Tag: Medical

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Stop Looking at me

Some background.

I’m a big believer that wearable sensor technology can, and should improve life. I think that with the American healthcare system in the shambles it is, essentially we’re going to be on our own for most healthcare.

I’ve written elsewhere in this blog about the difficulties in finding or seeing competent healthcare professionals.

From Dermatology appointments that are booked 6-9 months out, to primary care physicians that can’t book an appointment until well into the future, with doctors that don’t even speak English well enough for the patient to understand their instructions. The medical industry for various reasons is a complete shitshow.

We needn’t talk about the fact that many primary care physicians these days rarely actually touch the patient. Instead they sit or stand behind their computers being data entry clerks. They’re reluctant to even do the rudimentary action of listening to the patient’s heart. Because the data entry is more important than the actual patient. (Except when it comes to insurance billing. Then they want to know about financial responsibility and next of kin so that they can track the patient down in the event that insurance doesn’t pay.)

Hey men, when was the last time your Doctor did the old “Turn & Cough” routine? How many of you even remember what that is?

How is it that America can claim to have the most advanced healthcare in the world, and yet have some of the poorest patient treatment outcomes?

There are some amazing “saves”. I’ve got a friend that is with us because his wife was dialing 911 before he hit the ground.

On the other hand, I’ve got another friend that got put through the medical wringer during COVID. Because of the delay in treatment, and requirements to be vaccinated. In his case a relatively minor skin cancer, ended up metastasizing throughout his system into lung cancer. (Uhh No, He never smoked.)

I myself have found that obtaining medical routine medical care is a “challenge” (Beware of any politician touting Medicare for all as one of their campaign planks.)

Because I believe that we’re going to be on our own, especially if you’re an average genetic male, one viable alternative is wearable sensors and their ability to provide daily medical data that we monitor ourselves. This kind of data gives us a baseline for our particular “Normal” and deviations from our “Normal” state, can guide us to take care of ourselves. At least it gives us a fighting chance to use the 6 minutes that a doctor is going to pay attention to us, wisely.

I picture it something like, “Hey Doc, this and this are out of my normal range, what should be done?”

I also think that having reliable telemetry would reduce overall healthcare costs by helping to reduce unnecessary and wildly expensive tests. Who hasn’t had their doctor demand exploratory testing only to find out that the test or tests were unnecessary?

Because I was a believer and willing to do what I could to advance the technology, I started participating in the Apple Health Research program via the Apple Research App. I’ve been doing this for years. The research app asked simple questions, and requested access to medical telemetry from my Apple Watch or other sensors and honestly was pretty darn simple and non invasive in my body or my life. I’d been enrolled in one study for 537 days.

Note I said “Was” and the other uses of past tense.

50 days ago I received an invitation about another study. This one was a little more involved. Nothing that I wasn’t willing to do, even including the study requesting some blood samples. Fine, I’m willing to bleed for my belief that technology is going to make us more independent of the “Medical Industrial Complex”.

Oh, I use that term with purpose.

By now it’s become painfully obvious that the Medical industry is nothing more than a mechanism for generating obscene profits, and in addition, the medical industry is probably as much about control of a populace that doesn’t ask questions. Those of us who do ask questions in an attempt to understand why a particular treatment is better than another, are listed as “Difficult Patients”. Once designated with this label, you’ll find your overall care is significantly degraded. Independent thought, or questioning the Arch Practitioners of arcane medical arts is seen as heresy. People who question, should be put into camps to die, right? Reference events from 2020 – 2024. There were entertainers, pundits, wags, and even some politicians, who said that kind of thing live, on air. Often to “seal claps” of a wonderfully compliant audience.

That kind of thing made my blood run cold, and fueled my desire to assist any real research. My hope was/is at least the technology could be improved allowing average, and reasonably intelligent people to use it to their advantage, providing hard data about their own bodies to push back against a medical person or establishment trying to railroad them into some treatment that was questionable. Or worse, touted as the only treatment available when there were other equally effective treatments that their physician simply didn’t like.

Oddly, if you look at outcomes, the key differentiator between one treatment and another often boils down to money. Either how much the insurance company will pay, or how much profit the hospital or clinic can derive. Many times, the patient outcome is the same, plus or minus a few percentage points.

So I was in. I signed all their paperwork, I noted that they were willing to pay a small amount for participation but that amount was trivial.

