Seattle Plastic Surgeon loves David Sedaris’ account of his experiences with Socialized Medicine in the heart of Old Europe.
American Humorist David Sedaris
This week’s New Yorker Magazine has a hilarious piece by humorist David Sedaris. Mr. Sedaris now lives in Paris and I squeal with delight every time I read one of his essays on his French experiences. Here is his take on French medicine. This is just an excerpt and you should really pick up the April 2, 2012 New Yorker to read the entire essay.
I was lying in bed and found a lump on my right side, just below my rib cage. It was like a devilled egg tucked beneath my skin. Cancer, I thought. A phone call and twenty minutes later, I was stretched out on the examining table with my shirt raised.
“Oh, that’s nothing,” Dr. Medioni said. “A little fatty tumor. Dogs get them all the time.”
I thought of other things dogs have that I don’t want: Dewclaws, for example. Hookworms. “Can I have it removed?”
“I guess you could , but why would you want to?”
He made me feel vain and frivolous for even thinking about it. “Your right,” I told him. “I’ll just pull my bathing suit up a little higher.”
When I asked him if the tumor would get any bigger, the doctor gave it a little squeeze. “Bigger? Sure, probably.”
“Will it get a lot bigger?”
“No.”
“Why not?” I asked.
And he said, sounding suddenly weary, “I don’t know. Why don’t trees touch the sky?”
This conversation would never happen in my office. The conversation would go something like this.
Me: It’s probably a lipoma, a fatty tumor. They are very common. (I’d leave the dog reference out). It could be something else but I am almost certain it’s a lipoma.
David: Can I have it removed?
Me: Sure. I would send it to pathology to make sure it wasn’t something more serious and that would take care of it. These lipomas can get pretty big. I could remove it next week in the office. I would inject some local anesthetic and remove it though a small incision. You could drive yourself home. It will leave a scar but the scar won’t be as noticable as the lipoma.
David: Will my insurance pay for it?
Me: Maybe, it depends on your insurance. I’ll have you pay me, then I will send the information to your insurance company and they might reimburse you.
David: How much will it cost?
Me: I’ll have my patient care coordinator give you a price quote and get you on my schedule. Make sure you don’t take any aspirin between now and next week.
So here’s the difference: I’m happy to take the lipoma out. I like doing surgery and that’s how I pay my bills. Also, I want to make sure it is a lipoma. If it is something horrible like a fibro-fatty cancerous horrindoma and Mr. Sedaris has a delayed diagnosis because of me, he will sue me for a bazillion dollars. I, like all American doctors, practice defensive medicine. In America, defensive medicine is the standard of care. Also, this conversation takes place between two Americans. American patients like to get things fixed and American doctors like to fix things. Even minor things. So there will be about $500 changing hands because of Mr. Sedaris’ lipoma, $250 for the use of the operating room and $250 for my time and skill. In France, $50 changes hands because Dr. Medioni is dismissive about Mr. Sedris’ lipoma and is not worried about being sued even with the 0.1% chance his clinical impression is wrong. And Mr. Sedaris lives with his lipoma and pulls his bathing suit up a little higher.
This, folks, is why American Health care is so expensive.
Thanks for reading! Dr. Lisa Lynn Sowder
@lisalynnsowder
