Medical Practice

Today was another first for me: my first time registering with and visiting an American medical practice.

Unfortunately, I have had cause to visit an American A&E / ER before.  Back in 1995, I developed a severe cellulitis reaction to some insect bites and developed blood poisoning and had to go to hospital.  That travel insurance was definitely worth the investment, that’s for sure.  That had been my sole interaction with the US medical healthcare system until today.

Obviously we needed to register with a medical practice anyway.  With six of us – and especially four kids – it is always sensible to know where you need to go when some illness develops or some sort of accident happens.  However, today’s appointment was not about illness or aching body parts.  Today it was just about filling out yet more forms to get my husband and I a step closer to holding PA driving licenses.  We needed to have formal medicals, signed by a medical practitioner, to prove that we were fit and healthy enough to even obtain the learner’s permit.

There is a long list of things I don’t know about living in America but if I had to rank those things in order of things I am most ignorant about then healthcare would have to be top of the list.  I just don’t get it.  Obviously I’ve not been living in a dank cave all these years so I know that there is a requirement for medical insurance, that medical visits and treatments are paid for by the patient directly and per use rather than through general central taxation.  The way that system operates, however, is a complete and utter mystery to me.  My husband has family medical insurance through his employer so the little plastic card he handed me is my portal to receiving medical care here in the US.  That is pretty much the extent of my knowledge.

Even booking the appointment was farcical.  The person who answered the phone could not understand why I didn’t know how things worked so every question I asked just threw her.  Eventually curiosity got the better of her and she asked how healthcare worked in the UK.  Her mind was blown.  Blown completely.  I am not a patriotic soul but if I had to name something that could possibly make me feel a tingle of pride in being British (and I do mean British as opposed to Scottish on this occasion) then the National Health Service would be the thing that sprang to mind.  A healthcare system that is centrally funded through general taxation and is free at the point of need is, I think, one of the best achievements of the UK.  It has its failings, of course, as every system does, but to know that everyone will receive the same care regardless of their income level or some other means test is, to my mind, a wonderful thing.  I think it finally clicked with the admin person making the appointment that the reason I had not a clue how the insurance system worked was because I had never had to even countenance how I was going to fund medical treatment before.  In Scotland, even prescriptions and eye tests are free.

My appointment was 10.40 and Mr Pict had his appointment right after me at 11.  My husband was off work today because I had parent-teacher conferences in the afternoon to attend, so he was needed at home to provide the childcare, so we thought it made sense to use the morning productively and achieve something we were needing to progress with – namely obtaining driving licenses.  I had agreed that we would come early so as to fill out the paperwork we needed in order to register, though I had downloaded and filled out the medical history form in advance.  So we provided our contact details and our insurance details and were instructed to wait to be called to our appointments.

Time passed.

More time passed.

Now here’s the thing.  If I am paying for something, I expect a certain level of service.  Conversely, if something is free then I will make some concessions.  So, while tardiness in doctors’ surgeries had always frustrated me in the past, this waiting was not just tedious and wasteful but was actually irksome.

Eventually an hour passed and neither my husband or I had been called to our appointments and we had a preschooler to collect from nursery.  So Mr Pict and I switched appointments so that I could nip off and collect our youngest child from preschool and then return.  He was being called just as I left.  When I returned, almost half an hour later, he had only just finished up.  I let the receptionist know that I was back and had thankfully just a short wait before being called.  That said, time was getting tight for collecting our older children from school – as they were on an early finish – so I left Mr Pict with the car keys just in case.

I was taken to a room where I had to answer a series of questions, some so complex and precise it was difficult to provide an accurate answer, about my health, medical history and lifestyle.  All of the answers I had already furnished them with on my medical history form incidentally.  I had my height and weight recorded, had to provide a urine sample, had my blood pressure taken, had my eyesight tested and my eyes, ears, neck and abdomen all checked.  All of which took even more time.  Back in July, the children and I had had to undergo pretty intense medicals at a clinic in London as part of the immigration process.  We were all healthy and disease free hence we were permitted to enter America as legal permanent residents.  Apparently this medical was good enough to assess our suitability to be resident in America but was not good enough to be an indicator of my ability to get behind the wheel of a car.  It’s frustrating to have to do the same things over and over just to prove things to different administrative organisations, never more so than when time is ticking away and you have places you urgently need to be.  

From the time when I first walked through the door of the medical practice to when I left with my signed piece of paper telling the DMV it was OK to issue me with a learner’s permit took two hours.  Two.   Hours.  Now the NHS is a socialist institution so it is often attacked by people who are not proponents of that political system and, yes, it can be inefficient and flawed.  However, my first experience of privately funded medicine was not exactly convincing me of its benefits.  Perhaps all medical services are inefficient and flawed because, let’s face it, healthcare is as unpredictable at times as health is.  But it’s hard not to resent paying for something as pointless as this medical was and then having to waste two hours of your life obtaining a signed piece of paper.  Between the financial and time cost, that’s definitely some motivation to stay healthy.

At least now, however, Mr Pict can go ahead and obtain a learner’s permit.  I, on the other hand, have some more hoops to jump through since, as a non-citizen, I need a whole heap of paperwork that I don’t yet possess.  Any progress I make here is always tempered by delays and obstacles and bureaucracy.