A week or so later I got an email confirming an “On boarding” appointment. That email contained a link to a website. Okay… The link required that I create an account. Hmm it’s just a teleconference appointment. I can set one of those up on FaceTime, or Half a dozen other services wherein only the administrator of the teleconference needs to have an account. The participants don’t have to provide any information whatsoever. All they need is a conference ID number.

Then I thought about it and remembered that because medical data is protected under HIPPA, they might need some kind of more secure conference. Okay, I created an account. I didn’t like it, but for the sake of the research it was probably worth it.

The conference day comes and I’m logged into the video site. The person on the other end of the call asks a bunch of questions and such. None of which were any different than something I’d tell a stranger. They walked me through changing a few settings regarding permissions on my phone so the research app could read that data, then the conference was over, and I was in.

Immediately, my phone started burning 10 – 15% more power per day. This was because the study was accessing my phone’s camera every single time the phone was moved. The theory was that they were trying to capture and process facial expressions and face shape using the onboard AI. I suspect there were two points to this image capture. One, was to insure that the phone was only being accessed by a single person. The second reason was to try to capture data that could be correlated to the mood of that person throughout their average day. (Was the person stressed, depressed, angry, sad, etc.)

The first issue was kind of dumb. If the person was only moving the phone but unable to unlock it, then they weren’t an authorized user. Any additional data captured about the person’s expression or facial shape was therefore moot. It would have to be excluded from the study data.

The second issue might have made more sense if the analysis only happened after the phone was unlocked. Trouble was, the study was burning energy capturing photos of the inside of hand bags, backpacks, ceilings, and back pockets. The analysis literally activated if I slid the phone out of the way to make room for something else on my desk or counter top.

I’m pretty sure the camera was active the entire time the phone was in my back pocket while I was walking the dog. I don’t know for sure, but I can say that the camera was active even before I unlocked the phone to read a text message or answer a phone call. So what valid data was the study actually getting?

How much of that data was going to be fed into some processor to refine the newer generation of cars that supposedly won’t allow you to drive them if an AI in the car decides you’re too angry, stressed or otherwise impaired to operate a vehicle?

I can tell you from experience, that transporting a loved one to an ER I was extremely stressed and very focused (You kind of have to be, doing 90MPH on a Southern California freeway where nobody obeys the “Slower traffic keep right” rule).

The last thing I’d tolerate in that situation was an AI in my car refusing to let me get a person to an ER. I’d be so pissed when I got back from a $300 taxi ride, or paying $500 to an ambulance that I’d go at an AI in my car with sharp objects and a soldering iron. Asinine Federal safety laws be damned!

This realization gave me pause about my participation in the study. I however continued.

Weeks go by and I grudgingly tolerated my phone “looking” at me & draining power no matter the situation.

Then came the email from the study. It was an email, that told me I had an email. You know the kind I’m talking about. We get them from our mortgage companies, insurance companies, and banks all the time. “Oh you have a message, login to your account to read this important message.” Then you log in and the “important” message is that interest rates have changed on your savings account. Duh, we all already knew that because the Prime Interest Rate was changed, or stayed the same, or another quarter closed.

In other words the important message could have been sent via normal email and didn’t require special handling.

I knew what the email from the study was. It was most likely a lab order requesting that I make an appointment to go have some blood drawn for the study. Since the study itself was a double blind study. It’s entirely likely that the name was a number, the billing code was one that belonged to the study, and the requested testing was a standard panel. None of which required security. In fact the message could have been sent to any modern email program fully encrypted if the study had simply provided a PGP or RSA key during the initial setup/onboarding.

To make matters worse, whoever sent the email, didn’t send a link. What they sent was an entire HTTP file that opened a page locally in my browser. Because the page had been opened locally with no connections to the actual server it was supposed to open on, the page failed. My email program had dutifully tossed the entire email into my “Junk Mail” folder because that is exactly the kind of behavior scammers use to trick people into resetting passwords and user names.

I, on the other hand knew what I was looking at, and pulled the file apart until I found that it was supposed to be a link to a secure CISCO Mail delivery program. I accessed the server properly and was presented with… You guessed it, “Hey you need to create another account. Please provide a unique user ID and a 12 character password. Don’t forget, your password must have upper and lower case characters, numbers, and at least 2 special characters.”

I tired using the unique user ID and password from the video conferencing account. No Joy! That was a different format. Then I realized I hadn’t used that conferencing account more than once. I wondered, “just how many accounts am I going to have to create and maintain with forced password changes every 90 days, for this damn study?”

