by Chad McNabb
America is sick. We are getting fatter and we do all the drugs we can get our hands on. Yet, we have outsourced our medical care to semi-professionals, machines or in most cases ourselves. Where have all the doctors gone? When was the last time you actually saw one? Americans see a doctor far less than any industrialized country, averaging just 4 visits per year. I thought this number was somewhat high. I haven't been to a real doctor since the Bush 43 administration and I have health insurance! Upon reflection, I realized I have been practicing medicine for over a decade now. Why am I doing this?
So what used to be the case? You got sick; you made an appointment and saw a doctor. Hell, doctors used to make home visits! Can you imagine??? You ideally followed the doctor’s advice and got well. If you broke a bone in the 1950’s, you were hospitalized for a week. Friends came to the hospital and visited you. They signed your cast while you were in a hospital bed! This is no longer the case. The first stop for any medical problem from a hangnail to avian flu is WebMD. Founded in 1996, WebMD has more visitors than any other healthcare site, private or governmental. Over 180 million unique visitors diagnose themselves each month, with 3.6 billion views per quarter! Gucci!
What is WebMD actually telling us? Not much. You have a cough. You search WebMD for help. Immediately a screen appears with the phrase "when is a cough just a cough?" Great! That's what I want to know! I can live with it if it's just a cough. It continues "a cough could be brought on by a cold, allergy, digestive issue or even disease." The table is set. An interactive slideshow is dialed up to help diagnose what brought on the cough. The first slide says “things in the air.” Allergies, that’s what I thought! Slide two says “the common cold.” Who hasn’t had that? Slide three “Flu.” No, I don’t feel that sick. Slide four. “Postnasal Drip.” Exotic! Maybe? Slide 5: “Whooping Cough.” Saucy, but pretty sure I got a shot for that back in the 80’s. Then the turn. Slide 6 “Gastroesophageal Reflux Disease.” Shit! “Heart Failure.” Fuck! Then the biggie. “Lung Cancer!” I then go to the mirror to check my color. I exhale and inhale through a stethoscope on my futon. I have lung cancer.
I light a cigarette. I experience the five stages of grief. I can’t have lung cancer. I’m too young. I’m so pissed off that I have lung cancer and Keith Richards doesn’t. Maybe I don’t have lung cancer and I have Postnasal Drip. I’m not sure what that is, but it sounds like I can live with it. Did my skin look that yellow? I don’t feel like moving. Maybe I’m really not sick at all and it’s just in my head. I haven’t coughed since my diagnosis. And then. I do nothing. I either have allergies or lung cancer. What has this accomplished? In hindsight quite a bit. We use logic to determine we are probably ok and avoid going to the doctor’s office or hospital and being exposed to real disease.
The outsourcing of Western medicine was like a mutual break up. The rising health care costs which have no direct link the actual product or service was the catalyst. The affair in the relationship that led both parties (patients and doctors) to realize this wasn’t working. Hospitals have started devoting so much space to insurance companies they resemble some strange Felliniesque night terror. The experience of the ER closely resembles a Stalin era Gulag. Any sane person would take their chances to avoid it at all costs. And we do.
The American patient has strong inherent inclinations toward self-reliance and anti-authoritarianism. We trust ourselves better than doctors. Jordan Peterson, in his excellent new book, 12 Rules for Life, makes the point that Americans take better care of their animals than they do themselves. Only about a third of patients actually take the medicine a doctor has prescribed them as directed. Yet with a veterinarian’s advice, the prescription is more likely to be carried out as directed.
The rise of the walk-in clinic is evidence of this. Americans diagnose themselves at home via WebMD, and only when they have something they determine they need medicine for, do they venture out to the last resort. The Walgreen’s walk-in clinic. We can go there to visit a Nurse Practitioner who will give us what we have determined we need. The doctors are completely out of the mix. We have gotten our collective fill of their snake oil.
The acceleration of this model will result in home surgery. This is nothing new here in Appalachia. Countless successful home surgeries have been performed using Jack Daniels and Tweezers. We are reverting back to a pre-western medicine era where babies were born in homes with no anesthesia. Yet with all this, we are living much longer in this post-medical reality. WebMD is successful because of the enormous need for it. There have been hundreds of thousands, if not millions of trips to a doctor avoided because of it. Just imagine what our health care costs would be without it.
We are all Robert De Niro in The Deer Hunter, and the chamber is usually empty. What WebMD subconsciously tells us is, it’s usually not lung cancer. Just wait it out.