A $20 co-pay and the value of an office visit

‘Tis the season for upper respiratory infections, and since I couldn’t tell if what I had was garden-variety crud or crud that needed antibiotics, I went to the doctor. I handed over my $20 co-pay at the reception desk, where they have an electric candle burning, a tradition when a soldier is off to war. Their soldier is my family doctor, who’s in Afghanistan as a colonel with the Army Reserve. They’ll keep the flame burning until his safe return.

My doctor is in his early 60s; the one I saw in his absence must be in his 30s but it’s hard to tell. From my mid-50s vantage point, people in their 30s look like they’re in their 20s, and people in their 20s look like they’re 12. He noticed my Kindle and wanted to know if I got it for Christmas. I said yes and he told me he got an iPad although he had been looking at Kindles. He downloaded Treasure Island, which I had thought about downloading. We compared notes on what you can get on each platform, and then it was time to get down to business.

I dutifully reported how my week-old crud had escalated from clear runny stuff to green globs and wondered if that change in volume and color meant I was working on a secondary bacterial infection. He said studies have shown that color or lack thereof isn’t really helpful in determining whether it’s bacterial. He said they watch for other symptoms.

He asked about presence or absence and timing of coughing, headache, fever, chills, nausea, looked in my nose and throat and listened to my lungs. He said my symptoms indicated drainage issues and proceeded to draw a nose and sinuses from the front and side. (I love it when doctors draw. My oncologist has drawn breast ducts, and my surgeon has illustrated breast surgery. It always reminds me of when my family doctor told me the word “doctor” comes from the Greek for “teacher” and that there’s a lot of teaching involved.)

He said I didn’t need antibiotics, which was fine with me although I know some people feel like it’s wasted money and time if they don’t get a prescription. One friend said it was too bad they couldn’t just call something in, and another asked if he gave me anything.

To answer that question, what did I get for my $20? I got knowledge. Next time I’ll have a much better idea of what to do, when to call and what to take because let’s face it, even over the counter choices can be confusing. He gave me a care list that had some things I was doing already and a couple that never would have occurred to me.

I also got faith in the next generation of doctors. It won’t be long before every doctor I see will be a lot younger than I am. This doctor, and the young woman MD I saw during my doctor’s last tour of duty in Iraq, made me realize that won’t be a bad thing. I’m impressed by their knowledge and the way they communicate.  Knowing that young people like them are going into primary care gives me hope.

All things considered, my $20 co-pay was a bargain.

Jackie Fox is the author of From Zero to Mastectomy: What I Learned And You Need to Know About Stage 0 Breast Cancer, and blogs at Dispatch From Second Base.

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