I jiggled my phone on the desk putting down my morning coffee. My phone took a clear unobstructed 45 second long picture of my ceiling.

At that point, I’d had enough.

The research app has communications built in. My email has encrypted communications built in. My phone is burning power to no good end, and I wondered how many pictures they had of my private parts.

I was perfectly willing to be inconvenienced by going and having blood drawn but I wasn’t interested in some unknown number of accounts needing to be created in service of this study. I’m trying to minimize my digital footprint, and all these people were doing was expanding it.

Every single user ID and password these people wanted was another opportunity for some shithead hacker to get information they could use to screw me. And it was painfully clear that the people running the study weren’t particularly good with technology.

So I withdrew from not only the new study, but every study these people were running. If they can’t handle the basics, how can they be relied upon to correlate the data?

Then, I deleted the Research App from my phone.

The next day, I got a call from a lovely lady asking me if I’d gotten their email about my upcoming blood draw. “Uhhh yes I did,” I replied. She asked if she could help me set up the appointment and I said, “Uhh NOPE! Then explained I’d withdrawn from the study.”

She thought I’d withdrawn because I was afraid of the blood work. I explained that wasn’t the problem. Then explained what the problem(s) were. I continued, I as an older person had no interest in multiple accounts just to support their study and that perhaps they’d be better served having a single web page that supported all the necessary functions required by the study. I also pointed out that I was sure they’d gotten some lovely photos of my ceiling, my back pocket, and the inside of my backpack. I added I’m sure that someone was equally thrilled to have pictures of my “Johnson” too since I tended to be nude, surprisingly, in my own home, and my bedroom, in particular.

She was understandably flummoxed.

She recovered well, and pointed out that the call was being recorded. I said, “Great! Then there will be no confusion about why I dropped out.” I asked her to make sure the IT people, in particular those that came up with this insanity rethink their approach. While I’m willing to share information with them, I’m not interested in having my participation in their study become a full time job involving an unknown number of “Surprise” accounts that have to be created, just to deal with the basics.

She said she’d refer the matter to the IT people and that she’d initiate the payout for my contributions to the study.

I said, “That’s fine. The money isn’t important but a clean efficient study is.”

This morning, I got a call from the study payout group. Another lovely lady wanted to verify my email address because they were going to send me a “Virtual” debit card that would be loaded with $70. She went on to tell me that this card could be used anywhere, or that the funds on it could be transferred to my bank account or Apple Pay account.

“Okay, that’s fine,” I said. A minute later I got an email from the study payout group. They directed me to a website where my “Virtual” debit card awaited. Then I got another email saying that the debit card had $70 on it.

Sure enough, there was the card, and it claimed to have $70 loaded on it. But there was no way to transfer the amount anywhere. No matter, I had the number, expiration date, and security number.

I tried to use the card online to pay a couple of subscriptions.

I couldn’t.

While puzzling over why I couldn’t use the funds. I noticed the following in the terms and conditions.

Unless otherwise specified, not redeemable for merchandise, food and beverage. Allpurchases made with this card are subject to the applicable refund and exchange policy and the amount of ClinCard’s any refunds will be placed back on card. Not redeemable for cash except where required by law. Not reloadable. Not a credit or debit card.

There was also a helpful 1-800 phone number.

I called it. It was a Canadian Bank. After navigating through their phone tree I got a helpful person to whom I explained the problem and quoted the text above. Then I asked so what is this card good for?

He didn’t know. He helpfully suggested that I keep trying random sites until it worked.

Either it’s money or it’s not… I didn’t go into that with him.

I asked how I might transfer this cash to a usable platform.

He responded that I could go to their website or download their app, open an account, provide my banking information, and then I’d be able to transfer the cash to another account.

I fired back, “So you’re telling me that to get this $70, I’ll have to give you all the information necessary for you to steal my identity and since you’re in Canada international law applies, meaning that my privacy is not secure under even the most minimal laws of the United States and any disputes will be handled under EU rules or would that be under Canadian rules?”

He had no response.

So ladies & gentlemen, that’s how I made $70 selling my body and how that $70 is in no way real.

Beware virtual debit cards!

I rather suspect they’re nothing more than a mechanism to turn us all into data products to be sold to the highest bidder.

It’s a great scam if you think about it. These people offer you money you can’t access, then tell you to access those funds they’ll just need a little bit more information. When you give them the information they’ll give you the cash. On the back end, they’ll make 1000 times more money selling your information to data brokers.

