--may well be one of the most important here in a long time, and it should be read by a lot more than the denizens of Neurotalk. (I'm going to see what I can do about that, if everyone's okay with it--don't think there's anything particularly egregiously identifying here, except may be for me, and I'm extremely public with my conditions for advocacy reasons.)

In a few posts, the major problems with patient/physician interaction in the US today have been delineated, with many sides represented. And as we can see, both physicians and patients have contributions to make to improving the situation.

Many here at Neurotalk are familiar with my quest to get my neuropathy diagnosed some eleven years ago and how multiple doctors were clueless until my own research led me to a world-renown research and practice center (which fortunately I lived within reach of). While it was hard to get an appointment there, when I finally did the doctors and other staff were not only knowledgeable, but they listened to my suspicions and were quite willing to test them (and, of course, they did have access to state of the art practice, which is how I got my skin biopsy). Moreover, I got the most thorough general physical examination I have ever received that day.

Now, part of this may well be that I was immediately considered an interesting case. And part of it was that the doctors there, for some reason, did not seem to have a big ego thing going on which required them to believe the obviously intelligent patient before them couldn't possibly know what he was talking about. But I suspect that a big part of it was that this was taking place at a tertiary center, very well-funded, at which time could be taken with patients and the practice wasn't about shoving twelve patients through each hour, because financially it didn't need to be.

This also happened eleven years ago now, when pressures were a little less. I am led to understand that at the same place now, while the service is still good, there do seem to be reports of shorter shrift; there seem to be more financial and population pressures there than previously. (My initial visit there was two hours and then I had a skin biopsy later that afternoon; that doesn't seem to be happening with initial visits there anymore as much. More's the pity.)

But, I'll end this with my somewhat usual rant. These problems will go on unless we, as patients and health professionals, and especially as voters, take action to stop it. The health care system we have set up here is not an inevitability--it's much more a historical accident of insurance companies getting ties in with employers in World War II--and we do not have to keep a system that looks to profit first, second and third, no matter how entrenched those interests are. Plenty of other nations have systems that work better and get better outcomes for much less cost and which allow much more personal attention, and while that may involve some hard decisions about how we're going to distribute and ration resources, we're already allowing such decisions to be made by profit making entities, and hardly fairly. I'd be quite willing to let other entities (citizen councils, government advisory boards) take a crack at devising a system under which health professionals can promote health rather than the bottom line. (And if that's "socialist", so be it.)