I’ve been a little frustrated with our health care system lately, and have had a few conversations about it. The Affordable Care Act has done a few things to help some, like allowing a person to stay on their parents’ insurance longer or removing the provision for preexisting conditions. It still has a long way to go; but that’s not what this post is about. I’ll save that for another time.
In what other industry do we NOT know the cost of services before services are rendered? There may be a few, but not many. We know how much our groceries are going to cost before checkout; we know how much our haircut is going to cost; we at least have an estimate of how much the renovation on the house is going to be. Have you ever tried to find out how much a medical procedure is going to cost? No one can tell you!
Several months ago we were considering a procedure for our daughter that was considered “not medically necessary” by the insurance. My wife tried to call and find out how much the out of pocket cost would be. No one she talked to could give her an amount. My son had some medical issues about 6 months ago that required visits to several different doctors and many additional tests over about a month’s time. We still don’t know what the final cost is…we have yet to receive a final bill. Again, my wife called at one point to ask how much we would be responsible for and was told everything was still “in processing”. The issues were resolved and my son is doing just fine, and we’ve moved on. Until we get another envelope in the mail that says “this is not a bill”. When willit be a bill?! It’s been 6 months and counting!
I’m not saying I have the fix, but I have a pretty good idea of where to start. If we want to fix our health care system, we need to do something about the industry that’s really in control:
The insurance industry.
Pain is something that I think a lot about. Not because I have a lot of it – thankfully – but because it’s a huge part of what I do. 98% of people who come to physical therapy come because of pain, and they want the pain to go away. I wish people would rely on us more for prevention, but that’s a topic for a different post. This also isn’t going to be the only post about pain, either. Like I said, it’s something I think about a lot and therefore have a lot of thoughts on the subject.
There’s been a lot of talk lately about pain and pain science. I think the general consensus these days is that pain is in our heads. Literally. Pain is just the brain’s interpretation of signals from the body. The funny (more appropriately frustrating) thing about pain is that it’s not always caused by injury to a specific tissue. In cases of chronic pain for example, tissues usually have healed long ago, but the brain is still interpreting pain. Why can the same noxious stimulus cause one person extreme pain, but not really affect another person? Why can a paper cut be so small but so painful, yet we can often notice a scrape or a scratch long after the fact without feeling the pain at the initial insult, or any pain at all?
Pain is complicated…
There was a great list/discussion recently posted about pain here by Joe Brence that is a quick and interesting read. One of my other recent favorite finds is a rather entertaining and informative TEDx talk by Lorimer Moseley, a clinical neuroscientist and PT out of Australia that has done a lot of pain research. If you have 15 minutes I recommend it.
Like I said, I have lots of thoughts on the subject, and lots has been said by others, and I can guarantee there will be more on the matter.
I’ve toyed with the idea of starting a blog before, but admittedly was turned off and overwhelmed because there are already many great physical therapy blogs out there and I didn’t really feel like I had much to contribute to the discussion. A lot of these guys have been in the field a long time, have a lot of knowledge, teach courses, etc. That’s where I want to end up, but still have a ways to go. But I’m trying.
Over the last 4 years of learning how to be a PT, and more specifically in the last year or so, I’ve had a lot of thoughts and ideas and a lot of conversations with myself in my head. Like I said in the about section, the blog is a way to get these thoughts and conversations out and hopefully somewhat synthesized. If others and to contribute that’s great, since collaboration is a great way to learn and progress. If not that’s fine too.
I have to admit that I’m not the best at keeping up with the research…I am good at checking up on things that are brought to my attention. So hopefully by doing this I can be a little more accountable for that and keep up on it better.
So there you have it. I hope to share my thoughts on and discuss not only physical therapy but exercise, health and wellness, nutrition, and maybe even thoughts about life in general. If a few people decide to follow along that’s cool too.