Wednesday, November 9, 2011

Let's be in charge of our health

Erin, an Americorps member who arrived at the clinic two months before me, is in charge of organizing my training schedule. She has me "shadowing" the practitioners; basically I sit beside the practitioner and observe his/her interaction with the patient to learn about the services at the clinic. I have done this four times in the last two days, and a few encounters already have my socio-economic wheels spinning.

#1: Yesterday, I was doing this shadowing of a personable male NP (nurse practitioner, who the patients refuse to call anything but "Doctor"), and he was checking over a petite Italian woman with diabetes. He got her up on the exam table and looked at her shins and feet. He saw enormous bunion-like callouses on her toes and asked her the last time she visited the foot doctor. "A long time ago," she said, "It cost $18 to go...I figure it's better to get a pedicure for $25." The NP played along and said, "Why? Because they'll also paint your nails all nice?" and then tried explaining that if she got cut at the pedicurist's, she could get a really horrible infection, especially because of her diabetes. In her Italian-stilted English, she shrugged off his suggestion.

#2: Today I was with sitting with a representative at Member Services, and a young man in a big baseball cap and jeans, with a tattoo on his wrist, walked in and said that he was unable to pay his co-pay for his medicine. The rep asked him how much it was, and the young man said, "$3." The rep apologized and said that she was the wrong person to speak with about this. When the guy left I expressed my shock that someone would be unable to come up with just a few dollars, and was told that people like him might actually be able to pay, even though they say they cannot. I am not sure which would be worse, someone pretending they are poor to save $3, or someone who really cannot come up with three dollars.

#3: An independent 95-year-old man came to Member Services yesterday to ask a question about his bill. I felt something sacred in his presence. And in such good form he was! The rep said after that of course the man, because of his age, qualifies for free medical care, but that he must be too proud to depend on the government. It was inspirational to see someone of his age taking full charge (not necessarily in the financial sense, but in the physical) of himself and his affairs. 95 years of being alive, and still so on point!

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These instances (especially #1 and #2) make me feel confused and a bit sad about people, and why they don't do more in their power to take care of themselves. Maybe they are just misguided, I don't know. To me though it is hard to imagine choosing a pedicure over a professional foot doctor, or not doing everything I can to come with just 300 cents to cover but a fraction of the billed cost of one of my medicines. I know that I must have compassion for people, and not anger. I know that I am lucky to value taking care of myself.

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