And the sky is still blue.

What Texas patients value most is their physician, the relationship with their physician, and the ability to choose their physician. They also value the freedom to choose their own medical treatment, facility and health insurance. The other items that came to the top of their list was timely access to care, quality of care and state-of-the-art medical technology and innovation.

Patients believe that what needs to be fixed in today’s health care system is abusive health insurance business practices. Specifically, Texas patients want insurance portability, transparency and elimination of pre-existing condition clauses. They also wanted less interference in medical decisions from both government and private health insurers.

As far as health system reform goes – What we heard loud and clear from Texas patients is that didn’t want a government take-over of medicine, a single-payer system or socialized medicine. They also didn’t want health system reforms that increase costs, either by increasing the deficit or through new taxes. However, what Texas patients do want in health reform legislation is greater transparency and accountability of big health insurers, increased personal responsibility and preventive care coverage or incentives, and national medical liability reform.

Seems to me that medicine is a business. If a product is not cost effective, then it’s not offered-such as relationship building. This goes beyond primary care-try to get an urgent appointment with a specialist. We cling to nostagia, wanting medical care of the past when in reality, we are moving toward assembly line medicine, where providers are interchangeable.

As for those feelings of hopelessness…there are always the online support groups.

That said, there are still some primary care providers out there (like mine) who do provide excellent, unrushed care, even for patients like me with several complicated and chronic conditions. Keep looking until you find one.

My doctor didn’t get the memo. My complicated medical problems were mismanaged because there was never any time for a relationship. I went to the internet for diagnosis and treatment. Trying to explain my frustration and pain to the medical assistant was a waste of time. While attempting to have a discussion about my feelings of hopelessness, I was told I couldn’t get an urgnet appointment with my doctor because reimbersements were too low to leave spots available during the day.

The path to realistic improvements — if not solutions — involves recognizing the wide variety, and then building on what is working well and eliminating (as much as possible) what is pulling the system down.

Unless your medical problem is easily curable, a strong and healing physician-patient bond is essential for both (1) getting good care (making all the right diagnoses, prescribing the best treatments, preventing and minimizing complications) AND (2) living as fully as possible (preserving self-esteem, feeling hopeful and comforted).

And in cases where the problem is easily curable, a good relationship still makes the inconvenience and stress of the problem more tolerable.

With hope, Wendy

If medicine valued the “doctor-patient relationship,” there would be no need for urgent care clinics. Appointments wouldn’t be five minutes, and conversations on the phone would not have to go through the medical assistant who has no idea what’s going one.

Physicians use these time savers to make more money. Most rely on technology to make diagnosis. Why waste money on a relationship? Mid-levels can fill in the gaps for simple things.

If you look beyond the high-tech machines, medicine at its heart is still about people caring for people. Like all meaningful relationships, the physician-patient bond evolves over time. And it grows stronger when based on mutual respect and understanding.

Investing in healing physician-patient bonds is time well-spent.