The thing is, the clinical study could have texted the $70 to my phone number (which they had on file,) and it would have been loaded automatically onto my Apple Cash card. That would have cut out the middleman and provided instant payment.

They could also have sent it to Zelle, or Venmo. The accounting would have been no different. They just had to have yet another corporate entity in the mix.

Here’s the recap of corporations:

Apple
Brigham and Women’s Hospital, Harvard Medical School
GlobalMed
CISCO
SUVODA
ClinCard
Greenphire

Really?

And they turned on my phone camera for hours during the day, while using the devices and sensors I purchased to collect information for their study. They in turn, provided literally nothing but annoyance.

To anyone who might be reading this that is in the medical industry, Do Better!

The study cohort invites you into their lives and their homes. They give you information freely and while you claim to “pay” for that information, the reality appears to be much different.

I might consider joining another research study in the future. But I’ll be far more interested in doing so if that study was geared specifically to Men’s health issues. Right at the moment, I’ll be leaving the Apple Research application off my phone.

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Well that’s interesting!

So I was very displeased with the original Doctor that I was assigned when I got insurance.

No problem! There are other Doctors. At least that’s what you’d think. 

Yes, there are other doctors. So I did some research, asked some questions of knowledgeable people and selected a new one.

I called today to get an appointment and guess what? The first available appointment is mid September.

You’ve got to be kidding me! Oh, they can put you on a “standby list” But September? Really? Oh, and that time frame is for the whole group, not just the Doctor I was assigned.

The funniest part of all of this is, I’m no better off having insurance, than I was when I didn’t have insurance. I can go to a shit head doctor that doesn’t pay any attention to my actual concern or what I’m there to see him about, thereby not getting the care that I need, OR choose a doctor that I can’t see in a reasonable time frame.

WTAF?

For someone like myself, this is totally unacceptable. I don’t need that much in the way of care, but waiting 7 months? Really? Are you kidding me?

This sort of thing is why people like myself just stop trying. When the barriers to getting something done are so high, or the goals posts/rules are shifting in a random fashion people like me just choose not to play. This philosophy extends to Doctors, Lawyers, Job Searches, and virtually every other aspect of life today.

Okay, back to shopping for a doctor.

Once again, I’m reminded why I went to Orange County 70 MILES from where I live, to see a Doctor.

 

On the other hand, supposedly this insurance is a POS, which used to mean that I could walk in to any Doctor that was “In-Network” and the insurance company would sort it out on the back end.

Maybe I’ll investigate that 

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Who the Hell is Complex Care Solutions?

I’ve found them to be remarkably annoying!

Who they are is a 3rd party vendor that works with many of the major health insurance companies.

They seem to be a bunch of paper pushers, whose job is to arrange things like in-home nurse assessments. Yeah, their name says it all. Complex Care Solutions, indeed adds complexity to your medical care.

In my case they forced me into some bullshit video assessment with a nurse practitioner.

After that one contact. Then they embarked on a campaign of twice weekly phone calls asking for me to review their service, or their nurse practitioner. They said they were gathering information for the insurance company. But I ask “Why?”

Surely that information was provided by my “Doctor” during our appointment, wherein he played on his computer for the entire appointment, but didn’t really examine me as a patient. In truth the entire appointment could have been handled on a video call and honestly the level of actual “care” I got, was about as impersonal or useful as WebMD.

They called again today mid-morning asking when my next Doctor’s appointment is.

Okay… That’s it!

Why do they, a third party, need to know that bit of information?

The insurance company will find out when they’re billed.

I called the insurance provider and asked what this was about. More importantly, I asked if this bullshit was necessary to the continuance of my policy.

Turns out, Complex Care Solutions can be cut right out of the equation. Which I did!

I explained that I was talking to Complex Care Solutions more than I talk to my own family. Every time I spoke with these people it was like I was talking to  my own personal mother hen. There may come a time when I’ll need their services but not today!

A) I’m not keeping my current Doctor
B) I’m actively researching and investigating new Doctors
C) I’d like to keep my private medical information, oh I don’t know… private.
D) They got real quiet when I mentioned privacy and cited HIPPA rules. Which thankfully I know due to previous employment (quarterly training will do that). They haven’t violated HIPPA, but as a patient, I have the ability to exercise at least some control over my personal information and who has access to it.

I may be over-reacting but it’s like they’re trying to rope me into some endless bullshit loop of living my life around the medical profession, insurance companies, and pharmaceutical companies.

