Wednesday, September 26, 2018

Access to Healthcare In The USA Vs Quality of Healthcare

urgent care in USA

Many of my British friends always tell me how they love their NHS because it is free healthcare.  They somehow think that what they have  in the UK is far more superior than what I have here in the USA. They can be right if only I don't have health insurance in the USA.  But they are dead wrong  when I have health insurance in the USA.

Recently I had been suffering from Shingles.  I'm not the average usual case because people my age don't usually get shingles.  I'm still in the age group where I am still fighting with acne, but shingles?  It started out with a migraine like headache, a tingling sensation on the side of the neck, a red rash on  the eye lid.  Then the headache became intense with intermittent ice-pick sharp pain, my left ear also got the same ice-pick pain deep inside, the side of my neck had a tight and stiff sensation yet it also had similar muscle pain like what I usually had during a flu fever.  I didn't have a fever but I felt this very painful big lump on the back of my neck near my head. All these are on the left side of my head and neck only.  I was told that Shingles usually showed symptoms on one side of the body.

Initially I ignored all these pain and skin rash on my eye lid because I thought I may have an allergic reaction to something I ate.  But soon the rash on my eye became a clutter of pearl-like blisters.  When I bumped into my doctor neighbor hauling my trash cans out, he looked at my eyelid and told me I had shingles and I must go seek medical help as soon as possible.

Freaking out, I walked in the Urgent Care Clinic at 6:30pm and I was checked-in smoothly and quickly.  After my efficient and pleasant pre-screening with the nurses, a medical doctor came in to ask about my symptoms, then she looked at my blister on my eye lid, she checked my scalp, and she felt and checked the painful lump on my neck.  She then dropped some special eye drop on my left eye and used a special equipment to examine my eye with flashes of bright  light.  She then  confirmed my doctor neighbor's opinion that I indeed had shingles.  She prescribed 10-days' worth of the anti-viral medicine called Valacyclovir, and she told me to follow-up with an opthamologist  the next day. I spent approximately 25 minutes at the Urgent Care Clinic without an advanced appointment.  I don't know how much faster my British friends  in the UK can get the Shingles treatment at their beloved NHS, than what I got here in the US.  But I'm happy with the speedy access that I have here in the USA.

Yes, my visit at the Urgent Care Clinic wasn't free, I paid $45 when I checked-in.  But such was the cost of immediate access to a doctor, with health insurance.  The prescription cost me another $14.58  at a pharmacy.  My only complaint about the U.S. healthcare system is the separation of medicine dispatch from the doctors.  If only the Urgent Care Clinic had a pharmacy department to dispatch the medicine, that would have saved me a trip to drive to a pharmacy.  When I didn't feel well  with that acute ice-pick pain on my head and ear, the last thing I wanted to do  was to drive.  Then after I arrived at the pharmacy, I had to stand in line to wait for the pharmacist to type a lot of stuff  into her computer before she could give me the medicine.  The typing was long and it felt forever to me when I was waiting at the window, impatiently while I felt like someone was viciously stabbing my head and ear with an ice pick.  I was waiting in tears at the Pharmacy, not because I felt sad. It was because of the acute pain inside my head.  It was the worst pain I had experienced in my entire life.  It was tortuous.  But there was a few minutes' pain-free break in between every ice-pick stab when I could breathe.

The next day, I was able to make an immediate appointment with my opthamologist, who squeezed me in based on the Urgent Care Doctor's assessment.  How long do my British friends have to wait to see an opthamologist at the NHS?  This time, my neighbor who is a retired doctor went with me.  He drove me to my opthamologist, because I couldn't drive with my tortuous headache.  No, Ibuprofen didn't help one bit even though I was taking the highest dose recommended by the doctor at the Urgent Care.  I had already taken 3 doses of the antiviral medication when my opthamologist did another exam on my eye.  He didn't see the shingles got into my eyes yet even though they were on my eye lid and eyebrow and was starting to show on my left forehead.  He told me to continue taking my anti-viral medicine. But my concern was the tortuous nerve pain inside my head that made me want to die, literally.  The opthamologist told me that the pain would reduce as the anti-viral medicine continued its work inside my body.  It was then my doctor neighbor kindly suggested the prescription of prednisone.  My opthamologist was not too willing though, thinking the anit-viral medication that I'm taking will eventually disarm the viruses and thus the pain caused by the viruses' attack on my nerve in my head.  But after a friendly professional discussion  between the opthamologist and my neighbor door on the pros and cons and the side effects on giving me the prednisone. My opthamologist wrote me the prescription.  I didn't even know that it was and I never heard of prednizone before.  But I took the highest doze allowed and it was a life saver!  I thank god for having a neighbor who is a retired doctor.  The doctor at Urgent Care and my opthamolostist wanted me to just wait it out and let the anti-viral medicine to work.  But that acute pain deep inside my head was so horrible that, every time it stabbed like an ice pick, I felt my mind went blank and my heart smashed. Yes, that kind of severe pain actually hurt my heart too.  The second the pain hit my head, I felt like I was going to drop to the floor.  It was extremely painful.  But prednizone took the pain away, how? I have no idea. I only know after I took the maximum allowable daily dose, I felt like I was healed from my painful Shingles, but of course I continued to take my anti-viral meds diligently.  But can you imagine if I didn't have the prednizone?  I was screaming in pain with tears while waiting for my prednizone at the pharmacy.  How could I survive one more day of acute pain or possibly a few more days, a week?   I was just lucky that my neighbor was a retired doctor and he with me at my doctor's office, and he was able to convince my opthamologist to give me the prednizone. How about the many who went to the doctors, relying on their professional judgement and just went home to wait out the acute pain?  Prednizone isn't for everybody but in my case it really worked the wonder.  And it only cost me $1.88. No, I hadn't suffered any side effect because I was on it for only a very short time.

