Wednesday, March 27, 2002
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Wednesday, March 27, 2002 |
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Doctors, what about your younger patients? An open letter to health care providers and their patients: Dear doctor: My wife and I were patients of yours. In the past year, you've done my physical and treated both of us when ill. Until today. I called to your office today for an urgent health matter. Yesterday you diagnosed my wife as having influenza and prescribed several days of bed rest. While not as ill, I had also begun coughing and by this morning was showing similar signs of flu. With my wife bedridden, I was left to care for our two young children and I didn't want to risk being knocked out by a full-blown flu as well. I called your office hoping you could see me and prescribe the new flu inhibitor, Tamiflu (oseltamivir phosphate), which must be taken within two days after the onset of symptoms to be effective. Your assistant said that you were booked solid, and offered to make an appointment for tomorrow. But I was pushing the 48-hour time limit in which the medication might work, so that was of no help. When I explained the time element to your assistant, you sent back word that if it was an emergency, I should go to the emergency room. Isn't the ER for life-threatening emergencies that can't be treated in a doctor's office? Should we be further taxing our overburdened ER staffs with medical issues that can be handled by a family physician during business hours? Unfortunately, you left me no choice but to take your advice. It will cost me more, and will cost the taxpayers as well. When we spoke later, you framed the issue as a question of dividing your time between young patients and elderly patients. I respect your dedication to serving your elderly patients, but I don't think that should make those of us under 65 second-class patients. Your contention that I was "selfish" to request an appointment because I'm "a young, healthy man" is curious. The late Jim Henson was a young, healthy man who only thought he had a mild flu. Tens of thousands of people each year are hospitalized due to influenza, many succumbing to complications from the disease. According to Roche Group website: "Visit your doctor right away if you think you have symptoms. Tamiflu treatment should begin within two days of symptom onset." This recommendation is made to all patients, so I gather you think this drug company is selfish. And since oseltamivir phosphate is FDA-approved, they must be selfish, too. I also had my baby daughter to consider. With my wife ill, I am my daughter's caretaker. (We took great care to minimize her exposure to my wife's illness.) If I too became highly contagious, my infant daughter would be exposed and therefore at greater risk. (The medical risks of influenza in children under 1 are equivalent to the risks for people over 65.) While the jury is still out on the issue, there is some medical evidence that inhibiting the flu virus with oseltamivir phosphate also reduces the level of contagions. And since my 4-year-old attends preschool, minimizing his exposure to influenza would lower the risk to other children in the community. If that's your definition of selfish, so be it. I am sharing this letter with the readers of our local paper both patients and doctors with a genuine interest in their perspective. Maybe I'm wrong. I am open to other points of view. Kevin Kelton Fayetteville
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