I am a Number
I know that healthcare has changed over the last 5 years and particularly the last 2.5 years. Since the beginning of covid, most physician’s appointments have been by video and/or the telephone. This was necessary and appropriate during the time (maybe still time) of covid. Now, after three doctor’s appointments in the last two weeks, two by video and one in person, I’m feeling less like a human being and more like a number, or several numbers. There’s my age, which all three remind me of as in “you can expect these medications not to work as they do in younger patients,” and “if you were 40, the decision would be easier.”
They don’t look at me and, in the case of the cardiologist, seem to be endlessly impatient with my understanding or lack of understanding of their recommendations. I feel like a chastised six year old, another number.
Louise Aronson, the UCSF gerontologist, writes frankly about this. She writes that many physicians treat older adults as if they all have mild cognitive impairment. The physicians aren’t trained to listen to or express compassion for the changes endured and tolerated by all older adults. For instance, my arms and legs are covered with bruises, not from bumping into things, but from the blood thinner I take to prevent a stroke. I cover myself from neck to calf in embarrassment and frustration. When I mention this to two cardiologists and yesterday, to an electrophysiologist, they smile indulgently and offer no alternatives, because, they say, there are none.
My oldest daughter works for a university health system. She tells me this situation cannot be any different. She tells me there is no time for compassion in the current system. She tells me that most primary care physicians have 1800 patients. A pat on the knee and a prescription are about all the time they have for each patient.
I didn’t notice this so much with my prior primary care doc. She would listen closely and help me problem solve both physical and psychological issues. She’s gone back to her prior specialty, palliative care. I think the stress of the requirements for patient numbers got too much for her.
I’m considering an appointment with Dr. Aronson. She is out of my insurance plan, but has seen some of my friends, also on a consultative basis. I want to know if my being a number is just what is and there is no option for better care, or if there is an option for real connection in medical care now.