So before praising the NHS in the UK, let's compare the access of care and the quality of care head to head when a person has actually fallen ill.  At this point, I personally prefer the U.S. healthcare system to the UK's NHS, but if you ask me when I lose my health insurance and when I am too broke to have $45 and $14.58 to pay for the out-of-pocket expense that insurance doesn't pay, then yes, I will tell you I need the NHS, even if I may have to wait for a long time to see just a GP. (General Practitioner).

I don't think there is the "Perfect" free quality healthcare anywhere in this world. There is however the quality healthcare that works beautifully at the moment when you happen to have the money to afford it.  In the USA, one must have a job that offers group health insurance coverage. Once you have that, healthcare is fantastic.  But I bet this works in the same way even in the UK , because private insurance can get you quicker treatment at private hospitals and clinics.  But of course for Americans who are younger than 65 and who absolutely can't get a job that offers health insurance, there is a need for the UK's NHS to be in place. But then isn't this what Medicaid in the USA is all about?  Now, what's our problem with American healthcare again?  I'm now getting confused.

If I have to choose one aspect of  the U.S. healthcare system that I must dedicate my life to advocating, please let the doctor's office dispatch medicine!!!!!  My visits at the pharmacy during this Shingles outbreak were the most tortuous experience I ever had, so far.  It wasn't the pharmacy's fault, it was just I didn't have anybody to go wait in line for me to get the medication.  I very much prefer to take my meds immediately at my doctors' visits, and not to driving in great pain to go elsewhere to get my meds! Just how much unnecessary pain I would have avoided if only I could take my meds at my doctors' visits!

Wednesday, April 11, 2018

Non-invasive Brain Tumor Surgery With Gamma Knife


This is truly impressive!  I'm for any medical technology advances that can deliver non-invasive treatment.  But no matter how non-invasive this medical procedure is, I pray to God that I will never need it.  It's good to be informed though, just in case. As of now, I don't know where exactly in the USA can patients get this kind of treatment, except in  UCSF.  So if any of you know, please tell me.

Monday, April 9, 2018

All The Technology Doesn't Seem To Speed Up On-Hold Time At Doctors' Office

May be it's just Providence Medical Group, I recently was asked to call the office back  because my original appointment with my doctor had to be rescheduled due to reasons at their side.  Now, if you called me to call you back regarding your office's request for me to return your call or to response to your message, can you at least queue me to a dedicated line for call-backs from patients?

It's really annoying  to have to be put on-hold for such a very long time. I've been put on-hold for 20 minutes now, and I'm still being put on hold as of now.  Sorry, I'm not going to leave your voice mail my phone number because you already called me and I'm now calling you back!  I don't want to play this back and forth ping-pong game of you calling me and me calling you back just to be told that the call volume is unusually high at  this time, so I should leave you a voice mail message to start the vicious cycle  of telephone ping-pong all over again!

I still remember when I was a teen, calling a doctor's office wasn't like  this.  I wasn't questioned by stupid robots and kicked around so I could end up in an "on-hold" line where the call volume is "unusually high" at all times. I still remember the good young days when I called a doctor's office, it was a nice and friendly human nurse or receptionist who greeted me first.  This aspect of a medical practice seems to be so much worse today, even with all that fancy "IT"?  So for those politicians or doctors who think technology can improve healthcare, don't rush to sink more money and time into it before looking at it twice.

This problem is certainly not the doctor's fault.  But whose fault is this?

Saturday, March 31, 2018

Get A Beautiful Gardening Book By Donating To A Healthcare Fund

My healthcare plan has high deductible, so I would like to give away my book to help fund it. After you donate $7.90 to help me fund my healthcare expense, I will mail you the following book which is very new in condition. This book has 672 pages and is full of inspiring gardening ideas. The book has always been sitting on my bookshelf unread since I bought it.


