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"Modern medicine seems almost identical to medieval medicine, except the leeches are larger and more impersonal."

The Muse and I belong to a Health Network, a common modern American euphemism which means 'limited monopoly.' Once 'enrolled' and accepted, a Health Network combines with insurance coverage to become a client's one-stop service center for all things medical, from check-ups to diagnostic procedures to prescribing. Ours features a patient Portal which was obviously designed to try our patience. It looks just like an early Windoze app and performs like one, too. All communication gets funneled through this needle's eye which might send a text message reporting that new information's been posted before denying access. What was that Pastword again?

The Network suffers from all the shortcomings common to transactional associations gussied up to appear relational. I, for instance, don't actually have a doctor but a nurse practitioner, which seems fine with me.
Any deeper diagnostics, she refers to actual doctors which I never actually meet since other nurse practitioners perform actual procedures. Later, the doctor will post conclusions to the Portal which might deny me access again. Every encounter with The Network finds me repeating my birthdate, address, and the last four digits of my social security number, just to confirm that I am who I purport to be. I have been known to leave a waiting room if the questioning becomes too onerous. They always ask me to report The Muse's birthdate, too, which I tell them that I do not know precisely. They've allowed me entrance anyway, so far.

My Portal record, once I access it, always insists that I have not fully completed my personal patient history paperwork, though I have completed it to the very best of my ability. This shortcoming has also never prevented me from passing through security to spend a few minutes with a nurse and a few fewer minutes with my nurse practitioner. Much of that time I spend filling them in on who I am, for I imagine that they both service a few hundred personal relationships and the personal data within the Portal hardly proves adequate to completely fill them in. No, I can never remember what medication I'm taking, explaining that the prescriptions over-use consonants and would benefit from more memorable and more iconic names. Pronounceability would help, too. I report fewer complaints than either thinks I should because I don't get all worked up about my health. As far as I'm concerned, I'm fine, though the blood pressure readings don't always agree with my personal assessment. Neither do my triglyceride readings, but she's coerced me into agreeing to medications which while not exactly correcting the conditions, seem to so far satisfy The Muse and her that the underlying issue's being addressed if not resolved.

I once had a doctor with whom I had a genuinely personal relationship. He'd visit with me longer than the insurance would reimburse him for because he said that he could not assess my situation in the seven minutes allowed. He finally stopped accepting insurance because 80% of his practice had grown to involve dealing with insurance companies rather than with patients. I'd moved to a different town by then, one where I never did find an actual doctor or even a nurse practitioner with whom to develop a personal relationship. None there were accepting new patients. Every ten years or so, The Muse would manage to find a doctor who'd agree to see me and I'd submit to the anonymous examination before heading back out into the wasteland again. I only agreed to join this Health Network because The Muse insisted. I don't begrudge the encounters, though as a private person, I do feel intruded upon. I'm getting more skilled at demonstrating my gratitude for the services provided and steadfastly refuse to fill out any patient satisfaction survey. Satisfaction's beyond my ability to assess.

Of all the applications of Scientific Management, our health care system might serve as the one most frequently encountered. complete with individual anonymity, data-driven familiarity, and curious efficiencies in lieu of relationships. The practitioners seem competent enough, though less personable than the average witch doctor. They're on a busy schedule. I know my butcher by name but I have to check the building registry to remember my nurse practitioner's name each time I visit. They sort of know me, too, or at least my incomplete history resident on the Portal. We're all at arm's length these days and the future promises even greater obscurity. I'll be switching over to Medicare one of these days and my introduction to that system's been going about as well as I could have expected. Their phone system features a hard of hearing voice recognition system which requires the caller to repeat each response four times before it recognizes the presence of a voice. Ironic, I think, and a little silly. It seems that I was signed up for Medicare Part B after explicitly refusing that option and it looks as though it might take a few weeks to correct the error. So far, once I make it to the call waiting queue, my call's dropped after a fifteen minute wait basking in tinny telephone Musac®. It's personal service without all the inconvenience of personal service.

©2020 by David A. Schmaltz - all rights reserved

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