…and not enough.
So, we just returned from the doctor’s, and what happened there evoked a couple of previous experiences with physicians – fairly recent. We’re blessed with good health, and don’t head to the doctor’s too often, but when there have been problems, I’ve noticed this of late:
The patient has intermittent back pain, and so x-rays were taken, no obvious causes were found, and in explaining what to do next, the doctor said, “What we generally have is three options….” and he ran through them quickly, and then looked at me and said, “Well, what do you want to do?”
Of course, I’m sitting there trying to still sort of what “lumbar” and “thoracic” are all about and trying to imprint in my brain of Notoriously Poor Retention whether he said a certain disc space was a bit small or large, and he’s presenting me with three options for treatment and I’m supposed to choose one? Now?
So I say, “Uh…what do you recommend?”
“Oh,” he says, “I usually do all three,” then whips out his pad.
Oh.
As I said, I noticed this before, I think in some of my appointments in which rather complicated options were explained to me and then the medical person just sort of sits there and looks at me. I sense what it is: a definite move away from the paternalism of days of old, because, of course, we patients should have final say over our treatment options (I’m not arguing with that), and Lord knows, if something goes wrong, there doesn’t need to be any hint that an unsuccessful treatment was forced over any other.
But still…I couldn’t help but wonder what I, not exactly a professional orthopedist, could knowledgeably decide without a bit more input. I now wonder what would have happened if I had just chosen “B” for example. Would he have said, “Oh, well, that’s good, but we usually add A and C anyway?”
I tend to blame all of the problems and constraints of contemporary life on the demands of insurance companies and fear of lawsuit. Not that I’d define what I’ve described as a “problem,” and I should mention that the reason I moved from OB/GYNs to midwives was precisely because of paternalism and attendant issues,  but this tentativeness gives me pause and a little crack in the my confidence about the care I’m receiving.  I like my rights, but I’m not sure I’m exactly competent to direct my – or someone else’s – medical treatment.