On 3/21/2010 7:35 PM, Han wrote:

So "effectiveness studies" should give you better care (less side
effects) and less costs. Your irrational fear of someone deciding for
you what kind of care you are going to get has warped your mind. Do your
research of what you think you need and have a good talk with someone you
trust, then with your doctor. And, please, do write down your living
will, advance directives or whatever you want to call them.

I don't mind giving you a personal, real life, less than 72 hours old,
example of the above.

Appointment at the VA for shoulder problem on this past Friday AM
(believe me, I _earned_ the VA medical care ("entitlement", if you
wish), the hard way!).

This was the third visit on this issue, taking four months to get this
far, each visit hopefully getting closer to an actual diagnoses, and
subsequent relief, based on something besides conjecture on the part of
the primary care physician, a GI specialist (but as long as I ask the
right questions, a competent health care professional).

Not enough doctors to go around in Orthopedics, so, after two and a half
hour wait, get a PA, (very accented English and hard to understand, but
very nice, attentive and obviously caring). PA ultimately makes
determination to give steroid injection in shoulder (step 5 of
apparently a 10 step procedure that must be followed, in order).

Relief is not as obvious as have been led to believe, so after a few
hours start doing some research on the expected efficacy of the
injection, with particular emphasis upon the site of the PA administered
injection, (posterior shoulder in this instance, with the main problem
exhibited on the anterior).

From a doctor friend: "A lateral injection is generally the preferred
site and best for the desired result. The posterior location is
considered the easiest place to administer the injection. It is the site
that requires the least amount of skill, and the site where it is
recommended for the unskilled to administer the procedure".

Light pops on ... basically, got a steroid injection (ouch!), in an area
of the shoulder least likely to benefit from the procedure, and by an
unskilled PA, with no doctor available.

Next possible appointment, and to then OK the escalation to the step 6 -
to see if an MRI is warranted: late July, 2010.

Don't get me wrong, this better than no care at all, but arguably
"second rate" by any medical yardstick.

That said, I accept the entirety of any blame because I failed to do my
homework beforehand. Had I done that, I could have asked the correct,
informed, questions and probably gotten a better result.

However, this anecdote is NOT partisan conjecture ... it is actual, day
before yesterday, "US government health care", in practice.

Moral: we should be damn careful what we wish for ...and, if you get
nothing else from this little anecdote, most definitely prepare yourself
to do MUCH more in managing your own health care when this bill passes.

.... and it appears that it will pass.

--
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Last update: 10/22/08
KarlC@ (the obvious)