Having worked the last several months in the office of an internal medicine
doc (primary care physician for adults), I have to say that the stampede for
things like 'social inductions' on the part of the CONSUMER is not limited
to obstetrics. People are making stupid choices about their own health care
in all sorts of areas. I have been amazed at the conversations I have had
with people. "Well, can't I just come in for a throat culture? Then I can
get some antibiotics." When asked, how long have you had a sore throat, the
frequent reply is "Oh, I woke up this morning with it." People seem
completely disconnected to the rhythms of their own bodies, totally
unfamiliar with the notion of intelligent self-care, astonishingly ignorant
about really basic stuff like how long does a cold last, absolutely 100%
willing to believe that the doctor will: 1) know what is wrong with them,
and 2) fix it NOW, and I do mean NOW, so that they don't miss ANY work.
When I would explain that a runny nose and sneezing for two days did NOT
indicate that one had a sinus infection, I got arguments: "But this
happened to me THREE TIMES last year, and my OTHER doctor would always
prescribe antibiotics!"
And people seem to have NO instincts for what is important, what can wait,
what constitutes an emergency, what is perfectly normal, what they can treat
themselves, what they need help with. Sadly, they don't seem to have any
ability to trust themselves to make reasonable decisions about their own
health. I counseled people on the phone - healthy people with various acute
complaints - and they were unwilling to try over the counter remedies
without the doctor's recommendation. I can't tell you the number of people
who called requesting prescription refills - asked "What medication are you
taking?" they would respond with surprise, "Well, doesn't the doctor know?
It's in my chart. *I* don't know what it is." (and I am not just talking
about people who were reluctant to pronounce the name. I mean they did NOT
know.)
It has been distressing to observe this. I started out ready to blame
doctors for breeding curiously apathetic and passive health care consumers,
and I *do* think there has been a distressing trend towards "medicalizing"
everything in such a way that people think they must not know enough to be
able to take care of themselves, but I can't believe that's the only thing
going on. I wish I knew! All I know for sure is that consumer awareness of
health care issues - and desire to be an active participant in one's health
care - seem to have *decreased* since I was in nursing school in the 70s,
then having my kids in the 80s.
From listening to the folks on Lactnet who aren't in the US, I am also
distressed to note that this phenomenon is not exclusive to the US. I would
like to blame it on the horrors of the managed care health system in the US
but that won't work either. I do think that the disjointed, disconnected,
out-of-touch nature of our society, with isolated nuclear families being
left to fend for themselves, is probably one big part of the problem. We're
losing the wisdom of "mom," it would seem, and that is a huge loss.
Of course my reason for pondering this isn't to find someone to "blame." I
would like to figure out a way to fix it!! I regretfully speculate that
this topic will *not* be on my syllabus in medical school this fall... if
it is, I'll be sure to let y'all know. (meanwhile i'm still wondering how
I'm going to pass my OB rotation!)
Mary Renard
Vienna Virginia USA
RN, BSN, LLLL, IBCLC
M.D. in 2004
***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
