Greg Roach's Berkshires Blog
Sunday, January 13, 2008
  Non-electoral Primary
Dr. Robert C. Jandl, the President of Williamstown Medical Associates, had an extraordinary and rather dramatic piece in the Eagle last week:
... But the system is so broken, distorted, and lacking in basic respect for the humanity of my patients or the professionalism of my life's occupation, that cynicism, fatigue, and burnout are a constant threat. Nowhere is this truer than in primary care, the bedrock of our health care system.
Good health care, and doctors to administer it, will not come about without fundamental reform. That reform must rest on the basic moral principle that when it comes to health care none of us is more worthy than another. Indeed it is often the poor, the unemployed, or the otherwise disadvantaged, who may require our most sincere efforts.
This piece was accompanied by statement of distress signed by 49 of Berkshire County's primary care physicians.

Ironically, my life of late has been too full of medical matters and work to have caught Jandl's piece the first time around. I only found it because of the slew of letters to the editor that it has provoked.

I can personally attest to the primary care crisis occurring in Berkshire County. My and my wife's own trusted and remarkably talented physician, Dan Sullivan, threw in his overburdened primary care towel a year ago to move to the Cleveland Clinic. Fortunately I quickly landed with another very talented Doc, but my wife was not so lucky. My current Doc reportedly has 3500 patients in his care; far more than anyone can reasonably handle. So his, like most of his colleagues', practices are closed to new patients.

During this time my wife has been in a rather severe and chronic medical situation that needed to be centrally managed by a good physician. Instead, between December '06 and the present, she was shuffled around between no fewer than 8 docs and 2 P.A.s. During this time our supposedly gold-plated insurance policy rejected claims for three critical prescriptions yet unflinchingly paid a bill from an over-rated specialist in Boston who charged $900 for a 15 minute consultation that told us absolutely nothing.

Fortunately, after months of visceral and debilitating pain, she found a new primary physician who referred her to the BMC pain clinic which set her up with an appropriate specialist in Albany. The healing process appears to have begun.

But here is the rub - If she had wanted elective surgery, say a nose job or face lift, she could have had the procedure within a few weeks of making the decision. Yet this real-life intensely critical situation took a year to figure out, and she still has to wait three months for a surgical procedure to help alleviate her pain and hopefully give her her life back.

The system is indeed broken. As Dr. Jandl writes:
I believe that doctors and patients want the same thing: comprehensive, thoughtful, personal, and skilled care. That is an achievable goal if we have the will and determination to fundamentally alter the way primary care is practiced and funded. Viable proposals now exist that will do just that, but given the vested interests of those who profit from health care as it is practiced today, it will never happen without an uprising of popular support.
Uprising?!?! Point me to the barricades.
And yet Dr. Jandl has proposed, and received permission for, demolishing the current Williamstown building and borrowing money to put up a brand new one on the same property because - the exam rooms are dark.

I'm all for everything Dr. Jandl has preached in his letter, but costs rise from many sources.
Medicine would be far cheaper if doctors practiced in mud huts.

In other words, it's all relative.
But is it all necessary?
FOOD FOR THOUGHT.....Why do the sick have to get out of their sick bed and travel to the doctor? If they have say the flue, ain't they just spreading the disease around by sitting in a waiting room full of people, while they cough, sneeze and touch the furniture and magazines and spread their germs into the air?
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