Again… I’m not to that stage of the game.

But there’s another aspect to all of this. It’s billing. 

I said it to the insurance company. “Just because I’m insured, doesn’t mean that I as The Insured should abdicate my responsibility to control costs.”

I don’t need their service or the attendant annoyance or billing from their phone calls. Believe me when I say, for each time they call me, they’re getting paid.

I also mentioned that I was less than pleased with my (Doctor of record) billing the insurance company almost $1000 for that single appointment. That’s obscene especially since the “physical exam” wasn’t in any way physical.

I mean, what happened to the days when the doctor looked at your eyes, ears, throat, felt the glands in your neck, did a cursory exam of your skin, listened to your heart & breathing, in the case of men, had you drop trou examined your naughty bits, maybe did a DRE, ordered up your blood work, asked if there was any concern you had, then took a look, made some suggestions, told you if there was any issue the blood work uncovered he’d call you, then swatted you on the ass and said, “Go Play!”

(Okay, maybe they didn’t swat you on the ass,) but it was personal and when you left the place you at least felt like you’d been seen. Maybe you felt a little violated, but you at least had some reasonable confidence that a professional who’d seen thousands of bodies, had in fact examined you and didn’t see anything glaringly obvious that needed immediate attention.

Personally, I didn’t mind being buck naked in the exam room and didn’t bother with those silly paper gowns or any pretense of modesty. It was the same mindset as being in the gym locker room. Who cared? The Doc was doing his job and that meant he was gonna see ya, all of you, including parts of your body you probably haven’t seen.

Today What passes for an “exam” might as well be done in a freaking board room.

Human bodies are messy, organic, and sometimes downright disgusting. I think that’s why, when I wrote the check for a yearly exam, I didn’t mind the expense.

That Doctor probably didn’t want to see another naked body by the end of the day. But it was his job, and his education gave him the baseline normal to compare against. The fee I paid was exchanging value for time spent & experience.

My favorite Doctor, spent our first appointment asking me about every scar on my body. “How’d you get that? When?” If I showed up with a new scar, he’d ask what that was about and if I’d had appropriate care when it happened.

That’s an intimacy that’s been lost, it was being seen and it felt like he gave a damn about me, the human standing naked in front of him or his nurse. Granted, if his nurse didn’t need to see me completely nude, he’d say something like, “Pull your boxers on, I’m going to need my nurse to…” do whatever needed doing.

Admittedly, I was comfortable putting my life in his hands because we had a relationship that was personal, and not based on how many billing codes he could tic on a form.

I knew he was a “Cookie Monster” with a fondness for home made chocolate chip cookies, well anything chocolate. I knew he performed in the Pagent of the Masters in Laguna Beach. I knew he was an avid bicyclist, and that often he’d bike to work. I knew he took his profession very seriously and when he lost a patient to illness it was personal to him. I knew his first whole name, and if I encountered him outside his office I never introduced him as “Doctor”. He was Tom. Why? Because if anyone knew he was a “Doctor” there were always people that tried to get free medical advice. If we happened to be at a social event I, among others kept an eye on him and would be rude to someone that had him “cornered” talking shop. He was respected, and he took care of a lot of my friends too. The man referred me when necessary, to other doctors that worked on him. If he trusted them, then so could I.

There’s nothing quite so comforting as coming out of anesthesia and seeing “Your Doctor” at the foot of the bed conferring with “The Doctor” that did a procedure on you. I remember snippets of their conversation. “Wow he’s got a mouth on him!”, “Yeah, but he’s a good guy, anything well need to follow up on?”, “Nah, he’s good, you might want to make a note that he’s cranky with this type of anesthesia.”, “Okay, thanks. I’ll hang out for a few minutes to see he comes out of it okay.”, “Hey thanks, I’m going to check on my next patient, we still on for… RIY&#%*^@ this Sunday?”, “huadiry7%$#3”

Then “My Doctor” prying one of my eyes open, “Hey, there you are… They’ve got you on O2, it’s the good stuff so breathe deep. There you go, nice & slow, trust me it’ll help clear your head. Apparently you were searing like a sailor at some point.”

“Muff uhh, probably like a Marine Doc. My friends… all Marines.”

I still remember his chuckle and the warmth of his hand on my forehead telling me to take it easy before I started moving around. 

He was a healer, a man I trusted and no matter what, I knew he’d see me through.

That bond of trust, and confidence is missing these days. The humanity has been bled out of medical care.

