Saturday, July 7, 2007

Two Doctor Stories, And Takeaways

Some doctors are very good and others are not. It pays to pick your doctors carefully, and also to do your own research. This was reinforced when we spent time with Anita's brother Prakash and his family this past July 4th holiday.

During our chats Prakash and his wife Shabnam mentioned two health-related incidents, one relating to Shabnam and the other to their son Rishi that I'd like to share.

Some time back Shabnam developed a recurrent redness in one side of the white of her eye that would last for days. A Costco optometrist advised her to get this checked out by a large and flourishing ophthalmic practice that this Costco store worked with. Over the next year till recently Shabnam went to this practice seven times and was seen by three ophthalmologists. Each of them had a different diagnosis and prescribed a different (costly) treatment. Nothing helped.

Then Prakash who is a business professor with no medical background looked up the internet and found the answer - she has occular rosacea, a common condition for people with acne, and that she now manages with simple home treatment. I typed "redness eye" without quotes in the search box of http://www.webmd.com/ and it popped up right away.

The other incident relating to their son Rishi was also ophthalmologist related, and more disturbing. Rishi was a few months old when Prakash and Shabnam noticed in the mornings that he'd have excessive mucus in one inner corner of his eye that they'd clean up. On their pediatrician's recommendation they took him to an ophthalmologist. The ophthalmologist diagnosed 9 month old Rishi with a blocked tear duct and urged them to let him immediately operate on Rishi under general anesthesia. He said the procedure becomes more complicated after 12 months of age.

Prakash wanted to double check, and looked up on the internet as it existed then in 1996. He came across a Canadian website with discussions by doctors that said this blocked tear duct problem is common in infants, and frequently resolves by itself. Moreover, the doctors advised against surgery till at least 18 months of age. Prakash and Shabnam never went to that ophthalmologist again, and sure enough, Rishi's problem permanently cleared of its own by his first birthday. His parents are relieved that they didn't blindly go by the doctor's recommendations.

I've myself always relied on strong word of mouth by patients or doctor friends when choosing our doctors. I almost always end up with great doctors and recommend this practice. And as Prakash's stories show, it can help a lot to look up the internet to check on what your doctor says.

7 comments:

Rubina said...

You should see Michael Moore's new movie, "Sicko," on the healthcare industry. He points out a lot of the problems with U.S. healthcare, while visiting four other countries with universal healthcare (Canada, U.K., France and even Cuba).

kenrod said...

Thank you for the information on webmd. Many insurance companies also have a 24 hour nurse program which helps you diagnose problems. In addition many will direct you to the nearest healthcare center or hospital if necessary.

However, Rubina, the whole premise of "Sicko" is off based. He says the healthcare system has the shareholder to account for which means they cannot give care because they are profit based.

Profit based is wrong? Is he saying General Motors, because it is profit based and has shareholders will deny fixing my car during warranty? The reason why the baker down the street wakes up at 3 am is for a profit. And look at when you deny profits to people. Do you know where you find the best Canadian doctors in December? In Florida. Why? Because the govt doesn't allow them to make more than $400k a year. While that is a lot of money, a lot of doctors make that and then head off for vacation.

Yes, there can be a dark side to profit. Like when a product is said to cost X, but is really X plus 25%. Like our medical billing system. But profit in itself, which Micheal Moore wrongly alleges, is not bad and the whole movie is another left wing propoganda gone awry.

Like Farenheit 911. While I'm not a GWB fan, no one really believes he conspired with the terrorist to bring Sept.11 around. So Moore has lost all credibilty with me.

And talking about Cuba. Neither he nor Hillary who throws around doomsday figures will get their toe nails clipped in Cuba. My sister just got back from there and tells me people were begging for her used tube of toothpaste and shampoo when she was leaving. How can they be running a healthcare system when they don't shampoo?

The US has the best healthcare system in the world. And the worst. The best because the technolgy is superior. President Reagan's doctor came from India for that reason. The Shah of Iran came to NY to treat his cancer for that reason. But the worst in that the disparity of those who have it and those who don't is wide. And growing. But Micheal Moore's way of eliminating profit is not the answer.

