The Kindest Doctor
The U.S. healthcare system is a mess. One doctor can't change that, but she is trying.
A few months ago I made an unscheduled trip to my local emergency room, which now that I think of it is a dumb way to put it. After all, does anybody make a scheduled trip to the ER? (Everything is fine, by the way.) I had a couple of tests and was there for probably two hours. Several weeks later, I got a bill for $14,000. That almost sent me back to the ER, until I realized the bill was what the hospital charged my insurance; my share was $95. I was greatly relieved to learn this, but the idea that our for-profit medical model is set up to allow for such a thing. is, well, obscene.
Is it a surprise that the median annual salary for a hospital CEO in my geographical area is over $1 million, according to Salary.com? Or that a study by Rice University’s Baker Institute for Public Policy revealed that annual CEO compensation for nonprofit (my italics) hospitals and health-care systems nationwide is now approaching $1.5 million?
You don’t have to go far to find a patient with a gripe about the American health-care system, whether it’s about a prescription that costs over $1,000 or the challenge of finding the right doctor in your network, or the astronomical cost of insurance premiums for people (like Substack writers and their spouses) who can expect to pay $600-$700 a month for a middle-of-the-road plan.
On average, per capita spending on health care in the U.S. was over $12,500 in 2022 – about double the amount spent in other wealthy countries. And yet life expectancy in the U.S. is 77.5 years, almost 5 years lower than other first-world countries. We spend more money and live shorter lives.
Gee, you think something is broken?
All of this is troubling, and alarming, and an inevitable by-product of our for-profit health care setup. But as much as it makes me ill thinking about it, it does not mean that there are not many patients who get excellent care and many wonderful, compassionate physicians who provide it. I’d like to tell you about one of them, for two reasons. One, it’s much more spiritually uplifting than thinking about hospital honchos who cut staffing and costs and then get fat raises. And two, this doctor is a gift to humanity.
The doctor and the patient will remain anonymous, to protect their privacy. I will call them Dr. Reynolds and Gretchen.
Gretchen is in her 60s and has had a number of long-running health, and financial, challenges. The sum total of her income is her monthly Social Security disability check. She lives in subsidized housing. She has had a half-dozen extended hospital stays in the last few years, and even longer stays in rehabilitation centers. She also suffers from chronic depression and anxiety. After she underwent a couple of surgeries, neither of which had the desired outcome, a series of serious, even life-threatening infections sapped Gretchen of her strength and mobility, to the point that she uses a walker in her apartment and a wheelchair when she goes out.
It was pure serendipity that Gretchen connected with Dr. Reynolds. Her previous primary-care physician left the area and someone recommended Dr. Reynolds. Gretchen was anxious about starting over with a new PCP, but what choice did she have? From the moment Gretchen entered the office, she had a positive feeling about the place. The staff was warm and welcoming. She didn’t have to wait long before a nurse escorted into an examination room, or for Dr. Reynolds to come in. It was clear from the start that Dr. Reynolds, who works for a major health-care system, had carefully looked over Gretchen’s records. That by itself was a major stress-reducer for Gretchen, who was relieved she didn’t have to give a full recounting of her medical history.
“It’s very nice to meet you, Gretchen,” Dr. Reynolds said. “I’ve looked through your chart. You certainly have been through a lot, haven’t you?”
Gretchen smiled and said, “Yes, I have.” Already she felt understood. Already she felt cared for. Gretchen has uncanny human intuition, a keen sense of when someone is self-involved or disinterested, and when someone is authentic. Dr. Reynolds struck her from the start as one of the most authentic people she had ever met. That assessment has proven to be 100 percent accurate.
Dr. Reynolds spent a full hour with Gretchen that day. Much of the time was spent listening to Gretchen’s health concerns, from her chronic gastrointestinal issues to the pain and swelling she was experiencing in one of her legs. Gretchen sometimes goes on at length when she is talking about her health. Dr. Reynolds never showed a trace of impatience or irritation. What she showed instead was profound empathy for the hardship this patient had been going through. They discussed treatment options, and Dr. Reynolds prescribed a couple of medications. By the time Gretchen left, she felt a lightness and sense of hope that she hadn’t felt in a long time. She felt as though she had an ally, someone she could count on, and turn to, through her health journey. What a gift that was.
When she got home, Gretchen called her best friend. “I just had an appointment with the best doctor I’ve ever met,” Gretchen said. She told her friend about the warmth in Dr. Reynold’s eyes, and about the sensitivity she showed throughout the visit.
“This doctor is an angel,” Gretchen said.
Gretchen has now been a patient of Dr. Reynolds for about two years, in which time her appreciation for her doctor has only increased. Every appointment is still a full hour. She never feels rushed. She always feels heard, and valued. Sometimes Gretchen feels guilty because Dr. Reynolds, who has a very busy practice, is spending so much time with her that other patients much be getting shortchanged.
With all of the medical issues she is facing, Gretchen has lots of doctor’s appointments. Between the hour or two it takes her to get ready, and the pain that is her constant companion, and the unreliable transportation options that often result in making her late or missing an appointment altogether, these visits make Gretchen very anxious. There is only one doctor who she actually looks forward to seeing. Every time.
“I love Dr. Reynolds,” Gretchen said. “She has been such a blessing in my life.”