Thursday, March 29, 2018

We Will Never Have This Kind Of Hospital In USA Or Canada


Correct me if I'm wrong.  There is no for-profit private hospital here in the USA or in Canada, is it?  For those of you who had never experienced private for-profit healthcare, I want to tell you that, you totally have no idea what quality healthcare is about.  I can't say I had the honor to be sick a few years ago when I was visiting Hong Kong, but that experience had sent me into a really great private hospital (not this new one in the video) where I was treated like a royalty.  The nurses there had such good bedside manner only the flight attendants in Singapore airlines can match.  I'm not kidding.  My travel insurance paid for it because it was a sudden illness and it happened when I was traveling, and of course that illness wasn't because of a pre-existing condition that I had. I had never seen such caring and handsome doctors my entire life.  But I have to say, I have been healthy enough to not have seen that many doctors to really conclude that American doctors aren't good looking.   But the few doctors whom I had seen in the USA are not good looking, and a couple of them look scarily deranged like those individuals who show up on police mugshots in the news, wearing dirty white coats.  I was really grossed out by those white coats that aren't starchy white and that had traces of dark rings around the cuffs and collars.  But you will never see that kind of white coats in a private hospital in Hong Kong, no no !

Other occasions when I witnessed how good the private "for-profit" healthcare in Hong Kong, was when I was visiting my mother who had her hysterectomy and my sister-in-law who had her  C-Section.  Those private rooms where they stayed were so nice that they made them feel like they were vacationing in a hotel and not being sick in a depressing hospital.  My mother's surgery and hospital stay was 100% paid for by her catastrophic health insurance, which even though didn't cover pre-existing conditions for her, covered all new conditions.  The premium was so low (compared to my health plan here in the USA) that the lack of coverage for pre-existing conditions wasn't an issue to my mom.  That surgery and week-long hospital stay had more than enough paid off her premium.  The hospital meals were so good that I actually paid my sister-in-law and my mom more visits than I needed to because I just wanted to have my meals there.  Then there was the frequent rounding of the handsome doctors who actually took an interest in my sister-in-law's and my mom's personal lives.  The doctors there were so reassuring, friendly and caring that they made them feel so safe and comforted.  I slept with my mom on the night of her surgery in her room and it was really comfortable, like it was just a hotel stay.  Then there were aids and nurses coming in to bring magazines to my mom and sister-in-law, to peel oranges, apples and even grapes for them, while offering great company and uplifting conversations. 

Now back here in the USA, I had never witnessed healthcare at this level, even though I suspect that I'm not paying any less than what my mother paid for her catastrophic insurance and what my sister-in-law paid 100% out of pocket for the delivery of my niece. My sister-in-law paid approx. a total of $12,000 for her week-long stay and C-Section. I'm not sure what my mom's insurance paid for her surgery and hospital stay.  But what my sister-in-law paid wasn't that much, compared to the fact that I paid thousands of dollars a year to just have health insurance in the USA, and to constantly pray that I will never have to ever use it because I have a $6000+ deductible... and I'm not sure if my insurance will pay 100% of the covered treatments or 80%, I forgot and I have to go back to re-read the fine prints.

So, as you can see, my sister-in-law living in Hong Kong doesn't have to really worry about getting health insurance because even if she doesn't have health insurance, paying 100% out of pocket can get her a better deal than what I pay here to be medically insured.  It's because the overall medical cost in private hospitals in Hong Kong is a lot cheaper than in the USA even though the locals in Hong Kong think private hospitals and clinics are expensive, so many of them opt for the universal care offered by the government instead.  For those who don't want to go to the government-run universal care, like my mom, they purchase catastrophic health insurance that they can use to go to private doctors and hospitals.  The low premium and flexibility made such  policies very popular among people like my mom, who prefer private hospitals but don't mind to be covered for each major condition only once in her life time.  I doubt my mom will ever have another problem with her reproductive system though, since it was all surgically removed, but she will not have to worry, and god forbids, when she is going to have breasts cancer next time.

I don't think I will ever see a healthcare facility in the USA that can match those private ones in  Hong Kong, in terms of comfort and patient dignity. It's because in Hong Kong, private hospitals can thrive at competitive pricing due to the lack of class action lawsuits or the extra high cost in bullshit compliance and paper works like here in the USA. In Hong Kong, private healthcare can focus on patient care, instead of paper pushing in the USA.  This is just what I observe. correct me if I'm wrong since I'm not a doctor and I don't work in the healthcare industry.

Wednesday, March 28, 2018

Are Doctors Aware That Their Fancy Computer Systems Are Turning Away Patients?

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I had recently read an article about how patients disappeared for years from the practice. But have doctors ever wondered there could be a reason behind.

