Friday, January 2, 2009

Commerce and "health care"

Nebraska and America are both faced with the overwhelming problem of providing adequate health care in the face of astronomical costs and increasing liabilities. Many of us are aware that Nebraska is in process of refurbishing its health care system. America’s health care system was the world’s most effective and efficient based on a system of free enterprise and competition. When it was patient-centered and emphasized a close doctor-patient relationship, its rendering was most economical and proficient. Models emulating from a business or political initiative have taught us that it is important to create systems which avoid domination by institutions that promulgate socialistic patterns or foster control by a few who seek to gain power and profit from the “business of heath care.”

The above was taken from a letter which I helped draft on behalf of one of my clients, a prominent physician here in the city. It couldn’t be more appropriate and analogous with regard to what is currently happening with Elliot and his new “diagnosis.”

Indeed, “the business of health care.” Since one physician, spending a mere one hour with our son, has diagnosed him as having autism, we have been shuffled around, placed in some random, (but what they think is an appropriate) order, like a deck of cards.

Following our initial visit with said physician, I have received four telephone calls from outside groups indicating that it is paramount that we be seen RIGHT AWAY. Oh, and it is so hard to get in, “We cannot alter your appointment time.” Supply and demand you know. Sad to say, demand indeed.

As a friend has noted, “The pendulum has swung so wildly the other way. It used to be peds wouldn't diagnose autism because of denial or whatever, and now so many are so quick to diagnose it to get services.”

Services? The only service that I requested was one associated with assisting our son with his food aversion. He does not need to see two different developmental psychologists at the youthful age of two. He does not need another upper GI investigation. He does not need another swallow study, and for Heaven’s sake, “I” do not need a lecture from a nutritionist regarding his other written diagnosis of “failure to thrive.”

My poor babe only refused his Pediasure and lost a bit of weight because his primary care provider neglected to detect his ongoing ear infections. And, while I am on the topic of his PCP, she also abandoned the idea that he may have a tethered spinal cord, dismissed a multitude of his thyroid issues and diagnosed him as having ringworm when it was flipping contact dermatitis! And, in the two and a half years that she has treated him, never once has she mentioned autism. “He’s so social.” That’s all she has said. So, her elder associate, and again, seeing Elliot for an hour, says ‘autism’ and she’s jumping right on the damned bandwagon. Referring us all over hell! Again, “the business of health care.” Where is the close doctor-patient relationship when a patient really needs it? What happened to communication?

What is interesting is that two pediatricians (in the SAME practice) have referred us to different specialists offering parallel services, both in Lincoln and in Omaha. Are they not even on the same page? The specialists have all been appalled when I have noted that “No, the pediatricians have not called to talk with me personally regarding said referrals.”

One group went so far as to request a DVD of Elliot and his behavior prior to his visit. Interesting. I suppose they compile these to present a lecture on dual diagnosis…oh so very specialized! Sorry, not my child. He will not be their guinea pig.

In a nutshell, I have said "no:" no to three of the four referrals. I will visit the feeding clinic because Elliot does need to eat. I will also increase our occupational therapy and speech therapy sessions at the entity we already frequent (they are excellent and do help him). I’ll allow the school system to come in to our home more often to help our child, but I will NOT drive all over hell for evaluations when said evaluations are not warranted at this point. Not on my dime, wasting my time and further traumatizing a poor little boy who merely needs to learn to eat.


Carey said...

Michelle, all I can say is, you know what's best for him. Keep it up. We love you Wee E!

All 4 My Gals said...

Good for you sister. YOU know what is best for your boy and what he needs. No one else loves him the way you do! You are an awesome Mommy!!