Thank you.
It was my last thought before the anesthesia took effect. I was having a hysterectomy as a means of dealing with a massive cluster of uterine fibroid tumors. I’d expected to be scared or, given the circumstances, hysterical (pun intended). I wasn’t, not even a little bit. On the operating table, I closed my eyes, took in a deep breath.
I could hear my surgeon, Dr. Lu, talking to the attendants; I could hear the anesthesiologist, Dr. Alexander, humming happily as he did whatever one does to ensure the patient is anesthetized, not euthanized. It was a joyful noise.
My being in the operating room with those two doctors was not by chance. I’d spent the previous year assembling an awesome medical team, doctors I chose specifically because I believed they could be trusted with my life. This brought me a long-overdue peace.
Navigating the health care industry has been one of the most time-wasting and stress-inducing activities of my adult life. I’d always felt at the mercy of a system I didn’t quite understand, a system seemingly designed to disempower people. Finding a suitable doctor via one’s health insurance website is, in my estimation, as random as the process of finding a suitable date online. Actually, the latter relationship is probably easier to find, since it’s regarded as a human interaction, not an impersonal provision of service.
The first time I ever had to choose a doctor was in the mid-1980s. I was 19, had just moved from D.C. and was working in Costa Mesa. During a weekly office meeting I suddenly started sweating; my neck started itching, then my ears, and my arms. Breathing turned difficult.
“Somebody call 911!” the boss yelled. I’d broken out in hives, from head to toe, and my face was swollen. I looked like a blowfish. I was rushed to the closest ER and treated for what I would later learn was a serious anxiety attack.
Upon my discharge, I was instructed to follow up with my regular doctor. I didn’t think I had one, but was soon informed I’d been randomly assigned one by my health insurance carrier.
That doctor was loathsome. She snapped her gum and barely spoke or made eye contact during the entire three-minute exam. Thankfully, I was told I was free to find another doctor so long as that person was listed in my insurance plan’s directory, a thick book with names, addresses, educational backgrounds and areas of practice.
Oh, that book. Before that book, if anyone had ever uttered my name in the same sentence as the word “prejudice,” I would have been deeply offended. How could I be prejudiced? Me, whose family had emigrated from Ghana when I was 6; I know what it is to be “other.” But how exactly does one select a doctor from a book of names without discriminating or prejudging?
I used the process of elimination: no offices in shady neighborhoods and no degrees from third- or fourth-rate universities. Then there were the trickier exclusions, the ones based primarily on stereotypes and cultural assumptions. It was an awful scheme, and it led me to awful doctors.
Dr. Lu, the first doctor I ever decided was a “keeper,” did not come to me by way of that scheme. We met in 1990, when we were both in our 20s. Dr. Lu was the resident on duty for obstetrics and gynecology when a minor car accident landed me in the ER while I was pregnant with my daughter.
He was compassionate, with a shy smile that always seemed to catch him by surprise. He was a far cry from my regular obstetrician, who’d taken umbrage at the many questions I asked.
“I will not,” the obstetrician had once barked, “reduce my years of training to simple answers for your benefit.”
When the following day Dr. Lu himself called to discuss my test results, I was sold. But he was a resident and couldn’t take private patients. The best I could do was show up on the days he was scheduled to work in the hospital’s ambulatory care clinic, where the residents were on rotation.
So I did. I’d wait for hours, allowing others to go ahead of me until the patients’ queue and the residents’ queue aligned in such a way that my file ended up in Dr. Lu’s hands.
Time has only increased my dedication. Dr. Lu is in private practice now in Torrance, which may as well be Tuscaloosa for me because it can sometimes take an hour and a half to drive there. But he’s the one I want.
I’d always chalked up finding Dr. Lu to a chance encounter and wished I could also find other doctors with whom I felt as comfortable. I’d grown weary of dealing more with medical assistants than with medical doctors; having my blood pressure checked with the same drugstore-inventory machine I owned; sensing my complaints were being dismissed; and, worse, feeling like the victim of a cash-cow venture, a long hallway of rooms with a patient in an open-back johnny gown behind each door, each one awaiting their three-minute exam.
I wanted doctors who knew my name and would take my calls – who worked in my best interest, not that of the insurance companies or the pharmaceutical reps. I deserved doctors who were interested in creating relationships based on mutual respect and trust. Was that asking for too much?
I got rid of the insurance lists. In fact, I decided to choose my insurance based on the doctors I wanted, not the other way around. I asked for referrals from friends and other doctors; I read “best of” ratings in magazines and newspapers; I researched and researched and, based on my needs, came up with some names. I then met with each doctor so personal chemistry could weigh in.
I must say: The women and men I chose are amazing and highly skilled. Yes, I’m biased, but it is my body and my life at stake.
When Dr. Lu suggested I have my procedure at an outpatient surgery center where Total IV anesthesia (TIVA) was used, I was hesitant. Under California law, patients in such facilities must be discharged within 24 hours. That’s no time at all to convalesce. Still, I trusted Dr. Lu’s opinion, so I went to the facility and met with the anesthesiologist. It’s a starring role in the operating theater, but few people know, or give themselves a say in, who lands that job.
Dr. Alexander spent nearly an hour with me. It felt more like an informative catch-up chat with an old friend than a meeting with a prospective doctor. I left thinking, Yep, he’s the right guy. So much so that it kind of makes me sad to pray, as I do, that I won’t need his particular expertise again.
While putting together a comprehensive medical dream team, from cardiologist to ophthalmologist, it occurred to me that I had missed the most central figure, the primary care physician. That’s your go-to person, the first point of contact. It took me a while to find the right person, but it was well worth the wait. Without Dr. Michael Duffy in place, I would have never agreed to have major surgery in an outpatient center.
A few hours after my discharge, Dr. Duffy came to my makeshift post-op recovery haven to check on me. He’s an internist with a private practice, but I also engage him as a concierge doctor. It’s a brilliant way of bringing back the most missed part of old-school medicine: house calls. In Dr. Duffy’s case, though, it’s minus the white coat and black bag. He walked in wearing khaki jeans and a great haircut, looking like MacGyver, a folded stethoscope tucked away in his back pocket. I laughed, imagining a Swiss army knife in the other back pocket to make the picture complete.
The days of feeling lost in a labyrinth of medical indifference, inexperience and ineptitude are long gone. With my dream team, I’ve created a sure path to good health.