Now it’s about how many different Doctors can get their finger in the insurance scam. How much can be billed and that’s dependent on sheer numbers of patients. At the same time the rates keep going up for less time spent with a patient the insurance companies keep jacking their rates, and plugging in more “services” that add nothing but opportunities to bill.

I’ve digressed, but I think it’s really important to remember what the title “Doctor” once meant. The profession was once about humanity, care, respect, and dignity.

When was the last time you felt like baking, individually wrapping, and labeling 2 dozen cookies with ingredients, then delivering them to your Doctor’s office before a holiday?

When was the last time you had your Doctor compliment you on weight loss, increased musculature, quitting smoking, your baking skills, or a custom holiday card made up of a photo you’d taken?

When was the last time you felt you’d been seen?

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Saw this post on X and it got me to thinking

“ If Republicans kill ACA subsidies, a couple making $85K will pay $25,000 a year for healthcare.

That’s 30% of their income—just to stay alive.

This isn’t “fiscal conservatism.” It’s economic violence against the middle class.”

  • Brian Allen @allenanalysis

‪Health insurance doesn’t keep 90+ % of the population paying for it alive.

Most people in a given year don’t spend anywhere near the amount they pay in insurance premiums.‬

‪We joke about men not seeing their doctors. Women may see their doctors 3-4 times a year. If you’ve got children they’re seeing doctors more frequently, but even so an average normal family probably isn’t spending as much as their yearly or even monthly premium.‬

‪The question to ask is what does it really cost for a 20 minute visit with a doctor? What do medications actually cost to manufacture? Why can I self pay for a medication and pay $50 for 90 days, but if I put it through insurance suddenly that same medication is $400? Why can I “Self Pay” for my once a year doctor visit, have a physical + tests & have it cost $800 cash, but my monthly insurance premium per month is $1400? ‬

‪Yes, insurance costs are out of hand. Yes, insurance companies are making breath-taking profits not on illness but by selling fear. The fear they’re selling is rising medical costs but they have a hand in driving those costs up by making those actually practicing medicine have to add staff just to deal with insurance billing and coding.‬ Who are insurance bureaucrats to deny a doctor’s diagnosis?

‪The medical / insurance / pharmaceutical industry is a snake eating its own tail. That snake gets fatter each cycle but eventually it will eat itself to death.‬

‪This issue isn’t partisan. The issue is continuing to throw money at a system that is fundamentally broken and expecting the brokenness to get fixed without looking at or demanding to know why / how it’s broken and taking appropriate action to fix it.‬

‪ACA was presented as an attempt to address the problem. It didn’t work, the math never worked. Congress knew that going in. That’s why they attempted to mandate everyone pay into the system and why they were going to fine people who didn’t.

It failed In part because it didn’t account for economic conditions, and in part because it didn’t account for adherence to ACA rules adding cost and complexity to the practice of medicine.

‪The ACA pretty much drove small medical practices out of business. They had no choice but to merge with larger medical groups or hospitals meaning that a doctor hanging out a shingle and seeing patients on his or her own all but disappeared.

The quality of care decreased because now you may see one of four or more doctors none of whom know your name. None of them interact with you as a person and all of them are diagnosing / prescribing based on data in your chart, not actually knowing you as a living breathing human being.

Half the time they’re not listening and in some cases it’s questionable if they fully understand what you’re saying due to language barriers. You’re just one of a thousand bodies parading through an office in a given week.‬

‪Fixing this system isn’t about supplementing it with taxpayer’s dollars. Fixing this system is about bringing it to heel.

One way to start that might be for everyone that can, to stop buying the insurance companies fear. Switch to self pay and then negotiate fair pricing from medical practitioners.

Another possibility is to demand upfront pricing so that a patient knows it will cost X dollars for a procedure. If you see an MD it’s $100 /hr (And you get their FULL attention, no more playing with their computers). Blood work costs X dollars for a comprehensive panel. X-rays? What does it cost for materials+the hourly rate for the technician+the hourly rate for a doctor to look at the X-ray. There was a time when a film X-ray cost $50 flat. Why does where you have any testing done affect the bottom line cost? Just crossing county lines can have a 30% differential.‬

‪Why is it that we all have blood work done, but if you ask them to tell you what your blood type is, they want to charge you another fee? They’re already there, they’ve got the lab, the samples, and the typing cards. Shouldn’t we all know our blood type as a matter of safety?‬

‪These are the kinds of questions that should be asked.‬

‪You want the government to do something about healthcare? Then have them run audits and accounting to determine the real costs of care. ‬Then move forward to make changes beneficial to the American people, not the insurance companies.

