Friday, October 25, 2013

The Changed Face of Doctoring in America

Nancy and I have lived in the Cleveland, Ohio area for 2½ years in a retirement community. Over that time period, we have made 5 visits to doctors; and we have seen 4 different doctors. One visit was to an emergency room for a sore throat. The other visits were to primary care doctors to whom we went for general check-ups.

At each of those “general check-up” visits, we requested physical exams; but we were refused that service each time. The doctors only talked briefly to each of us about our present health situation and ordered lab tests. None of them ever laid a hand on us. One of the doctors charged Medicare $250 for each of us. All the other visits cost us $30 for each co-pay.

My, how things have changed!! When I was in the practice of primary care, a patient who came to me requesting a general check-up got a full physical exam including a check of vital signs (blood pressure, pulse, height, weight) a mirror exam of the larynx, an exam of the retina after dilatation of the pupils, and careful examination of the neck, chest, breasts, heart, abdomen, groin (pelvic and rectal), extremities, all lymph bearing areas, limbs and joints, and a brief neurologic exam.

A routine medical history included an interview of the present problem and review of the past history, including previous surgery, medications, illnesses, occupation, travel, recreational activities, family problems, and habits.

I am aware of the fact that laboratory tests are much better these days than they were when I was in practice (up until 7 years ago). It is possible to find a lot more disease by laboratory tests today than it was then, also. But…I still think that present day doctors miss some important things when they do not exercise their ability to find health problems by using classic tools of history and physical exam.

Monday, October 21, 2013

The Problems in America Are Just What Americans Want!


As most of you know, who read my blog post, I am no fan of President Obama. But I am having second thoughts about that attitude. I have come to the conclusion that the things I find fault with in the Obama years has less to do with President Obama, himself, and mostly to do with the Americans, themselves. I assume that Americans have voted for and obtained the things they value most. For example:

  1. We Americans have expressed a value for immediate benefits in exchange for long term safety and prosperity. Our welfare state affinities have shown that.
  2. We have shown that we do not mind spending money we don’t have up front without counting the cost of deficit spending down the road. As an example of this, the Office of Management and Budget for the White House in its historical tables points out of the last 73 years, our national budget has been in deficit 62 of those years. The deficit problem is getting worse and worse; and still, our politicians are screaming for more deficit money. Our national deficit is now about $17 trillion; and $6.2 trillion of that $17 trillion has been added in the past 4½ years. But we must admit that seems to be exactly what the American population wants.
  3. In the field of foreign policy, American prestige is at a low point in recent history. We try to appease our enemies and abuse our allies. We do not keep our promises. Our people do not want to fight for freedom of oppressed peoples around the globe and think that bad things cannot happen to us on our homeland—we seem to think we, too, are “too big to fail.”
  4. We put politicians in office who do such things as seducing the office girls. I assume that the morals of our politicians match the morals of the American peoples, ourselves. That is the kind of people we elect to office.
  5. Americans live in a country that was founded on Christian principles by Christian settlers who were willing to pay heavily for freedom; but now Christian principles are derided or ignored. We give far more consideration to Islamic values in our country than we do to the principles of our Christian heritage. That is all done at the altar of “diversity.”  
I suppose all the above sounds cynical; but I don’t think it is cynicism. I think it is just the true facts about our country and its people, in general. If we would only wake up and get some backbone into our character, we could undo all the harm that is going on. But…it will take effort and work. I believe we can do it.