Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

We have the potential to have the best health care system in the world

Aaron E. Carroll, MD
Policy
August 22, 2013
Share
Tweet
Share

Every once in a while, I’m forced to engage the health care system in a more personal way. Yesterday was one of those days. First, one of my children (who shall remain nameless), decided to take a stroll in the mulch on Monday without any shoes. He managed to lodge an enormous splinter in his foot which I couldn’t get out. By the time I saw it that night, it was already starting to look like it might be a problem. On the same night, another child (who shall remain nameless) reported that he was having some pain and swelling in an area of his body (which shall also remain nameless).

Yesterday morning, my wife called the pediatrician, who scheduled a visit for the latter problem. For the former, we made an appointment with the dermatologist for the foot. Before lunch, they had cut out the offending piece of wood and placed a stitch. The nameless part of the body was examined at 3:45, and there was some concern that it might be serious. He was sent to the emergency department, and I was pinged to join them. We all arrived around 5:05pm. At 5:15, a doctor was in the room apologizing about the wait. They did an ultrasound, and the urologist drove up from another hospital to see us in the ED and go over the issue with us. He even drew us a picture. We were out before dinner, dropped off the prescription, and gave the first dose of meds before bed.

What I’m describing could easily be taken as the finest health care system in the world.

People think that you get care because you have insurance. But I can swear to you that no one in this process cared one whit who our carrier was. People think you get care like this because you have more money. Believe me when I tell you that we are far from the richest people in this community. We get care like this because of who we are and what we do. We’re in the system.

The first doctor I mentioned had no sick visits available. But they squeezed in one of our children because they know I’m a pediatrician and they know my wife’s a nurse practitioner. They also know us personally. You have to remember that about a fifth of Americans can’t get an appointment when they’re sick within a week, let alone that day. The dermatologist appointment (for a splinter!) was arranged with a close friend at the practice. When our child was referred to the ED, I’m sure a call was placed to the urologist telling him who my son’s dad was and that I worked in the health care system, precipitating a level of service that few will see.

I’m so grateful for what everyone did. Please understand that I’m not saying one bit of this was fake. Every doctor we saw was unbelievable fantastic and ridiculously skilled. I’m not saying that these providers aren’t just as kind and caring with every other patient. I’m sure they are. We received no scans, no procedures, and no medications that someone else wouldn’t get. We just got them served to us in an ideal fashion.

That’s access. It has nothing to do with insurance or wealth.

We have such potential. For all my complaints here, we have the best trained health care workforce in the world. Our facilities are top notch. Our technology is amazing, as are our medications. The problem is that the way it’s organized and distributed doesn’t work well at all. It’s like we took the world’s best and most complicated Lego set and let a small child put it together without the instructions.

The Affordable Care Act will likely make things better for millions of people. Insurance will give them access to the health care system in ways they didn’t have before. But it won’t give them what I described above. Insurance is necessary, but not sufficient. Tons of Americans are attracted to concierge care (and I can’t blame them) because they bought the insurance, and still don’t get the access they want. Unfortunately, concierge care still won’t give you the level of care that I try very hard not to take for granted.

We don’t have the best health care system in the world. But we could. I long for the day when we can start talking about getting that instead of whether we should give Medicaid to people making less than the poverty line.

Aaron E. Carroll is an associate professor of pediatrics, Indiana University School of Medicine and blogs at The Incidental Economist.

Prev

The challenge of using health IT more effectively

August 21, 2013 Kevin 8
…
Next

Doctors are conflicted about sharing discharge summaries with patients

August 22, 2013 Kevin 11
…

Tagged as: Pediatrics, Public Health & Policy

Post navigation

< Previous Post
The challenge of using health IT more effectively
Next Post >
Doctors are conflicted about sharing discharge summaries with patients

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Aaron E. Carroll, MD

  • I will never be the physician that my father was

    Aaron E. Carroll, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Health reform and the iron triangle of health care

    Aaron E. Carroll, MD
  • a desk with keyboard and ipad with the kevinmd logo

    How a specialty pharmacy denies a physician his medication

    Aaron E. Carroll, MD

More in Policy

  • Why Medicaid cuts should alarm every doctor

    Ilan Shapiro, MD
  • Why physician voices matter in the fight against anti-LGBTQ+ laws

    BJ Ferguson
  • The silent toll of ICE raids on U.S. patient care

    Carlin Lockwood
  • What Adam Smith would say about America’s for-profit health care

    M. Bennet Broner, PhD
  • The lab behind the lens: Equity begins with diagnosis

    Michael Misialek, MD
  • Conflicts of interest are eroding trust in U.S. health agencies

    Martha Rosenberg
  • Most Popular

  • Past Week

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why flashy AI tools won’t fix health care without real infrastructure

      David Carmouche, MD | Tech
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
  • Recent Posts

    • Essential questions about nurse practitioner liability insurance [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why being a physician mom is harder than anyone admits

      Cynthia Chen-Joea, DO, MPH | Physician
    • 9 domains that will define the future of medical education

      Harvey Castro, MD, MBA | Tech
    • When the diagnosis is personal: What my mother’s Alzheimer’s taught me about healing

      Pearl Jones, MD | Conditions
    • What led me from nurse practitioner to medical school

      Sarah White, APRN | Education
    • Why local cardiac CT scans could save your life

      Benjamin Cohen, MD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 14 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why flashy AI tools won’t fix health care without real infrastructure

      David Carmouche, MD | Tech
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
  • Recent Posts

    • Essential questions about nurse practitioner liability insurance [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why being a physician mom is harder than anyone admits

      Cynthia Chen-Joea, DO, MPH | Physician
    • 9 domains that will define the future of medical education

      Harvey Castro, MD, MBA | Tech
    • When the diagnosis is personal: What my mother’s Alzheimer’s taught me about healing

      Pearl Jones, MD | Conditions
    • What led me from nurse practitioner to medical school

      Sarah White, APRN | Education
    • Why local cardiac CT scans could save your life

      Benjamin Cohen, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

We have the potential to have the best health care system in the world
14 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...