Sunday, July 16, 2006

The Doctors Office Before HMOs

Some things never change. Then there are those things that change so drastically you really long for the good old days. The doctors office is one of those things.

Back in the pre-HMO days, a visit to see the doctor seemed just like that, a visit. Nothing at all like today. When comparing the two eras, you notice the difference from the second you walked in the door. Before things changed, when you walked in, you did one thing, and only one thing. You waited to see the doctor with a magazine in your hand. It may have been a few minutes or a couple of hours, but that's how plain an office visit was.

I remember three doctors my mom used to take us to when we were kids: Dr. Samuel Foreman, Dr. Mario Salamone, and Dr. Peter Cocco, with Dr. Foreman being our regular family doctor. All three have departed and are no longer with us. My mom told me on numerous visits while we sat waiting, "you should have seen it here in the old days. People would be lined up outside the door to see Dr. Foreman". It seems he was a generous soul, if you couldn't afford to pay him, it was okay, he'd see you anyhow, no questions, IOUs, bills, or anything else. He was just a benevolent neighborhood doctor who cared. It wasn't possible for him to keep track of billing anyhow. As I said, when you walked in, you sat and waited. There were no receptionists, and no one to keep record of your visit. It was only after Dr. Foreman had a heart attack did his wife come to work in the office as his receptionist. You paid the doctor or receptionist ten dollars ($10.00) cash back then, no receipt, no insurance, nothing to complicate the visit. Your health mattered, the other things were handled later.

Speaking of complicating things, you didn't find pharmaceutical reps in the office in those days, only patients. I don't even know if such reps existed at that time, I never saw them. Today, they line up to see some doctors. There they sit with their big smiles, promotional materials, and dinners or vacations to offer the doctors if they'll write prescriptuions for their brand of medications for everything from hemmoroid treatments to pills that will grow new hair on your bald head. I give my neurologist credit, he seems to have no time for them. I was in his office a couple months ago when a rep came in all beaming, asking the receptionist to see the doc. The receptionist told her she had little chance, and sure enough, the Dr. sternly told the rep he was seeing patients and their care came first, he had no time for her. Finally, the patient gets first priority! That's exactly what you want to see.

And remember what I said about waiting? Part of that was because the doctor took more time to listen to you explain your problems, or maybe just your bellyaching to him. When you got in to the examination room, you had the physician's ear. No rushing because two dozen others were lined up behind you - a dozen more than should have been booked for the day. You were there because you had problems, and the doctor was the solution.

Those days are gone. Now if you don't have insurance or the - what is it, $80 or more to see your family doctor - you'll be heading to see a doctor somewhere else instead, maybe a clinic or some other low-cost facility. You won't be handing the doctor a ten for the visit, you'll be giving the receptionist $20 or more for your co-pay. And even though you'll get to see the doctor, you probably won't get to spend too much time with him or her. I don't fully fault the doctor for that. With HMOs and other insurance, you'll find many more people lining the seats in the waiting room than ever before. Ah, the good old days!

AND YOU MAY REMEMBER...

...Hands-on relief. Dr. Cocco used to get you on the table and align you at the beginning of each visit. You felt every joint in your upper body snap and you felt immediate relief. I haven't had a Dr. do that to me since he died in the 1980s.

...Syringe squirt guns - We used to ask Dr. Foreman and Salamone for hypodermic syringes to use to squirt each other and they'd give them to us with no question or hesitation. They'd simply remove the needle first and rinse it out. You'd not dare ask for such things today, who knows what the person had who's arm/leg/butt that needle was inserted into.

...Drip pills - It used to be said that Dr. Cocco would give you drip pills for just about anything whether it be a hang nail or high fever. I remember on a few visits myself he gave me a small envelope filled with a dozen or so small white pills that he called "drip pills" for whatever reason. Did they work? Who knows.

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