It’s probably not very smart, but I tend to avoid going to the doctor.
I have nothing against them personally. In fact, I like talking to doctors, much the same way I like talking to highly competent people in any field. There’s always something to learn, some interesting and obscure quirk of the profession that — who knows? — might someday find a place in a short story or a novel.
The only thing I don’t like discussing with doctors is my health. For some reason, they always feel obliged to point out things I already know. For instance, certain excesses around the middle of my manly physique. As in, “You might want to drop, like, forty pounds. For the sake of your heart.”
It’s true. I’d love to drop, like, forty pounds. Who wouldn’t? Do I really need a doctor to tell me something obvious like that?
I’ll tell you what I need a doctor for: relief from the nasty flu I had last week.
I knew it was coming. Our daughter was laid up with a fever and sore throat. It was just a matter of time before her flu bug crawled inexorably up the family tree.
Sure enough, a few days later I woke up with an awful sore throat. The sore throat kept getting worse. Four days into it, I started to worry.
I’d had strep throat before. I was familiar with the symptoms. I was also familiar with the consequences of leaving strep untreated, which can include rheumatic fever, septic shock, and organ failure.
I called my doctor’s office, only to find that my doctor, a fellow I met once, about five years ago, had skipped town and set up practice somewhere in North Carolina. The receptionist offered to make an appointment with a new doctor, but there weren’t any appointments available for a while.
“I think I have strep throat,” I said. “I’ve had it before. I’d just like to get tested, and, if I do have it, to start on antibiotics right away.”
The receptionist was sympathetic to my plight. In the quiet tones that a shopkeeper will use when she’s steering you to the competition, she told me that I could always go to Patient First, a chain of clinics down here in Baltimore that operate on a first-come, first-served basis.
She reassured me that my insurance would cover the visit, minus a co-pay.
It sounded like a pretty good idea. I drove out to the clinic, thinking that I might be experiencing a new model of health care: health care on demand. I could just imagine their marketing campaign: “All the convenience of an emergency room — at a fraction of the cost!”
What did I have to lose? I was “in between” primary care physicians. I knew what I wanted: a strep test. If I want to buy a galvanized bolt, I know where to go. If I want to renew my driver’s license, I know where to go. Why should a strep test be any different?
And, in fact, Patient First was a lot like the Department of Motor Vehicles. There was a check-in window, where you surrendered a ton of personal information, worked out the payment arrangements, and handed over your driver’s license. Why they needed me to prove I was, in fact, myself is a bit mysterious. It’s not like I was going to ask someone to sneak in and take the strep test for me.
After the so-called “wallet triage,” I was told to sit and wait for my name to be called. I’d brought a book along, but I barely had time to read two pages before they called for me.
What happened next was also very efficient. A bored nurse took my vitals with all the enthusiasm of someone working a fryolator at a Wendy’s. She administered the strep test. The only time she cracked a smile was when I protested, with some force, that, no, I couldn’t open my tiny little mouth any wider.
After a brief wait in an examination room, the doctor blew in. He used as few words as possible, and spoke those seemingly in fast-forward. Medicine was a volume business to him. I could almost hear his mental clock ticking as I told him my symptoms. He peered into my mouth. He scolded me for having too much ear wax for him to peer into my ears. He ran his fingers under my jaw and told me I had swollen glands, which I already knew.
Then he told me that the strep test was negative. I probably had a viral flu. Nothing to be done about it. Take some over-the-counter medicine. Try to rest up. Come back in a week if you’re not feeling better.
In other words, I had a common cold. There was nothing that modern, high-tech, American medicine could do for me.
My co-pay for the visit was twenty-five dollars. My health insurance will be billed an additional $177, which includes $39 for the strep test.
I happen to know that the strep test kit cost less than two dollars. You can buy them in bulk on Amazon.com. If you’re a doctor’s office.
I’m not advocating a “do-it-yourself” approach to all aspects of health care. But surely there’s a way of ruling out strep throat that costs less than $202.
This column was published in the Perry Co Times on 18 March 2010
For more information, please contact Mr. Olshan at writing@matthewolshan.com
