Healthy New Year everyone!

Like many people I’m starting the year with healthy – and preventive care – intentions. How about you?

That put a few items on my holiday ‘to do’ list:

• Get a pap smear,
• Find H1N1 vaccine,
• Wrestle the results of a recent bone density scan (Dexa) out of the hands of the medical center and into the hands of my physician, and
• Confirm with Morris White, my trainer, that I’d continue workouts.

The pap smear was easy – this time. I’d not been able to get one during my late-summer vacation visit to the doctor because the appointment was two weeks prior to the annual date of the prior test. That required another trip. Holiday downtime was a good time to do that. Check that off the list.

In doing so, I finally found an H1N1 vaccine dose! Getting a seasonal flu shot was easy at www.phillyflushots.com, but even after calling several immunization providers and both of my physicians at least twice monthly since H1N1 became available, checking websites and following news reports of shots at pharmacies – well, no success. Luckily, my doctor had just received a few doses of H1N1 that day of the pap smear. Check that off the list.

Results of a bone density scan months ago had still not shown up at my doctor’s office. Holiday time was a good time to badger for the ‘results,’ though it was hardly worth the trouble. Turns out  my physician is not part of that medical center’s ‘network’ and can’t get detailed results. Only a note: ‘normal.’ Sorry, that’s not good enough. Neither my physician nor I know whether there has been any change in bone mass since prior tests. Sure, the test results might be ‘normal,’ but the measures might also be trending in a direction that means I’m losing bone mass, something we both should know about. No check there, still on my list.

Oh, and agreeing with Morris to meet twice a week at 6 AM for workouts – that was easy. Check. Now for the hard part of getting up and getting to the gym, especially during these cold winter months ahead.

So, what the problem? It’s the gap between what’s reported in the news, discerned in health report cards or explained to Congress and what I experienced in the care here in Philly, ‘on the ground.’

• Pap smear. My insurance company will record my having received a pap smear in some set of ‘positive’ promotions about how it supports prevention – but it took a second trip, required using additional vacation or work time because the plan was so inflexible as to preclude coverage of a test two weeks before the anniversary date of the prior test.
• H1N1. Experts quoted in a January 1 New York Times article on the nation’s H1N1 experience gave the government a B+ and ‘excellent’ ratings for it’s preparations – but that did not translate to my experience on the ground. And, by the way, good thing I got my flu shot elsewhere, because neither of my physicians was able to get seasonal flu vaccine at all.
• Bone Density Scan. My insurance company and physician will also be able to report that I was appropriately screened for bone density, but none of us know the most meaningful of results – my scores – because they are locked up somewhere that we can’t see for some reason I can’t discern. We don’t know if the trend is bad and if some more cost-effective intervention should be initiated now. More weight-bearing exercise, perhaps.
• Workouts. Oh and then there’s Morris, whose immediate, hassle-free response to scheduling made him my easiest disease prevention/health promotion action of all. Unfortunately, there’s no way to capture the value of what he’s done for me ‘on the ground’ to have him recognized ‘on the Hill’ or rewarded in any special report card of quality.  I can cite a smaller dress size, increasing strength and great flexibility but perhaps best of all, I recovered quickly with no lasting impact from being hit by a bicycle – a real testament to being fit.

From a distance, in the air or on the Hill, the health grades of items on my list might look good. They might, in fact, be B+ granted in the Times article from those vantage points ‘above it all.’

From ‘on the ground,’ however, it feels like grade inflation to me. All except for Morris: he gets an A+.

Related posts:

1. What the new cervical cancer screening guidelines mean for women
2. Poll: Should the H1N1 vaccine be mandatory?
3. Health Reform 2009…Angels and Demons
4. Earning less, paying more for health care: fighting a battle on two fronts
5. Miracle by Accident

This entry was posted on Tuesday, January 5th, 2010 at 6:00 am and is filed under Consumer Health Care, Coverage Policy, Insurance, Quality, Women's Health. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.