This is what happened to me yesterday.  I got mixed up and I went to an appointment one day early.  I didn't realize it until I attempted to check-in and I was told my appointment wasn't yesterday but today.  But since I already took a sick day, I offered to just sit there and wait for an available slot and I told them I didn't mind the wait because I just had the entire day. 

The staff at my  doctor's office told me, "No, you can't wait here, we won't check you in no matter what, we can't service you even if you wait here till the end of the day. You can't just wait here."

"But I'm willing to sit here the entire day, I don't mind.  You can process the appointments first until there is an empty spot that I can fill in, I'm here in case there is a slot open. If not, I don't mind being here for one day.  If you don't want me here taking up the space, can you please call me or text me when there is an open slot, I will be around the building."  I pleaded.

The girl at the reception said, "No, we don't do that."

So today I overslept a little and I went back to my day of appointment and they said I was 35 minutes late and they would not check me in!  I pleaded again and a different girl from yesterday told me,  "No, your name isn't on the computer and we will not serve you if your name isn't in the computer, the computer deletes you and marks you as no-show if you don't show up 10 minutes after the scheduled time."

I pleaded to  them again to let me stay as a waiting-list case. "No, we don't do waiting list with walk-ins.", the girl said.  

It really pissed me off at that point, because in the good old days when my same doctor didn't have that new fancy computer appointment system, I would be able to sit and wait for the next open slot even I was late for my appointment. But back then, it was also a different person who manned the counter. She was the old-school type who reminded me of a generation of  very friendly secretaries assumed by baby boomers.  Now I get these 20 something who are totally robotic and inflexible.  I hope they will all be replaced by robots in a few years because I'd rather deal with a robot than a stupid human with zero flexibility.

Now I am rescheduled and my appointment will be more than a month later.  A lot can happen in a month, sometimes it means life and death. If my doctor doesn't see me next month and an illness kills me due to the lack of  proper medical detection in time, she may also wonder, "XXX  hasn't come in for years. She probably has lost her insurance or she is too cheap to want to spend the copay to come in."  But little will she know I tried to get in to see her twice and I was turned away by her inflexible staff.

I have health insurance so sometimes patients don't see their doctors frequent enough isn't because they don't have health insurance. It's because they can't get through the lazy and inflexible gatekeepers.  Having health insurance and having access to healthcare can be two separate things.  Dear doctors, if you want your patients to come see you more, make it easier for them to schedule and reschedule appointments, don't have your staff turn them away at the reception area if they are late, give them the option and opportunity to amend their "no-shows" or to prevent their "late arrival" from turning into a complete "no-show", if they are willing.  This is what I will do if only I run a medical practice.  

Tuesday, March 27, 2018

Finding It Difficult To Keep Doctors' Appointment?

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I had missed my OBGYN's appointment today.... I worked till very late last night and I had just missed my phone's alarm clock to not make it to the first appointment in the morning that I had long scheduled a month ago.  I picked this early time in the morning because I was unable to get my appointment at another time. Yes, my OBGYN is this booked!  Now I have to wait another month to see her.   This is not a big deal, you may say... But before my OBGYN's appointment, I also missed appointments with  my dentist and  my Dermatologist.

I feel bad for being a no-show, in a sense that I can't even keep up with a doctor's appointment now?  I've been feeling overwhelmed and I've been experiencing anxiety over a lot of things.  I had no idea when I started to have a problem with anxiety. May be when my patio is overgrown with weed.  I  never admitted I had anxiety. But now, I think I am seeing a problem.  No, I didn't miss my doctors appointments because I was too anxious to see my doctors.  It was because I was so exhausted doing everything else and I was so overwhelmed by life that I just missed my doctors' appointments.  Missing my doctors' appointments is just the consequence of me feeling anxious about other things in my life.

My becoming a no-show with my doctors makes me feel like a failure.  I know I shouldn't call myself this but what should I call it when I fail to even keep my doctors' appointments?  How do I pull myself together?  I already input all my doctors' appointments into my phone's calendar which I also added alerts.  My phone's calendar allows me to add a maximum 2 alerts per appointment.  I always max out the alerts allowed!   But still, I missed my doctors' appointment.  Now  I need to start doing something to at least help myself keep the next upcoming appointment,  so I will feel some sense of normality about myself, about my life.

Right now, I have no idea if I should see a doctor for my anxiety.  But according to what I read from the internet, I need to see a doctor if my anxiety is affecting my daily life.  I think it is a problem now, but the problem is if my anxiety is voiding my ability to keep up with appointments, how am I going to see a doctor to help me with my anxiety?

Am I alone in this?  I would like to hear from anyone and everyone who feels overwhelmed and anxious right now. I would like to hear how you guys deal with it and get on with life.