Wednesday, March 10, 2010

Medical Care for Mom?

Earlier today I took my son to see his pediatrician. This is a pediatrician we have been using since before he was born; I researched some recommended doctors and went in to interview one of the main doctors at the practice, all before he arrived. This group of doctors has been supporting the health of both my children, at all hours of they day, ever since.

You would think that I would take the same precaution for myself, and line up my own doctor in case I needed one, right? No. Here I am: nearly 6 years have gone by since I last had a Primary Care Physician. I'm fortunate enough to have health insurance, so you would think I could take the time to use it properly AND benefit from having a relationship with a doctor so that I could get an appointment easily if/when I really need one--with someone who has my medical history on file.

I've had a few instances when I would have liked to see a PCP, when I had chest pains, for instance. Unfortunately, since becoming a mother I have had trouble determining when exactly I am supposed to search for or visit a PCP, and how exactly I should go about finding a suitable one in the first place.

The Problem with 'When':
Primary Care Physicians' offices are open during 'normal business hours', as are dentists, eye doctors, etc. These are the hours in the day when

        a) I have my young children with me and
        b) I don't have a lot of spare time to schedule and attend unnecessary doctor appointments, such as an introductory doctor appointment would be.

My kids are distracting. It's all I can do to focus on the pediatrician during my childrens' doctor visits, so it has always seemed pointless to me to conduct an interview with a new doctor with kid in tow. (Although I would have found out fast whether the office was child and breastfeeding friendly!)

I could find child care for them, yes, but it's hard to use child care opportunities for a lower priority project such as interviewing a doctor. It's also challenging find last minute daytime child care for a sick visit. I could ask my husband to take time from work, and he has done that when I've been able to give him advance notice. (I've never been 'sick enough' for him to stay home for an entire day. My body seems to schedule illness 'conveniently' on weekends.)

What it boils down to is that it's difficult for me to determine when I would even go to a doctor appointment, whether the purpose is to interview/find a new doctor, or to obtain treatment for a problem. What I've done in the past is use a few short cuts for the occasional health care services I've needed over the years (other than the excellent midwifery care provided by my Birth Center, of course)
  • Urgent Care: They are open 24/7, and it's great! I've gone at 6 AM before my husband left for work, or late at night after the kids are in bed. I can go by myself, bring a book to read while I wait--did I mention it is located about 5 minutes from my house? The Downside: The care is generally decent, but not wonderful. Once, the doctor prescribed a medicine, and when I asked if it was safe for a breastfeeding mother; she said she wasn't sure but I probably shouldn't breastfeed, and she left the room! Clearly she wasn't too concerned about, uh, me potentially poisioning my child? (Note: On my insurance policy, we pay out of pocket for non-preventive care, so I don't overuse the service. I've used Urgent Care approximately three times for myself in 5 years, and one of those times I had chest pains, so please don't think that I 'waste' my health care benefit.) Oh, and the result of that example above was that I called my midwife to check on the medication. It wasn't safe, so I didn't take it. I recovered anyway.
  • CVS Minute Clinic: There is a CVS Minute Clinic located about 5 miles away that has hours on Saturdays as well as weekdays. I've used the clinic to get flu shots, TB tests (required to volunteer at preschool), and to get a test for Strep Throat. The care is professional and efficient. The Downside: They close for a lunch break arbitrarily at some point in the middle of the day. I don't begrudge the employees a break, but it is a little challenging to my schedule when I am trying to be seen before I have to get back to my kids (when they are with someone else). Sometimes they have a lot of people queued up to be seen. I've had to leave and come back at a less busy time to avoid my child(ren) being too disruptive while we wait.
These services have been invaluable to me during this period in my life when I haven't had a lot of flexibility or energy to locate a new primary care physician and I recommend them as a short-term solution for doctor-less people who need a quick solution.

I myself am entering a new season of parenting where I have a few hours a week to myself, and I've decided that I'd better prioritize this project and secure a relationship with a doctor before I'm really desperate for one. But how?

The Problem with 'How'

The Problem with 'how' is that I feel completely overwhelmed and lost when it comes to finding a doctor. It's not as simple as it seems. Yes, I could start looking doctors up in the provider directory offered by my insurance policy, but the only information that resource provides is the distance of the doctor's office from my house. Good to know, but I would like to know a little more about a doctor before I sign up with them.

In the past, we have received friends' recommendations to select doctors. Last summer we were looking for a dermatologist for my husband, and we received many glowing referrals from friends in the area. Unfortunately the recommended doctors were SO popular that a new patient had to wait over two months to obtain an appointment. (See? This is why I need to make this a priority now!) We did find a good dermatologist in the end, and Tom is all fixed up now. I'm glad we didn't wait two months, but it did feel a bit risky at first going to a doctor we knew nothing about.

Part of the problem I admit is with me: I don't like doctors, I don't trust doctors. I am the type of patient that doesn't take everything the doctor says as an absolute. I ask questions and request explanations and alternatives. More than once I have politely declined a doctor's recommendation and provided an informed explanation for my decision. I've been known to request care or treatment that isn't typically provided. When I haven't stuck to my values in these past instances, I've generally regretted it. I've sometimes received care I didn't really need, and at other times I didn't receive care that I did need.

All of this means that a doctor has to expend time and energy to deal with me; I don't follow the status quo. This would probably be all right with many doctors so long as I provided an income stream, but from the economic side of things, I am not a good prospect as a patient--I don't generate a lot of income for doctors. (Too healthy and too likely to turn down more invasive treatments. Heck, I don't even like to take medications. My favorite question is: "What happens if we just leave it alone? Will it heal itself?")

I am hopeful that if I spend a little time focusing and researching, I will secure a satisfactory primary care physician relationship within the next few months. If you have the good fortune to be covered by insurance yet you lack a relationship with a doctor, I hope that you are inspired to do the same. I'll check in with updates on my progress or lack thereof.

If anyone knows of a good General/Family Practice doctor in/near Arlington, VA who is accepting new patients, please let me know! I would also appreciate any advice/suggestions...

No comments: