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Hospital visit a reminder: Health system is flawed

Sunday, August 16, 2009
(Updated 2:00 am)

It’s good to be home after a recent night in the local emergency room where I learned I had acute bronchitis. Actually, I was a patient in the ER twice that day.

Part of the afternoon, I spent waiting to be seen, then the other part having an X-ray of my chest done to determine the diagnosis, getting an antibiotic by IV and a breathing treatment.

I was sent home with a prescription for an antibiotic to take by mouth and an inhaler for breathing.

Three hours after I was at home, I passed out on the kitchen floor while drinking ginger ale and feeling that I was choking. I hadn’t eaten all day, either.

My neighbor returned me to the ER for the night. In the ER, I was given a CAT scan of my head since I landed on it, and an X-ray of my coccyx bone since I landed on it, too. I had another CAT scan of my chest as well as one swallowing test. Five breathing treatments were given that night and part of the next day. I think eight hospital personnel attended to me.

Other than the usual waits, I received very good care during my ER and hospital visit. It helped that I knew lots of the nurses and doctors. This is a small town, after all.

The bill for the stay of my 24-hours-or-less hospital stay is $8,424.94. As a retired state employee, my insurance covers all but 20 percent of the bill. Last year, the insurance covered all but 10 percent.

I am one of the lucky ones; I have good health insurance. Why in the name of heaven does this make me privileged in America?

When my father practiced general medicine in the 1930s and 40s (he died in 1952), this is what my experience would have been if I had come to him as a patient with bronchitis:

I tell the one assistant at the one desk that I feel really sick. I cough a lot. She is now the triage “nurse.”

I do not register; I have no cards to show. She leaves her desk, goes into the doctor’s rooms and in a few minutes I am in his office.

He checks my pulse, respiration, temperature and listens to my chest. He asks a lot of questions. He checks the sputum I cough up.

Then he tells me to go home and boil a big pot of water, put a dish towel over my head and lean over the steam coming out of the pot for as long as I can stand it. Do this often. He tells me to put Vicks on my chest. He tells me to rest and drink lots of water. He says he will be by my house the next day to check on me, and to call the operator (“Central, tell Doc to call me”) if you need me in the night.

If it had been after office hours, I would have gone to his house and waited in line in the driveway to see him. The office visit would cost $2. No bills would be sent out. No one had insurance. The deals were between the doctor and the patient.

Money was scarce and a war was brewing overseas. “How much do I owe you, doc?” was answered with, “How much can you pay?” The only requirement from the patient was a need for health care.

Every patient got it. “Every patient” meant white, black, old, young and even a pet or two.

As a nation, we should be ashamed to be in a health care crisis. No doctor is willing to sacrifice his health and his family as my father did, unless they want immortality in the hearts of their patients and in the stories of the beloved doctor passed down through generations.

He practiced “hands-on” medicine. He alone made diagnoses with the help of a stellar education, experience, his medical books, and his knowledge of pharmacy.

The majority of his paperwork involved signing birth and death certificates. If a patient needed a specialist, he did not hesitate to send them to Baptist Hospital, Duke or Chapel Hill.

If we are stuck with health insurance, let us make sure that the medical doctors reclaim their rightful place at the top of the health chain for health care. They, not an insurance company, have the skills to diagnose. The argument that government will control medical care is a welcome response to corporate control of insurance companies whose bottom line is always to make a profit.

That’s the system we have now. Who wants more of this? Throw out the insurance rules. Return the doctor to the patient. Give them time to know one another.

Every person who is in need of health care gets health care in America. Otherwise, we do more harm than good.

Rachel Wright is an Eden native and a part-time instructor in basic skills at Rockingham Community College.

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