Banner photo of Larry Eugene Meredith, Ronald Tipton and Patrick Flynn, 2017.

The good times are memories
In the drinking of elder men...

-- Larry E.
Time II

Thursday, February 19, 2015

Nurse Practitioner, Nurse Practitioner, Give Me the News...Goodbye, Doctor Welby.

I looked at my calendar the other day and a pattern caught my eye, so I counted. In the last 30 days my wife and I had 25 appointments related to healthcare. A friend said we had turned into my parents, whose last days consisted of mostly doctor visits.

I certainly hope that is not the case. Granted a number of these are to my Physical Therapist, which has more to do with an ancient condition than anything age related. For some reason at this late period of my life my Primary decided to refer me to such therapy due to my curved back, my hump if you wish to be unkind. I saw little reason for this. I've been bent that way as far back (no pun intended) as I can remember, so what hope to stand tall and proud now. Still, it does seem to be helping and I do feel more upright.

Although going where a young lady named Kelly puts me through my paces doing several exercises, plunks my shoulder and neck strings with a deep massage and zaps my muscles with electronic stimulation, only accounts for 12 of those appointments. A goodly number, indeed, but not even half of the total, the rest directed toward newer and more pressing malfunctions of our human machines. We are acquiring a virtual menu of delicacies...I mean, specialties:  Rheumatologists, Endocrinologists, Gastroenterologists, Urologists and Orthopedists. There are 7,500 listed body parts and apparently there is some doctor dedicated to each one. There probably exists somewhere an Ossicleologist.

It wasn't always necessary to have a vocabulary of long-winded names. Once upon a time you simply went to the Doctor. The Doctor who birthed me was also the same Doctor who snipped out my appendix and cut out my tonsils. His name was Dr. Thomas Parke. He was a Quaker and his practice was in Downingtown, Pennsylvania for a long time. He was our family sawbones, a general practitioner; no one spoke of primary care physicians in those days.

Dr, Parke was it. He did it all. As noted, this included delivering babies and performing operations and treating you for the sniffles or gout or a splinter in the finger. Generally, if he outlived you, he signed your death certificate as well.

He was who I was taken to as a young boy every time I got a cough or ear ache or rash. In truth, I wasn't always taken to him. He often came to me because in those days Doctors did house calls, imagine that! More than likely if you had a rash he would come to call and determine if it be measles or chicken pox or worse, and if so, he'd be the guy sticking a big yellow sign on your door labeled "Quarantined" at the top in bold, black letters.

Sometime in my youth I switched over to Dr. Martin Neff. He was the new needleslinger in town, young guy. I don't know why the switch, because my family kept going to Dr. Parke at least until my grandfather passed in 1957. I thought maybe it was because Dr. Parke was so old. He seemed old to me, this gray mustached man, but looking at his tombstone I see he died in 1965 at the age of 64. This made him 40 when I was born and only 50 when I turned ten, hardly ancient. Maybe it was just that Dr. Neff loved kids, because he and his wife could not have any, and this made him gentler.

Whatever, these two men performed basically the same duties in the same way. You came and they touched you, thumping you here and there, looked in your ears, down your throat and even your eyes. If you needed a shot, they gave it to you. If you needed a pill, most times, they gave you a little box of those, too. They signed your note that excused you from school or work and when you needed cutting, they got their saw.

None of that happens anymore. No big Buick pulls in your drive bringing a doctor to visit. You go to him and not this afternoon either, but maybe in a week or two or more when he can squeeze you in. And now another big change, you probably don't even see the Doctor; you see his Nurse Practitioner.

Now, I don't want any charges of sexism here, because it is simply a fact that most Doctors are male and most Nurses are female. That may not be true ten, twenty years down the road, but it is the way it is right now. You could, of course, get a male Nurse, it's not an uncommon things anymore. My wife and I happen to have Nurse Practitioners who are both female. This is probably fine with her, but what about me, being of the male persuasion, am I uncomfortible being examined by a woman?

Not at all, she is competent and very nice and besides, my last Doctor, who I had for maybe two decades, was a woman.  She was just beginning her practice when I first started going to her. She was young and pretty, and still is pretty. (That is her picture on the right.) I never felt any embarrassment or hesitancy letting her examine me.

But the Doctor's examine is a different animal now, too. I can't remember the last time a Doctor touched me, beyond maybe with his or her stethoscope. I haven't had a Primary Physician give me a digital prostate exam or tell me to turn my head to the left and cough in decades. I certainly haven't had any ask me to remove my trousers and rarely even remove my shirt. They generally ask me some questions, maybe take my temperature and blood pressure, and then send me to get blood work.

If they see something spooky in the blood work results, they call me in, tell me what they saw and send me off to one of those guys with the long titles. Goodbye, Dr. Welby; hello, Doctors Ologist.

Even these specialists don't do a lot of touchy-feely stuff. They rely on the blood tests and X-rays and those long forms you always have to fill out. (Why isn't most of that stuff in their computers with the rest of your medical records that have been passed along to them?)

The last Doctor to do much of that was the Urologist I went too the other week and he got very up close and personal. What he did was about as touchy-feely as it gets. I did tell him, upon consideration, I would rather be in my position than in his. He seemed to agree with that.

Anyway, despite all these appointments taking up my time, I'm in good health. I do have arthritis, but my Rheumatologists has it under control. Both my Gastroenterologist and my Urologist have cleared me of any problems or cancers.  My wife has some knee problems that the Orthopedist is working on. I am learning to accept this new world of Nurse Practitioners and referrals, because what'cha going' do?

1 comment:

Ron said...

Again Larry, very well written and very informative. I enjoy reading a blog post of yours little bit of history in a little bit of your view of the current situation now. Thank you for another great blog post.