No more doctor visits for another year

We had our two year checkup today. Everything looks good. He’s at a solid 90th percentile on all the physical indicators, the doctor said his development is going well, and that parents of her other patients would probably be envious at his good sleep, good eating, good health and good development. She thought the idea of introducing a third language next year was a good one. Really, there are no worries at the moment, which is such a relief. Having lost a filling for the first time today and having to walk around with a gaping hole in my mouth for 26 hours, I’m reminded of the importance of appreciating things before they break.

River got a final two shots. It was still painful to watch him get the second one. The second seems so much worse than the first because the first can be interpreted as an aberration. For me to allow someone to come at him a second time seems harder to explain.

When I asked when we should return, the doctor said in a year, for the three-year checkup. So, knock on wood, if we are able to keep the good health streak and avoid any sick visits (we haven’t had any so far), the doctor from now on is going to be only a very rare occurrence.

New Rules for Doctors

The other day, after stupidly going to CNN.com for my news (why it is taking me so long to realize that when a news source includes headlines like So and So Is Pregnant or Man Reduces Calories and Loses Weight that it is no longer a quality news source?) I saw a headline New Rules for Doctors.

Cool, I thought, perhaps they are going to put limits on gifts doctors can receive, on the use of samples, on speaking fees. Perhaps they will do something to reduce or break the conflict of interest inherent in the relations between doctors and private healthcare and pharmaceutical companies. Perhaps when doctors revert to the simplest and most effective treatments, overall costs will go down and more people will have access to care.

Nope. What a disappointment to open the article and see instead that rules are being discussed to allow anti-abortion doctors to follow their beliefs – ie. not treat women who have the legal right to care.

“The rule, which applies to institutions receiving government money, would require as

many as 584,000 employers ranging from major hospitals to doctors' offices and nursing

homes to certify in writing that they are complying with several federal laws that protect

the conscience rights of health care workers. Violations could lead to a loss of government

funding and legal action to recoup federal money already paid.”

This is what our taxpayer money is being spent on? I think it violates my conscience to think of paying money for such nonsense. Can I get a refund please?

Searching for Quality Maternal Care

My husband and I had another pre-natal doctor’s appointment today and again, the quality of the visit was disappointing compared to Bolivia. At my last appointment in Bolivia I received quite a bit of information. In addition to 3-D pictures, the doctor spent a good 45 minutes examining the fetus, he provided detailed and helpful responses to my questions and I learned a lot. I was told the fetus was almost one kilo, and was in the top 3% for height-weight at its point in development. He showed me a chart indicated that if that rate of growth continues, I could expect the baby to be between 3.5 and 4 kilos at birth (postnote: he was correct, the baby was born at just under 4 kilos).

The American doctor listened to the heartbeat and measured my abdomen, saying “OK.” That was it. The answers to our questions were extremely terse and I had the feeling we were taking his valuable time. We asked if there were any doulas he’d recommend. He gave us a single first name.

“Any ideas on how we could locate Gloria?” Mark asked.

I asked why he recommended this particular person. “Because she knows my name,” he said. “The other don’t.”

Is that really a reason why we’d hire someone? Because she knows the doctor’s name?

Mark’s impression is that the doctor is flakey and he isn’t impressed with the knowledge levels displayed by the staff we’ve had contact with. Now, when we still don’t have full confidence in our primary doctor, we have to begin to rotate through the other four doctors in the practice, so that we’ll have had at least five minutes of contact with the random person who will deliver our child.

It’s understandable, with such a low level of personalization, with no single individual really paying attention to the needs of the couple throughout the pregnancy process, that demand is growing for non-medical staff like doulas. I almost look back nostalgically to the local country doctor – the person who knew his client well, who was available to come in the middle of the night if necessary. Since doctors have moved so far from this model, people have to look elsewhere to find a person who will listen, provide personalized advice and promise to be available over a period of several months.