than I can calmly handle. I will not use the type prescription that is
    like an ant-histamine on steroids. I’ll take an OTC of the basic form
    available and try to use as basic as I can to aid me to be functonal.
    Allergy medications seem to only reduce symptoms, not cure cause.

    I’ve seen seniors swallow vitamins by the handful, thinking they will
    make them feel peppy again. They don’t even bother to take them
    with food. No wonder next step is acid-reflux. That’s not always the
    cause, but can sure be one. I don’t even take Vit C except dissolved
    in a glass of water, so it goes through the system quickly , and in a
    more adaptable form. Also senior overtake of vitamin concentrates
    can add only to nervous energy, because the aging body, or the
    senior lifestyle cannot offer the degree of activity needed to use the
    energy generated. Nervous energy with no suitable outlet can be the
    cause of many elderly aches and pains. I learned this by observation
    of my own body and how it works.

    That is a most important clue for seniors ! Start noting the pro and con
    of wellbeing that results from diet, interest, and activities of your daily life. Don’t overload it with things that clog the circulation, elimination, and act as extra baggage of unhealthy nature. Find the factors of nutrition, for body, soul, mind and spirit that work for you personally, and apply them. No one ever became strong by reading a book on Good Health.
    Application is the route. But don’t judge yourself too harshly if it is hard to find that place in aging where energy. focus, and will are all there at the same time. The Elderly are scattered across past, present, and future. They move from Review, to Pre-view, to Fast Forward.
    Accept the Rhythm. God bless and guide us all.

  2. Gerald Rogan on July 28, 2012 at 5:39 pm

    Betty, you are a keen observer, a necessary skill for optimum health. From my 40 years of practice, I offer this reflection:

    One must monitor one’s own body: what goes in and what comes out, and how it responds to activities of daily living, inclduing sleep, sex, and exercise. Timing of seeminly unconnected events, sometimes over several days, can lead one to create a hypothesis of a cause and effect relationship among event, the veracity of which derives from more detailed observation and data. Physicians can best serve patients who self-observe, take notes, and succinctly report obervations and concerns. For diabetics and vascular disease patients, conditions which can be altered, an early discipline of observations and reporting will prolong life and improve its quality when a patient has the fortitude to follow a trusted and competent physician’s guidance.

    The word “doctor” means teacher. The patient is the student whose active role in observation and treatment must never be shunned in favor of the false comfort of passive reliance on physicians and their tools.

  3. Roland on August 13, 2012 at 3:50 pm

    Completely agree with both of you. I was a caregiver to my grandmother for a couple of years and she is currently 76 years old. She has a slowing thyroid, high blood pressure, arthritis, low iron, and a couple of other minor issues which means she has quite a few medications she needs to take on a daily basis. She is always good about taking meds with water & healthy food. She writes everything down and has a pretty good idea about her general diet. I am in the senior medical alarm industry and this issue comes up all the time with senior, patients, and caregivers. Many problems arise when people do not keep track of their normal dieting habits because they are unable to gather data points to help their physicians use in their diagnosis/evaluation. So you are absolutely right, it is very important to be a keen observer of your habits an take notes if you have a hard time remembering. Being aware is a big step in helping oneself.

  4. Claudia K. Nichols on August 13, 2012 at 5:32 pm

    Thanks for all of your remarks. As we age, we usually more medical issues, being more susceptible to injury and infection and lacking the youthful tendency to “bounce back.” Who was it that said aging isn’t for wimps?!?

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