As a consumer of healthcare, the majority of my adult life I have not had real insurance. To think that for 4 of those years I worked in a hospital as a private medical provider – but my boss didn’t have to offer me insurance because I was contract. God bless America.
For like 8 years I had a “fixed indemnity” plan – it would reimburse a max of 40% of my costs and got me a small discount on meds (though often less than GoodRX). This led to being a cash patient at most of my providers. I have a long history of beef with the American Medical Establishment (and that’s before you get me started on psychiatry which is a whole beast of its on fueled by the pharmaceutical industry).
One of the things I’ve come to realize the past year is how deeply my ADHD/neurodivergent brain impacts my ability to function within the systems of society. As I’ve needed additional treatment for my shoulder injury, the necessary steps to receive it seem completely back-asswards to me. Personally, I have REAL trouble engaging in shit that feels directly exploitative of my time and money.
On my first doctors visit – I was given a tentative diagnosis of bursitis – with the statement that the treatment (oral steroids) would confirm, if I received relief. I was also grateful to get my rescue inhaler and migraine prescriptions refilled at this appointment. He actually threw my old inhaler in the trash and told me it wouldn’t have done shit for me if I had needed it (I haven’t much since masking for COVID and quitting my beloved clove cigarettes 18 months ago). Best believe I’m going to get my bang for the buck on my appointments.
I was also sent for a shoulder x-ray “because if a MRI was necessary, the x-ray would have to be done first.” So that day, I spent 1.5 hours sitting in an Xray waiting room because they don’t take appointments.
Why do all medical offices have blaring TV’s? Like its 2021 – everybody has a phone in their pocket to entertain themselves with. Literally nothing like blaring daytime tv commercials to get me into sensory overload while I’m already frustrated with your inefficient system.
X-ray came back clean as totally expected because all 8 of the body workers (physical therapist, massage therapist, multiple chiropractors) had confirmed that duration, type of pain, symptomatology in general did not point to this. But hey I jumped through that loop.
After 48 hours I was not feeling any relief, so I requested a follow up appointment for the secondary treatment which was corticosteroid shot. I also received 2 weeks of sleeping aid.
To point out the dialectic – they did me a favor and worked me in on a Friday so I could get relief before the weekend. I’m grateful for that but my insurance and I paid a combined $200+ so is really a favor when capitalism operates to support maximum profit?
Yesterday it had been 12 days since the shot. Things have improved, it is clear the inflammation has greatly decreased. However, I am still not feeling well. Even with assisted sleep, I have the huge dark circles under my eyes. I recognize the potential for several other things going on in my body.
So yesterday I messaged my doctor’s office a short DEAR MAN:
While my shoulder pain has greatly improved, I am still feeling something is off in my body. I only have three covered visits per year and we’ve used two of them in the past month. Can you order a general panel as the symptoms (fatigue, insomnia, water retention, continued pain from inflammation) could point to multiple familial conditions (diabetes/thyroid) or infection which I have read is often concurring with bursitis. I will book an appointment for next week to review the results.
The response I received was “No I’m sorry we can’t do that”
Here’s where my ADHD comes at play. I am not a circus animal and I don’t jump through hoops just for the sake of it. I’m not going to use my last covered visit to explain my symptoms and leave with a lab order. That’s horse shit. Diagnosis cannot occur without data and truthfully the order was justified after my second visit.
In the past this is probably where I would have gotten tripped up and just given up. Either whats going on will clear itself up eventually or I’ll end up in the ER. I know that sounds ridiculous for a semi-intelligent human being, but that’s how my brain gets with stupid barriers.
I am getting a little more effective in my old age (or maybe I’m just truly terrified of the impact of ignoring this one). I figured out a work around that settles my need to not have my time wasted. I used a coupon/ discount site that allowed me to book the labs directly through Quest (where my insurance would have sent me). I will then be able to take the necessary data for diagnosis with me to my last covered visit.
I did the math it was cheaper than paying out of pocket for a second visit. It also saves me an entire encounter. It’s a win-win. But I shouldn’t have had to find a work around in the system.
We’re still in the middle of a pandemic. Access to healthcare should be as simple (and affordable) as possible. We already know there are multiple secondary pandemics that will need to be addressed post COVID. First and foremost Mental Health. But also the impacts of missing screeners and routine care – people skipping the dentist or gynecologist because they feel it is safer to put it off another 6 months than risk exposure to COVID by being in medical environments (especially sitting in stagnant waiting rooms for extended periods of time).