Tuesday, March 23, 2010

Paging Doctors Moylan and Crusher...

March 24, 2010

Doctor Moylan was our family doctor when I was growing up in the 1950s Detroit suburb of Oak Park. I don’t know his first name. “Doctor,” I guess.

Doc Moylan was maybe 40 years old. Or 45. Or 50. I was a kid, after all, and as a kid you think everyone is old.

Being about nine years old I remember one day when my mother sent me to visit Doc Moylan. Obviously I wasn’t sick because I walked or rode my bicycle a little over a half mile to Doc Moylan’s office. Might have been a physical checkup or something.

Doc Moylan had his little office on Geneva Street just off Nine Mile Road in Oak Park. I was in that neighborhood a lot. Across Geneva Street was Efros Drugs where my mother would send me to pick up stuff for her. I liked Efros because they had a lot of comic books and they had a cool section in the back where you could buy a bunch of those magic tricks that were advertised in the comic books. A few doors down from Efros on Nine Mile were the offices of Carpentry by Landry, a major contractor run by my uncle and a place from which my dad and most of my uncles worked.

I don’t remember if Doc Moylan had a secretary or a receptionist. I do know that he was an oldtime lone practitioner. And he made house calls. I recall him coming to our house and into my Vicks Vapo-Rub-smelling bedroom when I was sick. He had the traditional little doctor bag and would poke and examine me, then speak confident medical-type words to my mother, assuring her I was okay.

Doc Moylan liked to talk. You got not only health care from Doctor Moylan, but you got an enjoyable visit with a genial man who genuinely liked people. I remember on that day when I went by myself to his office on Geneva that he wanted to know how my parents were and what was going on with us.

I don’t remember paying Dr. Moylan anything that day – I imagine he billed my parents or more likely settled up with them the next time one of them made a visit.

Doctor Moylan couldn’t exist today. For one thing, advances in medical care for the most part have done away with the house call. Can’t lug all that fancy equipment around in the back of a Buick. Also, you can’t financially support the clerical staff needed for insurance and Medicare processing by sitting around chatting with the folks. Medical practice today has to be about producing revenue. And while I’m sure Doc Moylan had some kind of liability insurance he probably did not worry too much about his patients suing him. After all, they were his patients, his friends, and he was almost like an uncle in their families.

Doc Moylan had the luxury and the privilege of mainly providing personal care and expertise, much of it based upon the knowledge he carried around in his head (I’ve heard the old docs were experts at diagnosis by focusing on the smell of the patient and the room).

As great as Doctor Moylan was, I wouldn’t want to go back to the medical care of the 1950s.

Dentists offices in those days were torture chambers and an out-patient cataract operation I had about ten years ago would have required three weeks of recuperation in bed and permanent poor vision despite the operation. Today, it’s different: we have friends whose son had laser-directed heart surgery – heart surgery! – as an out-patient procedure.

It’s like we’ve been on the way to that little device Dr. Beverly Crusher waved over the patients of Star Trek the Next Generation that magically healed them.

Ah, but that won’t be coming anytime soon.

At least not from the United States.

That’s because we took the most advanced medical system in the world and one Sunday we broke it.

Correction: “we” did no such thing.

They did.

Driven by their pride, their bribes, their tricks, their cunning and most of all by the white hot Marxist agenda of the President and his White House thugs, they choked and stomped and kicked and gouged the American people until they got what they wanted.

And they’re wrecking a great health care system. It’s a system that prompted a Canadian provincial premier to leave left his national medical system to come here for surgery. Castro probably would have come here for medical treatment, too, but that would be hard to explain to the folks back in the worker’s paradise so he went to Spain instead.

To attain that health care has required investments of billions of dollars. And to secure those billions of dollars has required operation of the free market, even a free market compromised by government interference and the efforts of blood sucking tort lawyers.
And it truly has been a great system.

But now, like Captain Smith and the Titanic designer examining the damage shortly after the ship hit the iceberg, it’s dawning on us what we’re in for.

And it’s not pretty.

There’ll be no magic tools for Dr. Crusher.

And the standards we have today won’t last.

And medicine won’t be practiced the way it is now.

Which brings me back to Dr. Moylan.

Dr. Moylan had a personal relationship with his patients. But the technological advances made guys like him obsolete. Productivity became the byword. And because of changes in philosophies we had about insurance, we began to expect all the medical magic but with someone else paying. Throw in government pressure through Medicare and there was no way Dr. Moylan could spend his time chatting about your family.

As wonderful as the medical advances have been, a generation ago we lost the personal aspect of medicine. For a long time it’s been about costs and containment. Even my current doctor of fifteen years, a great guy in the tradition of old Doc Moylan, has time pressures. When I see him I can sense that as much as he’d like to sit and talk, there’s crushing financial overhead to fend off and revenue to be generated by moving on to another patient.

I understand.

But wait until my current doc becomes a government employee. We know how bureaucracies do things: they’ll squeeze the life out of us as individuals, but with their innate inefficiencies, they will never cut costs.

Sorry, Dr. Moylan. Sorry, Dr. Beverly Crusher.

It looks like the past and the future of American medicine are gone.

No comments:

Post a Comment