Doctoring-in-Place
I went to my new doctor for an introductory visit today despite all this Coronavirus hullabaloo. As a recently moved senior citizen, I thought it was important to get set up with a new GP because you never know when you might need a doctor, right? I am not a guy who goes to the doctor with every little ache or pain, but I am also not adverse to going to see the doctor when needed. My medical history is that I had my gallbladder out at the age of thirty-four and since then, most of my medical history consists of trying to lose weight (culminating with a lap band bariatric surgery fourteen years ago) and doctors trying to find something that my lifestyle implies I should be afflicted by, but am not.
My long-time Irish-born doctor at NYU told me a year ago, as he was moving on to greener pastures, that we know I did not and was unlikely to have coronary issues, I had low blood sugar, I had low cholesterol, no respiratory issues and no history or indications of cancer, including a low PSA level. All good, but he did go on to say that my joints were going to complain more and more over time about lugging around this excess weight (My lap band stopped me out about half way to my fighting weight). I took heed of that, but felt it was more a victory for my genetic profile than anything. My lab numbers always look fine and my January physical reconfirmed that all was OK for someone my age and no added medications or testing were called for (I already take a few anti-hypertension drugs because its easier than arguing with the doctors about how inaccurate BP measurement is).
When I went to find a new doctor our here in the land of sunshine, I hadn’t realized how hard it is to get a new doctor to take you on. I heard about a guy at UCSD Health and when I called I was told he wasn’t taking on new patients. However they did have a doctor who was taking on new folks. Did I have a problem with a woman doctor? No. Did I have a problem with an Asian woman? No. This was starting to feel like a #MeToo set-up. I was told to come for an introductory meeting, which was required. About a week ago I called to ask if I should reschedule or do this by video given the state of affairs. I was told UCSD didn’t do that and I needed to decide myself if I wanted to come in. I was referred to the CDC and UCSDH websites for guidance. OK then.
Two days ago I got a call from UCSDH asking if I was coming in for my appointment today. I said I was planning on it, but I explained my conversation last week. No reaction. Was I still coming in? Yes. Well, then they had a few questions for me. Did I have any respiratory illness symptoms? Did I have a fever? I said I was asymptomatic (there’s that great word again). I was then advised that I would likely be screened on my way into the facility to be sure that I was not infected. It seemed that UCSDH had come up the awareness curve rather briskly in the past week. I guess we are all playing catch-up with this situation.
Today I headed out extra early since I am still fairly new to the area. The roads out here do not seem any better or worse in terms of traffic than they ever are in the middle of the day. I’m inclined to suggest that San Diego is way behind on the infection curve (for better or for worse). When I got to the building, I was pleased to find plenty of parking spaces right in front of the main door. In the lobby was a masked, lonely-looking, medically smocked young lady at a folding table. She asked me several questions but did not take my temperature. I passed and went up to the office. There, I found a waiting room with no one waiting. There were literally forty empty chairs and neatly arrayed current magazines and a TV with the LG logo chasing around the screen, apparently on hold for some source input. Everything else seemed normal. The Muzak was playing and the receptionists were there waiting for the patients that weren’t coming. This was the middle of the day and there were no patients. Where exactly were all the people that usually frequent the doctor’s office? Are we such a culture of hypochondriacs that no one has to go to the doctor’s if they suspect there is a pandemic? We know UCSD is not chasing people away from keeping their appointments.
The office receptionists and nurses were not dressed in extreme protective gear like the woman downstairs. In the office it seemed like business as normal, and perhaps even more casual than normal since there were so few patients. I went through the normal procedures like weigh-in, height measurement, questions while the medical history was being uploaded, temperature and blood pressure. Then the female Asian doctor cane in and continued the interview, which was all as expected and perfectly normal. Her one suggestion to me for today was to get my pneumonia vaccination. I must admit, I didn’t know there was a pneumonia vaccination. I asked the obvious dopey question of whether it was wise to infect myself at his dicey time with a vaccine of a respiratory ailment. On the one hand it sounded like a smart precaution, but I think we owe it to ourselves to ask a few questions at such times. My female Asian doctor was quite patient with me so I got the vaccination.
As I left, I was reminded that I have a follow-up appointment in another month. This is to track a change in BP medication that my doctor suggested. What it really is about is a new physician making sure that she has a handle on this new case. I am fine with that because unlike my California tax accountant, who has gotten a full records download from my New York tax accountant, my California doctor seems uninterested or unable to get my records from NYU medical. I would have thought that getting medical records from someone who has handled a patient for thirty years would be important, but apparently not.
My female Asian doctor has told me that she would input the new prescription into the order system with Walgreens here in Escondido so I can pick it up when I want on a convenient basis. Walgreens’s owns Duane Reade, the pharmacy we used in NYC, so all those records got transferred across country because that’s a retail business that needs to keep clients. I guess the medical industry is not so agile as the pharmacy business. They get their money from the insurance companies and Medicare (I was not asked to pay a dime today). So exactly why should they care about my records transmittal?
I must admit, I’m beginning to think that we all might be better off going the Christian Science route and doctoring-in-place at home rather than depending on a system that seems more than a little hidebound, slow-to-react and somewhat disconnected from modern technology. I guess that so long as the Muzak is working, all’s well with the world.