Thursday, April 06, 2006

Urban Healthcare

New York City attracts all types of dreamers and thrill seekers. I relocated many years ago in equal parts to flee from my family and carve a new life for myself. I never dreamed I’d be sitting in a urban healthcare community center waiting room for hours on end. I don’t remember spending time in doctor’s offices while growing up in Texas beyond annual physicals.

I miss having a private doctor, but life as a freelancer comes with certain restrictions. I had medical coverage with most of my past fulltime jobs. I miss my private doctor who was a seven minute walk from my apartment. I miss his gentle nature and soothing voice. His specialty was cardiology, so I was usually the youngest patient in his waiting room. This used to comfort me because my maternal grandfather died of a heart attack.

More than anything else, I miss having my appointment time honored. I recall once or twice having to wait five or ten minutes beyond my scheduled time because a previous patient’s appointment lasted longer than he expected.

City and community hospitals require reading material or portable music players, but I’d caution against a personal music player because you might not hear your name being called by the overworked and/or irritable resident or doctor. I’d also suggest not going to the toilet for the same reason. The person swings the door open, yells your name, and if no response, feigns a look of concern and then disappears behind a locked door. It’s these types of urban health centers that might turn some people off doctors and medical care, opting for natural herbs and holistic care.

I couldn’t fall asleep last night. I was in bed, but aware of everything in the room. I’m not afraid of needles, doctors, and absolutely not a hypochondriac. My last visit to this unnamed uptown community health facility wasn’t good. I had an abrupt Asian female doctor who I felt lost or never had the desire to serve and treat patients as individuals rather than statistics.

No sooner had I arrived today that I was bombarded with outraged and belligerent patients screaming in the waiting room, demanding better service, attentiveness, and prescriptions. I was met with a cacophony of accents, dialects, and wailing babies competing for my attention.

It’s now 9:55 a.m., my scheduled appointment was 8:45 a.m. I’ve just returned from a strange interview with a sluggish financial officer who asked my nationality, stared at me in disbelief, and then asked what state I was born. Do Texans look Texan? He looked at me as if he knew me, or perhaps he was trying to focus on something other than his computer monitor.

I paid the twenty dollar fee after the determination that I was one of the working poor in New York City. I paid before seeing a doctor – maybe people have bolted without paying. Private care versus public care. 10:05 a.m. Returned from having my blood pressure and temperature checked and weighed. The medical assistant weighed me with my sneakers on. Sneakers or not, I know I’ve gained weight in the last year. My metabolism . . . I no longer can eat anything I want.

There were patients who were there as early as 7 a.m., long before I arrived at 8:40 a.m. who hadn’t seen a doctor by 10 a.m. God save us all. I don’t like how patients are herded like cattle in community clinics. After today’s physical, I will apply for Medicaid, insurance through FreelancersUnion.org and turn up the volume on my fulltime job search. I have to return to my previous private doctor or find a new one if he can longer accommodate me.

Healthcare for the uninsured or minimally insured reeks in this city. I’m sure some of the people were insured. Why in the heck did they go to that place?There’s an obvious shortage of doctors working today. This is the condition many metropolitan centers share – the demand outweighs the supply. People accept this mistreatment as par for the course. When names are called, people spring to attention from a seeming stasis or slumber.

Who wants to write letters to Congress for medical reform?

I’ve only seen three men with stethoscopes calling for patients, and there are about forty people in various stages of reading, eating, and agitation. I’ll do everything in my power to make this my last visit here. Why schedule appointments if they’re not going to be honored?

10:35 a.m. Still no doctor belching out my name, as he holds the door ajar with an extended foot. I’m hungry because I’ve not eaten since last night. I’m sleepy and on the brink of getting a refund and going home.

I’ve gone to another nearby clinic, but the experience was slightly different. The waiting room was deserted which spooked me, and the admissions staff was more pleasant. The doctor I was assigned seemed unsure of himself and his diagnoses, which was why I didn’t return. I’ll now rule out this place for medical care. It perpetuates most ethnic urban healthcare stereotypes: rude, uncooperative, impatient staff who’d rather gossip among themselves than greet and assist patients.

11:45 a.m. I decided to get a refund and return home for a 1 p.m. meeting. After zigzagging between framed windows and uncooperative customer agents, I finally got the necessary signature, my cash, and headed downtown to the comfort of my apartment.