I dreamt that the great debate of our time, between doctors who know how to reform our health care system and everyone else who doesn't want us to get our way (ie, lawyers, government officials, insurance companies, and particularly patients), could be solved by head-to-head verbal combat. The opponents: doctors, embodied collectively as Menelaus, vs the great misinformed mass of the population, represented by Paris. Here's how it went:
We patients know what we needâ€”cheap drugs. Cheap drugs can make us healthier, but we cannot afford them. Do something!
: Drug costs? That's not the problem! You don't bother to correctly take the drugs I prescribe, you don't learn the names of your drugs, and you keep demanding all those lifestyle drugs like Viagra. I have carpal tunnel syndrome from writing all those prescriptions.
: Hey! You're the problem! You give us five different drugs to be taken at five different times of the day. Some before meals, some after meals, and they've got unpronounceable names like hydro-chlorsomething-or-other. Give us a break!
: And what is all this belly-aching about malpractice costs? We can't sue an incompetent doctor? That's not fair.
: Is it fair that doctors take down their shingles every day? Is it fair that they stop doing operations that you patients need?
: Afraid of being sued? You don't trust a jury of honest Americans?
: Health care is expensive because you doctors charge too much, and some of you defraud insurance companies out of millions of dollars. We're the little guys paying for doctors' expenses.
: Really? What about the little guys who waltz into the office without their wallet, and then don't pay the bill? Or the little guys who don't bother to keep their appointments? You ignore your financial responsibilities, hurting all of us.
Mr. Paris: Still, you look like you've got plenty in your wallet. How much are you worth anyway?
: And look here, we're the consumers, and we need affordable insurance coverage so that we can get health care when we need it.
: You'll need health care because you don't take care of yourself as you should. Stop smoking, lose weight, and exerciseâ€”then you won't need care.
: You're so cold and heartless, doctor. You can't possibly understand what our lives are like. We're doing the best we can!
In the , the gods decide the outcome of the combat between Paris and Menelaus, as well as the eventual outcome of the war. The momentous struggle of men stood for nothing, and I woke up in a cold sweat.
No gods here in our age, so what will the outcome be? Will doctors or patients win? Dr. Menelaus is a winner when his patients strive to be more compliant with his advice. Yet Mr. Paris is also the winner when he gives Dr. Menelaus the support he needs to function in a world that has become far too full of conflict for proper medical care to occur.
a family practice physician
in Saginaw, Mich, is the editor of the
Saginaw County Medical Society Bulletin
and Michigan Family Practice. He welcomes
questions or comments at 3350 Shattuck
Road, Saginaw, MI 48603, 989-792-1899, or firstname.lastname@example.org.
Louis L. Constan,