Re: I think I'm gonna build a new bike.......
Thank you, Intrepid WW and Dan. I'm glad, too.
This episode contained an illustration of one of the problems with modern health care. My foot started aching on Wednesday, Oct 8. For about a week, it hurt. Then I went through a two week period where it was so bad that I was within sight of being incapacitated. So I made an appointment to see my doctor. (He's been my family physician for 26 years and counting. This is the first time, I think, that he's actually treated me for anything. It's been nothing but routine physicals to this point. I've been pretty lucky on that issue)
The moment he saw my foot he thought it was gout. I could tell that he had no doubts about it. Since then I've looked it up on Wikipedia. The photos and description left no doubt in my mind, either. So he had his nurse draw some blood and tested it for high levels of uric acid.
About a week later the nurse called and said that the tests came back negative and the doctor suggests an X-ray. (I've learned since that a negative blood test happens about half the time.)
I called a few places for quotes and figured out that an X-ray was going to cost me a couple hundred bucks. Perhaps more if I chose the wrong place. I asked questions like, "Can I have the X-ray taken and then have that forwarded to my doctor?" I've forgotten her exact wording, but I do recall that there was clearly going to be some third party involved. And, no doubt, another invoice. I just wasn't going to go to that kind of expense merely to learn that I don't have a fractured bone. I was as certain as I needed to be of that already.
So imagine I'd gotten that X-ray and it had come back negative. I'm speculating here. But based on the experiences of others, I feel pretty confident in this speculation. The doctor, perhaps, would have said, "Okay. We'll have to go with test such-and-such". The problem is that this test, though more precise and certain than a simple uric acid blood test, is much, much, much more expensive.
And perhaps I'm wrong about that. Maybe if the X-ray had come back negative he'd have said, "Still, it's gout. There's no point spending a bunch of money to confirm something as obvious as this. My diagnosis is gout and I recommend that we treat it as such". I'd have been fine with that. But I don't trust our medical system to get me there the easy way. I'm afraid that this system will squeeze every penny out of me before it'll give me answers. Even easy answers like this.
I suspect that my doctor, fearful of the accusation of malpractice, can not give a diagnosis on the basis of the evidence of his eyes plus tactile impressions and instead must, really must, get any documentation or conformation that he can. Regardless of cost.
If my impressions are correct, then we have a truly dysfunctional system here.