Doctor Visits

 

It seems unfair that only those of us in the senior generation are required to deal with changing health circumstances and unforeseen, sudden limitations, some of which require visits to the doctor’s office. I could go on, but instead I want to tell you about a recent happening that occurred during my recent visits to my doctor’s office. 

I have two regularly scheduled, annual doctor visits. The first is the “Wellness Visit” that was developed by Medicare and sponsored by a number of organizations that know my name and where I live. These organizations post advertisements promoting Wellness Visits and they send me periodic reminders that I should make an appointment to have my visit arranged. ‘They are good for you,’ seems to be their common refrain. And here is the kicker they use to convince us seniors to make a wellness visit appointment: the Wellness Visits are totally free! There is no charge, they are good for you, and a minor inconvenience for something that Medicare recommends. All this is explained in great detail if you bother to read the advertisements that come to the accounts that have my name on them.

I’m not a big fan of these appointments. I have now had several of them over a period of years and they don’t seem particularly helpful as they are all pretty much the same and I get little benefit from them. I’m also a little suspicious of all the claims made as to their value for the senior set, especially the claim of them being free.

At my Wellness Visit this year I had a heart-to-heart talk with the nurse. She admitted that her bosses, (the owners of the hospital that conduct the Wellness Visits in our area), encourages patients to schedule Wellness Visits because they earn a healthy fee from Medicare for each one conducted. Aha! So, it is not strictly free unless I am willing to ignore the monthly stipend that I must send to Medicare plus a payment to my health insurer. I knew money crossed palms somewhere in the long chain of related organizations and the ultimate payer is, you guessed it, YOU AND ME.

Nevertheless, I attended my Wellness check-up again this year since I hadn’t seen my doctor in a while. I knew he would be overseeing the check-up and I had a question for him concerning a few blemishes on my skin that were new. As soon as he walked in the examination room where the nurse was testing my wellness mettle, I blurted out my question. His answer was curt. He said I needed to make a separate appointment to cover the issue of skin blemishes. Apparently, things that are important to the patient are not sufficiently important to Medicare to be discussed. Some while later, the nurse explained that the doctor is allowed only five minutes of his time for overseeing each Wellness Visit. Scheesh! This, after I had sat in the waiting room, then the examination room for several of my important minutes during the part of my day that I had reserved for nap time, an important asset for us seniors according to my calculations.

As requested, I made a separate appointment to see the doctor about the skin issue. Since the supplier of my regular meds requires a new prescription each year that the doctor must approve, I figured I could get that done while I asked my question about skin blemishes at the upcoming appointment, the ol’ killing of two birds with one stone trick that would be my solace after the wasted time for the Wellness Visit. Accordingly, I decided that the second appointment would be a reasonable use of my valuable time.

At this appointment I told the sawbones about the ugly skin lesions that were decorating my face at the hairline and elsewhere. He examined each and announced that a separate visit was required for treatment since the treatment would take longer than an appointment for routine issues. I reluctantly made that appointment as well. The follow-up visit was for dermatological treatment of two kinds of blemishes on my skin, each of which had an unpronounceable, and unspellable name (at least for me). The treatment was the common procedure of freezing the skin at the site of the blemish. The doctor disappeared after I signaled my agreement for the treatment and returned with a small thermos bottle that had a nozzle and push button. The doctor seemed to relish this treatment as he smiled when he pulled the evil looking thermos to my face after a couple preliminary ‘wisches’ from the bottle that indicated its willingness to respond to the doctor’s trigger finger.

The white-coated medico began his use of the thermos, giving one or two wisches at each blemish that he found. I remained silent even though I was certain that a single wische was sufficient to destroy any living thing based on the amount of pain induced by a single wische. While administering the liquid nitrogen, the medicine man kept up a steady explanation about each of the blemishes and how some were precancerous, especially for those of us who grew up during the period of no shirts and no shoes during the warm summer afternoons when shirts and shoes were too warm to abide and no one suspected direct sunlight was not a good thing.

The doctor explained how the treatment worked and what would happen to my skin. He explained that the pre-cancerous tissues would be destroyed by the blast of freezing nitrogen. (I might have guessed that based on the pain of the freeze. It seemed to me that nothing could possibly survive even a single wische, let alone his preferred double wische.) In any event, he explained how the freezing would create a blister on the skin that would turn red and look hideous. “Then a scab will form after the blister drains. Leave the scabs alone,” he said, “they will fall off after several days to reveal fresh, new skin.” He continued his monologue, “In the meantime, your skin will develop a nasty-looking red spot.” He continued blasting away with the annoying nitrogen until he had counted 12 spots. I imagined that if he had not found at least that many he would have begun the dreaded double blasting again. “Not all of them are precancerous,” he said, “some are just blemishes that I can take care of while I’m doing the others.”

He paused to see if I had some objection. Since I was still wincing from the last wische, I was unable to respond. He took that as my agreement.

“I’ll treat these also so you can get back to your modeling career,” the doctor intoned with a hint of a smile. I couldn’t think of a thing to smile about until he had finished.

He put away the nitrogen bottle and I immediately felt better. In fact, his comment about the modeling career seemed to have done the trick and I decided right then that this doc was a likeable fellow who knew his stuff. Before I left his office, I found myself signing up for next year’s Wellness Visit.

So, there you have it. As a part of the senior set, I expect to continue being a consumer of the services of the doctor business that is alive and well here in Roscommon and I hope you will do the same.