By Cindy Phillips updated Tue, Apr 8, 2014 05:27 PM
I have to do it once a year, whether I like it or not. No, it’s not an annual physical. No, it’s not an annual pap test. No, it’s not an annual mammogram, colonoscopy or other radioactive assault on my body. It’s a blood test.
I have hypothyroidism – have for over 20 years. So once a year I need to have my blood drawn for a TSH test. This is the only way I can get a one-year prescription for Synthroid – the only medication I take. They tried to give me a generic one year. I didn’t understand why after a few months I once again felt sluggish and my hair became brittle.
For years my insurance has refused to pay for Synthroid – it will only pay for a generic even though it doesn’t work for me. So I pay out of my pocket – actually out of my health savings account – so that I can have the right medication to keep my thyroid operating properly.
Each year when I go for this blood test, I do it by making an appointment with the nurse practitioner at the family practice I have used since Noah built the ark. Yes, I am exaggerating a little, but that’s one of the perks of getting old -we are allowed to do that.
The CNP, Barbara, is also the mother of two daughters the same ages as mine. In fact, the girls went to school together. So once a year, I sit in Barbara’s office and we chat. While we catch up, she uses a stethoscope to listen to my heart and she sticks a light up my nose and into my ears. She points it at my eyes while making me look left, right, up and down.
When this process is done, Barbara tells me how I really should undergo all the other typical annual tests as stated in paragraph one. I politely decline, she nods, we talk more about our girls and then I go have my blood drawn for the TSH test. The last three years I also did allow them to test for Vitamin D, which has come up low all three years. Of course it has – we have been scared silly about spending too much time in the sun because it may cause cancer.
So this year, I called the office for an appointment to have my blood drawn. But the lady told me kindly “just come between 8 and 11 or 1 and 5.” So I showed up on Friday at 8 a.m., signed in for a blood draw and within ten minutes (record time) I was called to the back.
When asked why I was there, I stated for a TSH test. As the nurse looked at my file she said, “I don’t see any orders for blood work. Who do you see?”
I told her Barbara and she asked when I had my appointment. “I didn’t. They said I didn’t need an appointment for blood work,” I replied, quite proud to show off that I had followed a recommended procedure. “And Barbara would probably tell you to check my Vitamin D too,” I continued.
“So when are you coming for your annual physical?” she continued to prod. “I wasn’t planning to have one, I just need my Synthroid and Vitamin D prescriptions,” I replied.
The nurse was now flustered. She started to make a statement that started with “but”, but I cut her off. “Look, if you want me to make an appointment for Barbara and me to talk about our kids, ok, I’ll do it,” I said. The nurse made a note in my file that I would call for an appointment to get my test results. I had no intention of doing that, but it made her feel like she had done her job.
This sort of thing happens a lot. Why does healthcare have to be so complicated? Why can we not make our own choices about how much we want to be prodded and poked? Why can’t we refuse certain tests without being made to feel like we are breaking a law?
As a child, health insurance was bought through school for a reasonable cost. It included annual vaccines and a “physical” which was completed in less than five minutes. I think I can count on one hand the number of times I visited the inside of a doctor’s office prior to going away to college. I actually remember the doc coming to our house when I had one of the big three – chicken pox, measles or mumps. If I got sick, I was often diagnosed by one of the neighbors who had more kids than us. They were the experts on children’s illnesses and knew if it was serious enough to warrant a doctor visit.
Overall, I am extremely healthy. But it makes me sick every time I think of our healthcare “system.” Frankly, there is no system, it is totally chaotic. If you don’t believe me, ask any office administrator of any medical practice – but be prepared for an earful (and then they can prescribe you a decongestant).
I work for a corporation that provides me a low-cost option for insurance coverage. It has a high-deductible, they put $75 a month in my HSA and so long as I participate in our wellness program, I get a $40 per month discount on my premium. With a once-a-year blood test, bypassing an office exam, and the ability to roll over that HSA for so long as I live – I may actually be able to retire on the balance one day. That is, of course, if my healthcare plan doesn’t make me sick.
Cindy Philips can be reached at firstname.lastname@example.org.