I was thinking about how things have changed over the last 50 years. I remembered when doctors would make house calls. If you were too sick to go to see him you would call and make arrangements for the doctor to come and see you at home. Now, no matter how sick you are, you have to bring all your germs and spread them to all the people that are in the doctor’s waiting room. As you sit there waiting, your germs get to socialize with all the others in that room. You body now becomes the reception hall to all these strange germs and you may even bring some new ones home with you to share with the rest of your family and friends.
Why is that back then when I was sick my mother would call the doctor in the morning and he would come to the house later that same day and now when you call they tell you that you have to wait a month to see him. If you need medical attention you can see the physician’s assistant (PA) or you can go to the emergency room where you will wait many hours before you’ll be seen.
The family doctor from years past was truly a family doctor. He was the one that delivered you when you were born and would also be there twenty years later to deliver your children. He knew you and your family so well that he didn’t have to rely on medical records. You didn’t have to fill all those long forms that asked some very personal questions that you really didn’t want to be sharing with some strange receptionist. He knew you family’s medical history because he saw your mother and father and aunts and uncles and their children and sometimes even their grandchildren. I remember my family doctor (Dr. Scelso) was practicing medicine into his eighties. He had my family record all up there in his head because he treated them all.
I remember being in bed as a kid with a temperature of 102. My mother called Dr. Scelso and he came early that afternoon. He came wearing his fedora and carrying his little black bag. I don’t know what it was but it seems that you started feeling better as soon as he came into the house. He came into the bedroom and visited me. He only used two things, his stethoscope and a tongue depressor. He used the house thermometer to check my temperature avoiding the expense of having to buy his own. He would be done in a matter of minutes. Most times he didn’t he have to write a prescription, he would rely on mom’s chicken soup and tender loving care. He would tell her to make sure I was kept warm and given plenty of fluids. It was only if you had an infection that he would he either give you a shot on the spot or prescribe penicillin. You didn’t have to go to a lab for extensive blood work nor were you sent for a chest x-ray or some other cover their ass type of procedure. All the things that are done today weren’t necessary because no one dared to sue a doctor for malpractice. The house call cost $10 and my mother would also give the doctor some of her anisette cookies.
Back then you would probably have the same doctor all your life. Today, I’ve lost track of all the doctors that I’ve seen since I left the North End. Just in the past ten years I’ve changed to three different health plans and with each change I’ve had to select a new primary care physician. It seems that the salespeople at Filene’s Basement know me a lot better that my primary care physician. I’ve had to provide a resume to each doctor. I can’t understand why in this day and age where they track every move you make why they can’t store this information in some database that is accessible at your request by any medical professional you see.
I haven’t seen one doctor in the last ten years spend any time reviewing what I entered on the forms that I spent 15 – 20 minutes racking my brains over out in the waiting room. To some it’s just become a formality, a CYA (cover your ass) type of thing that needs to be done in case of a malpractice suit. The next time you are asked to fill out one of these forms enter something outlandish or better still, write a derogatory remark about the doctor and then see if anyone picks it up. I’ll put money on it that no one notices.
The more I look back the more I see how complicated things have become. I walk into a doctor’s office today and I find at least three people working for him. What are they all doing? They all seem to be busy pushing paperwork around and still there’s a lack of efficiency. They also seem to lack a concept of time because they always overbook. I have an appointment at 2:00 PM and notice that the next patient has been booked for a 2:10 PM appointment. If I’m lucky I’ll get to see the doctor for all of 10 minutes and for this he’s charging my health provider $150.00. If I’m lucky I’ll be called in to be weighed and have my blood pressure taken by a nurse at 2:45 PM. I feel that this is a gimmick to make you feel like you are being attended to.
My blood pressure was fine until I got agitated at having to wait in a room of germ infested people. It got increasingly higher after being told to undress and put on one of those foolish “jonnies.” I sit up on the examining table and wait like a fool for the doctor to come. Ten minutes elapse and the knock on the door is soon followed by the nurse telling me that the doctor should be there shortly. This almost feels as annoying as holding on the telephone and hearing “your call is important to us…” every 20 seconds for 30 minutes. What do you do with yourself sitting there in a jonnie while waiting patiently for the doctor’s entrance?
I don’t ever remember Dr. Scelso putting me in a jonnie and telling me to wait. Dr. Scelso didn’t have three or four people working for him. The only person he had working for him was his unmarried sister. Her main function was that of a receptionist. Dr. Scelso visited you and also collected the money. There were no medical forms or receipts or documents to worry about. Everything was paid in cash.
I just searched the internet for doctors who make house calls and found the following:
Soon you will experience what everyone has been talking about... modern medicine in the comfort of patient homes. Visiting Physicians Association (VPA) is revitalizing the "old-fashioned" tradition of house calls. Utilizing the advances of modern medicine, VPA brings the doctor's office right to the patient's home.
This has started in a few states and deals mainly with the elderly, but at least it’s a start and maybe with luck it will catch on throughout the country.
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