Sunday, January 25, 2004

21st Century Snake Oils

If you mindlessly accept what is read in the papers, heard on teevee soundbites and what is spewed by professional jobholders, the health system is a shambles.  It’s too expensive, not available to everyone, and, is not in need of an invisible hand, but a socialist hand.  Indeed, some professional jobholders, today, are mouthing platitudes to the fact that affordable health insurance is a right.  I’ve diligently read, and reread, the Bill of Rights, and I’ve found nothing of the sort within that states this.

The main reason for this push to socialize American medicine seems to be the costs.  Everyone complains about the costs.  Health insurance costs too much.  Health care, out of pocket, costs too much.  I can’t afford it, it costs too much.  Blah, blah, blah.  I’ve been thinking about this since cocktails were served Friday night.

A very good friend and I were standing in the kitchen enjoying a martini.  During the course of the conversation, he mentioned he was suffering from tendinitis, in his elbow.  Which, I think, is more commonly known as tennis elbow.  Since he was aware that I had, in the past, suffered from this minor inconvenience, he inquired as to my course of treatment.  I told him I took ibuprofen, of no particular brand name, and that the malaise, over time, disappeared.  In reply to my answer, my friend relayed to me a course of treatment he was invited to partake of, which, he stated, was “kind of strange.” “Do tell,” I replied, so he did.  What follows, are impressions of a foray into the world of physical therapy, which, if you think about it, may shine some light on why health care “costs too much.”

My friend had mentioned his tendinitis problem in a general conversation among his associates.  One of the listeners, immediately upon hearing of the problem, effusively informed him of a “great” physical therapy service that, evidently, performed “miracles” for exactly the type of problem from which my friend suffered.  As a bonus, the listener just happened to have a “free” consulation card my friend could utilize for an evaluation.  So he did.

He drove over to the physical therapy services offices, directions conveniently printed on the reverse of the “free” consultation card, tucked away in the commercial zone by the airport, and, was swept into the world of physical therapy for relatively healthy individuals.  You see, physical therapy isn’t just for accident victims and sports injuries any longer, it has become an indispensable tool for those injured while pecking away at their keyboards, although why it wasn’t when people were pounding at manual typewriters remains a mystery, lifting boxes and paper cuts.

When he walked into the physical therapy offices, he informed me, he was immediately impressed by the number of people coming and going.  Patients, therapists, UPS men and what not, it looked busy.  After waiting a short while, he was called by a receptionist who informed him a physical therapist would see him shortly.  Considering he would have a wait, he wandered around the waiting area to admire and explore the expansive display of diplomas and certificates.  There were Master degrees in physical therapy from actual universities, certificates of proficiency in short-wave diarthermy, electric muscle stimulation and phono/iontophoresis.  Not to mention certificates honoring proficiency in cryo-therapy, which, in my day, actually was simply known as soaking a sprained ankle in ice.  But what really surprised him, were the grandious certificates signed by L. Ron Hubbard.  A half-a-dozen or so of them, he said, which, he wanted to investigate in greater detail, but was unable to as his name was called.

He was ushered into a small room and immediately a physical therapist (PT), in a wonderfully white smock, entered the room.  The first question the PT asked, was “Do you know anyone you can refer?” Not, what the problem was, not what the physical therapy service could provide but “DO YOU KNOW ANYONE YOU CAN REFER?” The second question asked was, “Can you commit to a series of treatments?” After replying to these questions, the PT launched into the wonders the physical therapy service could perform.  As proof of this, the PT offered my friend a 6 inch thick binder of testimonials to peruse, hand written, by prior beneficiaries of the majic performed.  A couple of paraphrased testimonials from a brochure.

"They treated me like a person.  Not a number.  I am glad my doctor recommended therapy and a co-worker recommended..." so and so company.

"The staff here has been wonderful and so friendly.  I have already recommended..." so and so company, "to many people and will continue to do so in the future."

One can only assume, by reading these paraphrased testimonials, that the writers were also actually cured of some physical ailment.  I cannot ascertain for sure though.  The brochure containing these abbreviated testimonials also utilized the phrase “Many others.” It gave a listing of 23 different ailments which the physical therapy service could remedy, followed by “Many others.” I’m wondering if the physical therapy service has an R & D department continually adding to their hocus pocus.  They also used the phrase many others following the list of half-a-dozen insurances the service accepts.  They are not picky, I guess, and, the more lines you have in the water, the more fish you are liable to catch.

The PT did explain to my friend why he was suffering from tendinitis.  His tennis elbow was, according to the PT, caused by lifting too heavy of an object.  The PT then explained how this particular muscular area in my friends back was sending scrambled signals to his shoulder, which, misinterpreted the signals itself, and passed them on to his elbow which interpreted the signals from the shoulder as pain in the elbow.  My friend said it sounded like it made perfectly good sense while he was talking with the PT.  What I thought, upon hearing this, is of the old experiment of passing a short message from individual to individual in a pysch class and how scrambled the message was by the time it was received by the indivdual at the end of the line.

After this spiel from the physical therapist, my friend was directed to another person, the insurance expert.  The insurance expert informed my friend his doctor would have to okay the course of physical therapy treatment.  To expedite this, the insurance expert would forward the physical therapy services’ evalution of my friend’s condition to his doctor immediately, but, my friend would have to call his doctor as soon as he left to encourage his doctor to give the okay.  If this didn’t occur, insurance may not cover the cost and my friend would have to pay for services rendered out of pocket.  The insurance expert hammered this fact home, multiple times, and, as a parting reply to my friend asked, “What’s the first thing you are going to do when you leave?” My friend, not recalling, was supplied the answer when he had not replied in the five second alotted time span, “Call your doctor,” said the insurance man.

After this review with the insurance man, my friend thought he was on his way out, but he was wrong.  He next had to go through an exit interview with a young lass.  The exit interviewer wanted to know my friend’s impression of his visit, if he was ready to sign up for treatment, and she also reminded him to call his doctor so he could be “approved” for service.  And, she informed him, as she handed him a free consultation card, to “tell your friends.”

After listening to this story, I had to admit to my friend that his experience in the world of physical therapy for the relatively healthy was “kind of strange.” Even without having the time to review the certificates signed by L. Ron Hubbard.

Posted by John Venlet on 01/25 at 12:52 PM
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