I just had my first visit with a doctor here and thought you might be amused to read my initial impressions.

I felt like I had more time to discuss my problem with the doctor here than I’d usually get at home, but also like he was a lot more perfunctory and less friendly.  He didn’t, for example, say hello or goodbye, but instead said, “Come in, sit down, why are you here?”  Americans would probably find this rude.   Our doctors usually say things like, “hey, nice to meet you” or “nice to see you again.”    Actually, my mom ran into my old pediatrician in the grocery store the other day and he asked her about each of her kids by NAME.  He knew all of us, despite that fact that I probably saw him twice at most and that was a decade ago.

I was in about some pretty crippling headaches I’ve been getting, and he did the usual eyes/arteries/muscles kind of check I’d expect at home.  He sent me packing with a prescription for naproxen, which is comical to me as naproxen is something we can buy at any store at home without seeing a doctor or even talking to a pharmacist.  It’d be like someone giving a brit an Rx for paracetamol.

In comparison, the last time I saw an american doctor about my frequent headaches, I was put on migraine medication and immediately ordered to get an MRI to rule out major problems.

In the states, many people are without health insurance, and therefore do a lot of self-diagnosis and treatment, only going to the doctor when it’s seriously bad.  Also, our doctors are overwhelmingly and annoyingly reluctant to get off their old-school paper charting systems and move into electronic recordkeeping, (and patients fear a national database anyway)  and so if you see an allergist for one thing and an ophthalmologist for another, you - the patient - are responsible for providing each of them a list of what the other has you on, to avoid complications.   If you get all your medications at the same pharmacy, they frequently check for drug interactions automatically for you.

Anyway, the doc seemed a bit surprised and maybe slightly annoyed that I was able to rattle off everything I’ve tried so far, first by brand name in the states and here, and then by ingredient and how many milligrams of said ingredient are in each tablet.   At home, the doctor would expect it.  At the very least, the nurse would ask if you had a list with you and would add it to your chart.

I got the impression that he thought I was stepping on his doctorly toes.  He made it a point to tell me that americans always expect to see a specialist right away, and that it simply doesn’t work like that here… even though I hadn’t asked.   I got the impression that I should just smile, take his advice and then call again if it doesn’t seem to work.

The reason americans are so pushy with their doctors usually, people forget, is because most of us pay those visits out of pocket and therefore, coming back for more help can be expensive.

I should buy him a copy of Michael Moore’s Sicko next time I swing through.