Re: Posts 40647 and 40648

[Guest guest]

AJ –

Excellent observations on both of your posts (40647 & 40648).

I would like to add a few of my own to them.

One of the big ones you touched on was the " compartmentalization of

treatment " where you have the psyche crowd and the pain management

group each doing their own thing, not to mention any other care

givers that might be in the equation. Part of the problem with

something like this is that each discipline by human nature is

convinced of the absolute correctness of " their " approach, method,

whatever, almost to the exclusion of other possibilities. It is a

natural reaction to avoid admitting that they just might either be

wrong or not know everything after all.

Another critical issue as far as I am concerned is that psyche tests

are a lot like statistics – you can make any of them prove whatever

you want them to prove, depending on how you frame the questions.

They are subjective, with all the pitfalls of interpretation that

that implies. And you nailed a critical aspect of that. If an

incorrect interpretation is made for any reason, and the treatment

involves some form of chemical suppression therapy, you not only are

not addressing the problem – you are setting the stage for the

creation of other problems.

You are also right on the mark with your comments about medications

typically being prescribed to stop the feelings when in reality what

is required is to process the feelings. This is called " suppression

therapy " and it makes no difference whether the condition being

treated is mental, emotional or physical. All that any form of

suppression therapy does is mask the symptoms. There may be valid

reasons for doing this – but the fact is that the

underderlying " problem " is not being addressed and it is not going

to go away.

Why limit your comment about wanting to be " the authority of all

things " to just that one teaching hospital? This is a typical

attitude problem with much of conventional medicine. And the more

specialized the area or the higher the reputation of the parties

involved, the worse it seems to become.

On your second post, you raised the issue of insurance. Insurance

is definitely a factor, but it is only one component of a bigger

picture. That " bigger picture " in many ways is the changed nature

of medicine, or I should say, health care in the United States in

the last fifty years. When I was growing up, the norm was the

General Practitioner, the so-called " family doctor. " And that norm

tended to include your GP taking an interest in and treating

the " whole person. " I don't mean that in the sense of holistic

medicine as the term is commonly used to today. I mean it in the

sense that you saw your GP for all of your medical needs and your GP

tended to view you in a different light as well.

The old school GP-Family Doctor is today just about extinct. Today,

you have layers upon layers of specialization. More importantly, in

too many instances, it is viewed as the " business of health care. "

And the " business " of health care involves making money. This is in

no case truer than when you are dealing with any " managed care "

organization. It all too frequently is not the doctor who calls the

shots; it is the plan administrators who determine what will or will

not be done, what will or will not be provided, and under what

circumstances. And those decisions are not necessarily based on

patient needs. They are based on bottom-line financial

considerations – what gives the organization the highest return on

its investment?

And insurance often plays a pivotal role in these decisions, for a

number of reasons. Health care organizations can't survive (or make

money) if they are providing services for which they are not being

compensated. In many cases, that compensation level is determined

by what is covered by insurance. Some times, insurance simply will

not cover a given procedure at all. In other cases, they limit the

coverage to so many times a year or to a maximum dollar amount. And

in most cases, they pay based on a set scale for the geographical

area.

The Osteopath I used to see when I lived in Anchorage earned my ever-

lasting respect one time. I was taking care of my paperwork when he

told one of his nurses to give some kind of shot or medication to a

patient. The nurse said " We can't. " His reply was " What do you

mean we can't? " Nurse: " Her insurance won't pay for it. "

Him: " Did I say anything about insurance? I said she needs that,

so give it to her. " Nurse: " But the insurance won't pay us. "

Him: " Fine – so we don't get paid for it. She needs it – give it to

her. " I just wish all of our health care providers put the NEEDS of

their patients first, like he used to do.