What has healthcare become?

This musing comes after a relatively benign day at the clinic. However, something interesting happened that made me question the entire healthcare system. That is because, unfortunately, what happened is similar to what goes on in "Doctor's offices" around the nation.

I went to see a patient this morning whom I was informed was "self pay" prior to me going in. That is to say that the patient doesn't have insurance, so he will probably not want any blood work or much done. Or does it? This was a 60 year old truckdriver who had a full page worth of medical issues including chronic pain from an accident. He had never had any routine screenings or even a rudimentary prostate and hernia check. This would be unacceptable for any other post-50 year old man WITH insurance or medicare. So what did I do? I listened to all his ailments and decided it was pertinent to check him for a hernia and to check his prostate since he had never had it done and had symptoms relevant to the exam. For the first time ever, my preceptor comes knocking on the door wandering what is taking so long. I finished up and left the room. The first thing I hear from my Doc is "What took you so long?" "He is self pay, you can't be spending time asking him a bunch of questions and checking his prostate." So after I was a bit blown away, I rebutted with "I was doing him a service since he has never had a full physical or been checked out very well since he is self pay." A bit of a slap in the face to my preceptor since he has been seeing this guy for years. But his only response was, "True."

My lesson is that I shall decide now, as a student to always treat my future patients the same, whether insurance or not.