Sandip Madan said...

Thanks, Rubina, I was actually planning to see "Sicko" over the weekend, but we had good friends staying over. May see it tomorrow.

Kenrod, have you seen "Sicko?" From what I hear he has highlighted the problems with the highly flawed US healthcare system, though not with great depth or the best solutions. As I've said before it's the French model with private and public care (as a universal safety net) co-existing that US will at most work towards, not Canada. I think Moore included Cuba just to emphasize that even a country with such miserable living conditions and economy can be compared with the US when it comes to healthcare. Btw, the US ranks 37th and Cuba ranks 39th in WHO health availability rankings. See:
http://www.photius.com/rankings/healthranks.html

So far, Hillary seems to make a lot of sense on healthcare issues, but her detailed plan is yet to come out. For those with NYT subscription here's an interesting column today by Paul Krugman:
http://select.nytimes.com/2007/07/09/opinion/09krugman.html?hp

kenrod said...

The hyperbole of Krugman and Moore! Krugman equates the healthcare system with terrorism? Moore would rather be in Guantanamo than in a US hospital?

And I don't know how anyone can evaluate Hillary's health plan? Knowing the fiasco she created in 1994 she's learned to keep her mouth shut. With her myriad of secret committes our healthcare would become like the DMV.

And Edwards has such brilliance. Not!! Tax the richest 750 people and pay for healthcare? When they die or move to Switzerland will we leave the patients dying, or ship them to Guantanamo?

Why are we so insistent on healthcare equality? We don't ask for food equlity. Or housing. Or schools. Each to their needs. Each to their capabilities.

When countries are born, or emerge out of an old era, they lean toward big government solutions. It is needed to form the infrastructure. England, after WW II threw out the Churchill and brought in Labour. Israel, in 1948, glorified Haganah and Palmach, and Labor ruled for years. India, after 1947, installed socialist Nehru.

But if any of these govts want to keep overlooking the lives of their people, they would have taken them back to the Stone ages. India would never experience the staggering growth today if it kept nationalizing the banks, steel mills etc. So why do we want to nationalize our healthcare?

No, I wouldn't pay a plugged nickel to see Micheal Moore. Instead I sat home and read "The 12 books that changed history". In it there are major ideas of our time... Shakespeare, the Football rulebook of England, Newton's Principia, abolition of slavery, and Adam Smith's invisible hand and the Wealth of Nations. Adam Smith... may he dwell with the stars through eternity.

Sandip Madan said...

Paul Krugman equating the healthcare system with terrorism? To the contrary his column derides Fox News for doing this. He exposes the ridiculous stance of Neil Cavuto and Co. who solemnly talk of how universal healthcare promotes terrorism.

If private insurance isn't banned like in Canada, what's the harm in universal healthcare competing with it? That's the French and German model, and something Edwards and (presumably 'cos her details are awaited) Hillary are espousing. I favor private enterprise if it yields net benefits as it very often does. But in our convoluted US health system it has doubled the costs and prices even compared to the traditionally inefficient Europe.

Yes, Hillary's 1993 proposals were scuttled by special interests but we'd have been better off today if they hadn't. That said, they can certainly be further improved.

I'll be better positioned to talk about Moore's movie after seeing it. Meanwhile though, Moore made some interesting comments on CNN including on Giuliani's assertions about healthcare, that figure in my next post.

Anonymous said...

Glad to know that there's someone who supports getting all kinds of information from the web, especially medical information. My siblings always get exasperated when I tell them where I get my facts from :{

Rene.

Sandip Madan said...

Thanks for contributing, Rene. Yes, the web is really good if you know where you are getting the info from. There are reputed sites like webmd.com or those of Johns Hopkins, the Mayo Clinic or Cleveland clinic, etc.

What I'd not trust at all are those rumors and advice we tend to get in chain emails, though. My experience has been that most of these are wrong or misleading.