Professional services

On Saturday I went to the doctor.  To be more precise, I went to see a doctor.

I went to a medical centre which I am sure I have never attended before but which nevertheless (presumably as a result of some doctorial migration) had an address for me which I left in April 2000.

The consultation cost me $55, of which I will get back $43.55 eventually.  But it was a great disappointment.  I don’t go to doctors very often at all: often a whole year will pass without a single visit.  I only generally go if I want treatment and preferably drugs.  If I could buy these myself, I would, but you can’t because that is the doctors’ monopoly by reason of what used to be known rather quaintly as the Poisons Act, now the Poisons and Therapeutic Goods Act.

The first drug I wanted (based on a little internet searching, which I am sure is the bane of doctors’ existence as it is of lawyers’) was valium.  This is the drug that every woman of a certain age seems to have to hand virtually as a matter of course – or at least this used to be the case; perhaps things have tightened up.  I only wanted a 2 or 3 day course.  The doctor refused outright.  This confirms my belief that it is almost impossible for a man to be prescribed valium, even if on the not entirely scientific basis that I have never felt comfortable abasing myself to the requisite degree of fragility to ask for it until now.

Desperate to turn the consultation to some account, I raised two other symptoms.

The first of these was a  sharp pain together with some surface numbness on my elbow at a spot where I broke my arm falling off my bike 17 years ago.  I’ve been meaning to get to see a doctor (or, as my parents used to say, in a piece of old-fashioned slang which I realise I haven’t heard anyone else use for years, “the quack”) about this since I first started experiencing it some time over the Christmas break, but I never get around to doing it.  The doctor told me this was a bone inflammation.  If it swelled up it would be possible to operate.  It could also be treated with cortisone injections.  No, there was nothing which he proposed doing now.

The second is more embarrassing to spell out: suffice to say that I did manage to make the doctor take a look, and that he put on a rubber glove for this purpose. This (looking, rather than gloving) was an improvement on the last 2 doctors I saw about this (almost exactly 12 months ago) – first a GP and then a specialist, who were content respectively to refer to a specialist and then recommend quite complex treatment without so much as a look-see.  This doctor said that some of this symptom could be treated with an ointment.  But he declined either to tell me what ointment or to give me a prescription (assuming that was required).  

And don’t even get me started on this doctor’s bedside manner.  Even though other patients were waiting just outside, it was only at the rubber-glove moment that he went to shut the door.

I complained to the receptionist (just venting, I know) as I gave her my money, and she didn’t seem so surprised.  I think I now know why this medical centre was so empty and why this doctor was working on Saturday.

Now, I am not 100% blaming this doctor for his refusal or failure to give me any treatment or prescription whatsoever.  Perhaps his clinical judgment was correct on all fronts  But there is a massive misfit between the internet searches which led me to ask for the valium, which envisaged a series of ongoing consultations between the patient and “his” doctor, and the spot-transaction approach which characterises my dealings with the medical profession.  If you just roll up to the clinic (and many clinics will not even make appointments) you just can’t get that kind of treatment. 

When D heard of my elbow problem he laughed.  “You’re getting old,” he said.  As Yeats said (in a different context, admittedly), things fall apart.  I think it is probably time for me to bite the bullet and establish a more ongoing and satisfactory relationship with a particular medical practice and doctor.   

This raises a problem common to many professional and other services – how can we judge the quality of what we are receiving?  Certification ensures a certain minimum competency, but good enough to practise is not necessarily good enough for me, or even (because of personal fit factors) good for me.  It is hard enough to find a barber who cuts your hair the way you want it, let alone to procure services which, if botched, will not simply grow out.  Thank goodness the barber problem has pretty well solved itself for me, now that I have so little hair on my head that the “less-is-more” no 1 cut is the way to go.

If I were a parent concerned about the education of my children, this might well be the point where I would start putting my child down on some private school waiting list.  Not that I am going to rush in the opposite direction to the most expensive society doctor I can find, but experience from the other side of the counter in my own profession suggests that the cheapest and/or most available doctor will not necessarily be the best.  Unfortunately, I also know from within my own profession that the most “charming” practitioner is not necessarily the most competent, which would seem to take me right back to square one….

2 Responses to “Professional services”

  1. Victor Says:

    I’m always intrigued how often my doctor diagnoses my ailments without inspecting the area concerned. My doctor is gay and perhaps assumes he can readily identify the ailments of his gay patients. The only reason I keep seeing him is that so often his prescriptions/referrals work but it does make me wonder.

  2. ninglun Says:

    You should go to my doctor. ;) He is open on Saturday and still bulk-bills — but he is in Redfern… I had a course of valium in 1999; got off it as fast as possible, i.e. slowly. Did the job at the time though.

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