You wouldn’t continue to pump gas into your car from a leaky gas pump, why do people think it’s okay to keep pumping tax dollars into a system that is leaking money like a sieve and providing poor services?

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First Doctor’s appointment at this age

They gave me a minimal dementia test. They asked me to draw a clock after asking me to remember three words.

Yawn!

The young lady administering the test had a problem, (she was quiet, but obviously concerned,) when I started drawing the clock. Then she added that the clock show show 11:10.

I guess she thought I was having a problem when I started drawing the numbers.

I started with twelve, then 6, then 3, then 9, at the four cardinal points inside the circle. Then I added 1,2 then 4,5 then 7,8 then 10, 11.

When I started, she looked a little confused. I paused for a second or two. Visualizing the clock as I wanted it to appear. Then I started drawing. At that point she realized I wasn’t nuts, I simply had a plan. I drew the hands hour shorter and minute longer, indicating the requested time.

Then she asked me the three words. I gave them back in alphabetical order, then asked her if I was supposed to give them back in the order she said them.

She just smiled. 

My memories are apparently functional. As is planning, and visualizing.

All of this was with me running on empty. I’d walked the dog his 2.5 miles, showered, shaved, and had not eaten or had coffee with any sugar in it. It was 11:00 am and I had been really growly when I showed up for the appointment. It took over an hour to get there, traffic was stupid heavy.

Plus after spending 2 hours fighting their stupid web site on Sunday, I was annoyed they didn’t have the data available.

This was not a good combination. Me hungry, bordering on hangry and yet more stupid legal paperwork. They of course wanted an emergency contact. Which experience has shown me is a soft pedal way for them to target someone else if the bill isn’t paid.

I guess I’m overly suspicious.

I really don’t trust the medical profession anymore.

I liked the Dr. but as is in all visits these days, he had to play with his computer a lot. I was about to fire him. But then he actually examined me. He executed a good save.

I told him about a previous doctor I’d fired precisely because all he did was play on the computer the whole appointment. He seemed taken aback by that. I pay for a doctor’s expertise in medical matters not computer science. This is a “benefit” of the Obamacare BS and also the medicare system.

Doctors, even good ones, spend more time in filling out shitty online forms than they do hands-on with their patients.

He was suggesting blood work, and reminded me that it was time for a colonoscopy. Great! That’s going to be a problem. I’m going to need to have someone take the time to transport me on “The Day” Grrr.

I’m considering that when I have this done, I’m not going to be put out. There have been too many reports of medical people hitting IVs with vaccines they think a person should have.

I pushed back on the colonoscopy and he said I could do the home kit but if analysis was inconclusive I’d have to do the full thing.

The problem I have with doctors, particularly in the case of colonoscopies, is that if they find something, usually they’ll find it, then they’ll make another appointment to take care of it, then they’ll make another appointment to recheck that they fixed the problem, on and on. Until you say “Enough!“

If the doctors are already there, and they see the problem, they should fix the problem. But they don’t make as much money that way.

The Doc also suggested an ultrasound of my aorta. Yeah, I smoked so apparently in men It increases the risk of an aortic rupture. It’s probably worthwhile.

I don’t want to get sucked into the endless cycle of doctors, and medical appointments defining what’s left of my life. That’s not quality, it’s the final indignity of a life enslaved by working for the illusion of a retirement full of sunsets and travel.

——— Update 8/28 ———  

Okay,

I’m done with this Doctors office.

1) They’ve been spamming me to fill out a satisfaction survey since I left their office yesterday. I suppose I could fill out their survey saying that I was dissatisfied. I doubt seriously that it will change a damn thing.

2) I asked the Nurse or whatever she was, in-office if the Doctor could add one more test to the battery of tests he’d ordered. She said she’d ask and there’d be a modified lab order in their portal. Haven’t seen that yet.

3) The doctor issued another RX for a combo med I’ve been taking for years, but we’d discussed reducing the amount of one of the components, with the goal of getting off or minimizing the medication. The RX he issued is the exact same dosage. I noticed the error before I headed to the pharmacy and instead of going through the nightmare of the pharmacy, I sent a message via their patient portal noting that this wan’t what we’d discussed and that in any event I’m not going to do 30 day RXs if it’s decided that there will be no change to the med. I want 90 day supplies.

