Whenever I see too many commercial practices in a doctor’s office, I get turned off. I’m here so I can get better, not to help you make money. Think teeth-whitening brochures at the dentist. Don’t sell me a cosmetic procedure, just clean my teeth so I can get out of here.
I saw a dermatologist the other day who exemplified this for me.
It started on the phone, when I called to make the appointment. The receptionist was friendly and business-like. That was the first tip-off. Usually they are overworked and underpaid and completely unhelpful. She was finding appointments for me at 7:30am in 2 days time – what kind of doctor actually works at times that are convenient for his patients?
Then she had me fill out all these forms – online! – before I even got to the office. She explained that it will makes things go more smoothly. As a digital guy, I was impressed. Until she told me the url. www.thebestdermatologist.com Yep, this guy is the best and he’s not afraid to shout it from the rooftops of the internet.
Like Buddy Kane, The Real Estate King in American Beauty.
The office waiting room had 17 wooden chairs emblazoned with the Harvard logo. I counted them.
It was so great. “Veritas.” Truth! Written in Latin! These things cost like $395 each. I’ve never been in a more pretentious room. It was actually sad, though. Poor guy went to Harvard and now he injects Botox into rich peoples’ faces.
They called me back to the office, where I took off my shirt. And in walks The King, wearing a blazer with elbow patches and a bearing a remarkable resemblance to the real Buddy Kane. Here’s a real picture of him.
I show him the little growth on my back that my primary care doctor incorrectly diagnosed as a sebaceous cyst. He took one look and said it was perfectly healthy and it wasn’t necessary to remove. Then he stepped back and said, “But I would be a concerned about all those moles.”
“These? Oh, I’ve always had them. They’re beauty marks.” Continuing my long tradition of making awkward jokes when I’m around doctors (you should have been in the room for the births of my children). “I had a few removed when I was in high school but they don’t really bother me.”
“I’m not concerned about them cosmetically – I’ve seen much worse – but they do represent a risk for melanoma.”
“What John McCain has?”
“Yes. I patented a process that catches melanoma 60% more often than the best dermatologist.” The next 15 minutes were a well-rehearsed lecture about his patented process for detecting melanoma and other skin cancers at an early stage, how I was at risk, and how he’d be happy to do the process right now, just right in the next room.
The only catch was that the insurance company doesn’t cover it. That led to another 10 minutes about health insurance companies and how they, and the government, are responsible for the ridiculous allocation of resources towards end-stage care and away from preventative care.
“So how much is it?”
“$130.”
Done.
The nurse handed me a little thong in a plastic bag. I asked if I could keep it after. Another awkward doctor joke. Why, Chris, why? She laughed politely, to her credit. Then I stepped into “the machine,” a combination of the “Beam me up, Scotty” tube from Star Trek and a tanning salon bed. There were cylindrical fluorescent lights running vertically from the floor to the ceiling and a little stand with footprints on it, showing you where to stand. And 30+ digital cameras secured to the walls with plastic fasteners.
This is the genius invention of Buddy Kane, for which the US government has apparently issued him a patent. (I forgot to mention that lecture on patent law that I received while he examined my body.)
The cameras clicked away. I paid my $130, and I’ll go back next year to see if any of them changed size.
So is it good that we inject so much capitalism into medicine? Surely we want efficient solutions to medical problems. There is no reason an insurance company should pay to have a healthy 33-year-old man scanned every year for skin cancer, right?
But doctors who want to make a living sometimes make decisions that don’t seem in sync with good care. For example, my doctor won’t renew a prescription over the phone, because I assume he wants that copay and visit to submit to the insurance company. Not efficient.
And of course the cosmetic procedures that they sell blur the line between what is necessary for me and what is good for them.
An alternative is that we treat doctors like priests and make them rely on donations. And that is definitely not a solution I want. Another alternative is to have the government regulate what should and should not be covered. Another disaster scenario. I want freedom to find the best health care there is, and I want a system that fuels innovation to find it.
The answer all comes back to information. Sharing of reliable information to empower consumers to make their own choices. We need electronic medical records and we need huge data sets and we need scientists to examine those data sets for insights. How is it that in 2012 I’m still filling out paper forms in doctor’s offices? It is insane.
The King of Dermatology is a big proponent of this stuff. I loved it. Enough even to forgive the Harvard chairs (though some mockery couldn’t be avoided). He’s got patents on a procedure that uses technology and big data sets to scan for skin cancer. Maybe the numbers will show that it does make financial sense to do full-body scans of every individual, and have a centralized remote location with trained image-scanners to analyze the results.
Maybe the King actually deserves his crown. Or maybe I’m just being nice because he’s got hundreds of close-up pictures of me in a thong.
