5 Things I Miss About Health Care of the Past

While NPs have more training than a registered nurse, they receive less training than a doctor. They certainly can do much of what doctors do — 26 states and the District of Columbia even allow them to prescribe medications without a doctor’s approval or consent, according to the Duquesne University School of Nursing. But to my way of thinking, they are supplements, not substitutes, for doctors.

The American Medical Association, which represents doctors, appears to agree with me. Or maybe doctors just don’t like nurses encroaching on their turf. In a working paper published by the National Bureau of Economic Research and released by the AMA, a three-year study found that in the Veterans Health Administration system, nurse practitioners who delivered emergency care without physician supervision or collaboration increased patients’ length of stay by 11 percent and raised the number of 30-day preventable hospitalizations by 20 percent compared with emergency physicians.

Yet, without question, NPs are a growing presence in modern-day medicine. They are there for what I see as a scary reason: We are facing a looming doctor shortage, and to fill that gap, we are turning to NPs. It’s already happening. If you are a patient, you can get to be seen much faster by a nurse practitioner than a doctor.

And yes — they absolutely earn less than the guy with “M.D.” after his name.

4. Telemedicine didn’t exist

While certainly better than nothing and a great boon for rural communities that lack ready access to medical care, telemedicine takes too many shortcuts, in my opinion. For the uninitiated, telemedicine means you get a phone call with a doctor who has never seen you before. I was recently visiting my young adult, generally healthy, daughter when she developed what I was pretty sure was a urinary tract infection. Her insurance offered her a no-charge call from a doctor within the hour or an in-person visit in a few weeks. Or she could pay about $3,000 out of pocket and go to an out-of-network urgent care facility.

She took the teledoc, who spent a full six minutes with her on the phone — most of it confirming her insurance information. She told him she thought she had a UTI and described her symptoms. He then wrote a prescription for an antibiotic and sent it to her pharmacy.

She was relieved. I was mad as hell. Why? Most UTIs require a urine test for diagnosis, something that also was certainly not delivered over the phone.

5. Someone called with my test results

It might have taken a few days, but eventually I would get a call from the doctor about my test results. On the phone, I could ask my questions, discuss my worries, and gauge her concern by the urgency in her voice. That all went away, replaced by an app called MyChart where I am expected to look up test results myself and not annoy the nice doctor with my pesky questions.

I remember when my gynecologist first told me that if I didn’t hear from her, it meant my mammogram was just fine. If the news wasn’t just fine, I’d be sent a postcard telling me to make an appointment. And if I didn’t respond to the card, eventually someone would presumably notice and call me. Yeah, right.

Have you been to a doctor’s office lately? Mine are all madhouses. You can never get through on the phone without long holds and call drops, the doctors are always running late, and you can expect to be kept waiting to be seen. The medical staff literally runs between rooms. The staff’s stress is palpable, and chaos reigns.

These are precisely the conditions in which mistakes are made. And these are also the same conditions that someone unrealistically expects us patients to believe that if we don’t hear our results are bad, we should assume they are good. Nope, not buying it. At least put the results in MyChart.  

Share Your Experience: What parts of health care do you wish you could go back to? Tell us your thoughts in the comments below.