My personal opinion on where medicine is headed. (An Editorial)

My practice has spanned 25 years as of August 1st.  That is a significant amount of time, almost half of my life, and it gives me some perspective on the problems we all face in health care. Here is a list of issues I believe are critical.

1.  Many Americans, maybe most, have relinquished to one degree or another their accountability to pay for their health care needs. It has been an insidious change and is a result of the insurance companies taking more and more of a role in determining where and what health care we should obtain. These insurance companies are not doing this to help us receive the best health care but to make money. That is why they are in business, to make money, not to provide health care.  So, as we have gone along over the years we default our decisions about tests to be run and treatments to be administered to what is covered.  The doctors, to a lesser degree, are guilty of the same. We have insurance and we get tests and treatments when we need them.  The problem is that often these tests and treatments are really not necessary.  There is so much waste and we cannot afford it anymore. The average family health premium will exceed 700.00$ per month and it will only get higher.  If the burden of paying for tests and treatments were to shift back primarily to the patient, significantly more thought and care would be used to make determinations and fewer and fewer unnecessary tests and treatments would be given.

2.  Contributing to the above problem is our societies general belief that if something bad happens somebody should pay.  In medicine that turns out to be the doctor or the hospital.  Therefore, many tests are run and some treatments administered to avoid any "misses", however unlikely they are to occur.  For example, 20 years ago when one went into the ER to evaluate abdominal pain, a careful history and exam were performed as well as a few simple blood tests. This history, exam and tests was usually sufficient to rule out an acute appendix, an ectopic pregnancy a kidney stone or an ovarian cyst.  Maybe less then one percent of the time a serious problem was missed and a delay in diagnosis occurred.  Now, a C.T. scan is routinely performed to rule out these problems at a cost of 7 or 8 hundred dollars simply for the test.  After all it is "covered" and expected and the doctor has no disincentive to order the test.  It is only getting worse and I'll say again "we cannot afford it"!

3.  So what is going to happen?  Each of is going to decide we cannot afford the premiums on our health insurance policies and we won't pay them.  The government is going to try to make us pay them either thru taxes or penalties or both but the simple truth is we don't have enough money.  As the system, "govt." goes bankrupt we will be left to our own devices on how to take care of ourselves which is how it should be anyway.  We will find a doctor who is trustworthy and capable, "not perfect" and consideration will be made carefully on what the problem is, what tests may be useful, what can we afford, and what if any treatment is needed.  Isn't it ludicrous that we have allowed the health insurance industry to take such a sizeable portion of our health care dollar (some estimates as high as 60%) to tell us who to see and what we should have or have not done.  I am looking forward to the changes coming that will happen whether we want them to or not.  SD

I'm in heaven on a pack trip!

This past week we traveled to the Bookcliffs just east of Green River.  It is called the roadless area of this small mountain range and is a secluded part of heaven.

I try and get in there 1 or 2 times per year and I am blessed to have gotten there this early this year.  We pack two mules and I ride a mule named Lucy.  She is a relative new animal to my cadre of horses and mules but she is special.  Really calm with good confidence and a brisk pace.  My favorite mule is a john named Cody. I have had him since he was one year old.  A good friend of mine named Diana Tibbets raised and sold mules and he was from her draft mare, (a Percheron).

One trip I was riding Cody on the Muddy River down near Hanksville. We got to a deep hole in the river and I decided to "swim him across".  Now I won't pretend I know how to swim a mule nor even if he knows how to swim but at the time I thought it was a good idea.  He and I sank like a ton of bricks.
If any of you are interested in pack, horse and mule stories, I have written a short book of those stories and I would love to send you a copy.

I am excited for our next pack trip which will be into the upper reaches of the Yellowstone River to a place called Hawks Rest.  It is 26 miles one way so most of our time will be spent riding which suites me just fine.  Have a nice day and happy trails.  SD

More Book Review

I have been blessed with a desire to read and it has brought me much joy.  I believe it has also added to a better outlook on life in general. Several books that I have read some time ago that have much to recommend are the following.

1) The Virginian by Owen Wister.  A true cowboy western that depicts the rough but "square" deal to be had in the old west if one is willing to work an honest day.

2) The Last of the Mohicans by James Fennimore Cooper.  This is a classic about the history of the indians in the great lakes region of our country and how time take a toll on all of us in one way or another.

3) Half Broke Horses by J. Walls.  This is a story set in the Arizona, New Mexico area around the turn of the 19th century.  It is about a tough woman who makes the best of her life and I believe is fulfilled.

4) I may have mentioned this already but also recommend the book "These Is My Words" a rough approximation of a diary by Sarah Prinn.  It is excellent!

                                                                    ENJOY!!