21st Century Medicine
As the nation braces for the coming Swine Flu epidemic, those of us who built our houses with brick (and not sticks or straw) are feeling pretty smug. That does not mean that illness can’t befall us and I managed to encounter one this weekend. A quick review on the internet confirmed for me that I have another in a series of sinus infections. The key to the diagnosis being the pain radiating down into my teeth. So I set off for my local pharmacy which has on staff a Physician’s Assistant to help with such (hopefully mundane) illnesses. Placing medical help with prescription writing authority at the drug store was a stroke of genius. The theory is that the young Physicians Assistants will be bullied into writing the Rx for anything the patient wants and then the drug store gets to fill it. Win/Win.
This particular Physician’s Assistant was younger than the others I have seen. I’d say she must be 24 or so in order to get the degree, but she looked much younger. She also had something that none of my other health care provides have ever had, a small shiny stud in her nose.
It is a common occurrence for me know to have these semi-children making important decisions for me. I could not help but wonder if I had had more sinus infections over the course of my life than she had diagnosed over the course of hers. I doubt it, but it ran through my mind. At any rate, she was highly professional and competent. She has only been out of school since last spring, but she went to Columbia University in New York City which is nothing to sneeze at, but, if you do, she could cure you. I liked her very much even when my blood pressure (taken over my sleeve) turned out to be 172 over 120. In other words, I was apparently in the middle of cardiac arrest, and all the time I only thought that I had a sinus infection.
After retaking my blood pressure and finding that it fell roughly within the range of the living, she wrote me a prescription for the same antibiotic that I used to give my child for ear infections. The first one they would prescribe. The one that never worked. While I have my doubts as to the efficacy of the drug, at least it did not come in the bubble gum flavor my daughter’s used to. While she was printing out all that stuff they give you that your wife wants to see but it turns out that you threw away or left in your car, I began asking the young lady about Columbia and how her practice here in West Austin compared with her clinic chores in Harlem. She was quite fond of Austin. She admitted that it was a huge change from what she had formerly done and she liked the warm weather.
“How about the debt ?” I rather insensitively asked her, “bet you came down here with a lot of debt from Columbia.” This got her attention. “It is the only thing that causes me concern and I think about it all the time.” She said. Then she said, “You have no idea.”I do have some idea and I told her I was paying my daughter’s way through a private school, but I knew what she meant. Here is a 24 year old with a nose stud working at a drug store and I would bet anything that she is paying off a debt of probably between $100-$200,000. Welcome to the medical profession. I don’t know what CVS pays, but I will hazard a guess that she will not be able to pay the debt off this year.
This is the big difference in education today and what it was when I was using it to keep from being drafted. All these kids come out with debt the size of a decent house loan. That means, of course, that they can’t get a house loan and, if they could, they could not pay both while working at the CVS on Exposition. My education was just about free (and I never had a scholarship).After seven years of Post Secondary education I had more money than when I had started. The world no longer works like that, unless you can get Rayda to work for you like I did. It is too bad. This debt drives all of their decisions. Where to live, what job to take, marriage and children plans. It is just about the biggest factor in their lives. I don’t know how we let things get so out of hand. I don’t know that ANY education is worth $200,000. I am positive that no undergrad education is worth that. I have my doubts about graduate education. Maybe if CVS gave her drug kickbacks it would be worth it. She mentioned that I might want to pick up some Mucinex, which I did. It cost $27, the checkup cost me only a $20 co-pay. There is really something wrong with this picture.