4) As I mentioned above, the Doctor asked about colonoscopy. I told him I was not particularly interested. He said that we could do the “poo in a box” version then make a determination about doing the necessity of the full monty version. This morning, I get a call from an Indian (Dot not Feather) demanding that I call him back to schedule my upcoming colonoscopy.

5) Nowhere in their portal is there mention of making arrangements for the aortic ultrasound.

In other words, this is exactly what I will not do. I will not slave myself to the medical industrial complex so they can destroy my quality of life with endless tests, appointments, and medications, while they milk insurance fees.

I’m not angry about getting old, I refuse to live in terror of the next phase of aging or the next mega disease. I will not relinquish my life to yet another bunch of assholes telling me how to conduct my life.

I spent my adult working life enslaved to corporations and people who saw me as a easily replaceable cog or stepping stone to their goals. I sure as hell am not willing to allow myself to be enslaved to the medical profession and I will never allow these healthcare professionals to “COVID” me again.

Obviously these people or this practice is too damn busy to pay attention. If they can’t pay attention on minor issues, can I trust them to pay attention in the event of a major issue?

As a courtesy, I went to their website to cancel the October follow-up appointment to review the medication changes and lab results.

Since the medication changes weren’t made, and nothing else discussed in the appointment was as we discussed I’m not going to need to be at an appointment now am I?

Their system wouldn’t let me cancel the appointment without providing an explanation.

That was probably a mistake on their part. Because it was pretty much the only way for me to tell them what I thought.

I filled their demanding little box.

Wrong RX. (not what was discussed in appointment.)

Got a call from some unintelligible person demanding to schedule my upcoming colonoscopy (not what was discussed in appointment.)

I lost my other half of 34 years in 2023 due in part, to similar lack of precision / failure to listen on the part of a hospital, and the medical group where he was a patient. My feeling today is exactly the same as when I was dealing with his care. He was not just another body, and neither am I.

I do not want the remainder of my life, however long or short that may be, circumscribed by endless tests, labs, appointments, medications, and insurance billing opportunities.

Your staff and the Doctor are all very nice. You’re all doing your jobs as dictated by policy, procedure, and prevailing medical guidelines. I understand this, but I’m a person who is quite good at taking care of myself. I’m also a minimalist.

Biology in general, and Human biology, specifically appear to operate far better with a light touch. My experiences with medical intervention have generally resulted in poorer, rather than improved outcomes. 

I have zero desire to live a repeat of what the medical profession put the light of my life through in his last years. 

I’m going to take a step back, or a breath, then determine what I want to do, and how I want to do it. Even if that means filling out yet another ream of paperwork to see a physician.

Should I decide to go forward with the lab work, I’ll make an appointment to review the results.

FYI, My choice to cancel an appointment should not require a MANDATORY explanation.

The whole time I was writing that, I kept hearing Jerry telling me to “be nice”.

Then I remembered why I’d always maintained a doctor in Orange County. I’ve kept the Doctor in San Diego for the same reason.

It’s because the doctors, all of the doctors I’ve ever tried to work with in the San Bernardino area were sloppy just like this bunch appears to be. The doctors I dealt with for Jerry were, with one exception, the worst.

In 20+ years working with my doctor in OC he never made a mistake with prescriptions, or procedures, and with the exception of a dermatologist, (who are all basically shithead frat boys of the medical profession,) he referred me to the best specialists, meaning they knew their shit and were on the ball, when I needed them.

In part I think it was because the folks he referred me to, were the same people he went to for his care. (He was always searching for a decent dermatologist too.)

I actually fought with Jerry about changing doctors when he first started having problems. I wanted him to go to an Orange County doctor, specifically mine. Jerry had mentioned things in the years prior to him starting to have problems, which concerned me about the local practices. I felt that if he saw my Doctor, he’d be referred to the “right” specialists and would get better care.

I know that sounds elitist and effete.

Jerry didn’t want to have to travel that far. In the end, it might not have made a difference, but I doubt I’ll ever change my opinion that poor lackadaisical medical care led directly to his death.

Now, I’m going to try to rescind all the legal documents one must sign to see a fucking doctor, and at the same time make sure this practice cancels any authorization requests for additional tests. It may be insurance money, but damn if I’m going to let that money be spent wastefully.

Then I’ll work on finding another Doctor, or I’ll keep the guy in San Diego at least until I get the rest of my life sorted out.