Health care, close to home

While Washington does battle over health care reform, it’s instructive to look at the issue a little closer to home.

For the past 10 years or a little more, Dr. Richard Muller has been my physician. If you have a vision in your mind of the old-time country doctor, Rich Muller is probably the picture you’ll come up with. Never mind that he practices out of a less than elegant modular building that’s a clone of the kind popular in expanding school districts in the early ‘70s. Outside of the ambiance, of which there was none, his office was a throwback to the days when medicine was delivered by folks you called by their first names.

I have Type II diabetes, which requires a lot of vigilance and quarterly doctor visits. I was a regular in Rich Muller’s tawdry waiting room, but that is not to say I spent any time there to speak of. I never waited more than 10 minutes to be served, and I think that the total amount of time I was kept waiting, in 10 years, was less than four hours. That’s remarkable in this day and age.

And it wasn’t because the doctor had nurses do all the grunt work, flew in for two minutes and sailed out to the next patient. When I had questions, Rich Muller answered them to my satisfaction. We had many, many fairly long discussions about my ailment, new discoveries in the field of diabetes research and treatment and how that all related to me. And we also hit on politics, golf, families, what was happening around town and in the area. I always looked forward to my doctor appointments.

Rich Muller, however, has moved on, gone to work in a larger clinic in Virginia. He and his wife had had enough of the north country’s short summers, of the biting cold, of the snow and inconvenience of the long, long winter. Even in leaving, though, Rich went the extra mile, finding doctors for his patients that he thought might match both their medical needs and their unique personalities.

So with considerable trepidation, I had my first visit with my new doctor today. I will call this person simply Doc, because I’m not going to give any hint as to whom it might be. So don’t try to figure it out. Doc works in a practice with several other physicians, in a modern office with a dedicated lab. The reception area has a sliding glass partition that is closed (Rich had a sliding glass panel that had been perpetually open for so long I don’t think it could be closed), a waiting room with a television and a boatload of chairs. My first wait in my new Doc’s office was 46 minutes. My second wait in my new Doc’s office was 15 minutes. I quickly figured out that I had spent about four years of Muller waiting time on my first visit.

I think I’ll like my new Doc. Doc is sharp, has a sense of humor and to some degree, is willing to talk to patients. But I get the feeling that Doc likes, well, procedures. I’m going for an ultrasound exam tomorrow (Doc didn’t laugh all that loud when I said “Oh, great, I’ll be able to see the baby’s head!”) for something that Rich and I had discussed, and ultimately rejected. But I’ll cut Doc some slack, because I’m new and it isn’t entirely unreasonable to want to be cautious to the extreme at first.

But at some point, I suspect Doc and I are going to clash about some procedure. And it is the medical society’s proclivity for extra tests and expensive procedures that are in large part driving up the cost of medicine for you and me.

I don’t pretend to have the answers. But I can’t help but wonder if, perhaps, the totality of care offered by a Rich Muller — care based not only on medical observations, but on a keen understanding of the emotional and mental state of the patient being treated, a knowledge born of observation and interaction — isn’t being lost in the health care behemoth of modern America.

The march of medicine must go on. Research into disease provides miracle cures, and more importantly, provides the smaller steps that vastly improve the quality of life for millions suffering from long-term diseases. But depersonalizing the delivery of medical care must, in the long run, increase its cost and decrease its efficacy. When the patient becomes a number on a chart, and not the stepfather of Sarah and Megan and Chris who loves golf and likes nothing more than a lazy day on the lake, something infinitely valuable is lost.