One of the greatest puzzles about living in Tucson is how so many people manage to escape “medical care” in this town without death or permanent disability. As they do with everything else in life, the residents of this miserable shit hole settle for second, third, fourth…fiftieth best, and medical “care” here is not only no exception, but particularly illustrative of the phenomenon.
As to the “why” behind the substandard care in El Pueblo Viejo, the answer is pretty simple and obvious: shitty wages for health care professionals, shittier working conditions, and a patient population that not only cannot/will not pay for quality care, but doesn’t even know how to demand such care, or even recognize what such a thing is. Ergo, the cream of the medical field crop flees elsewhere or doesn’t come here in the first place. Instead, the real professionals choose localities where skilled healthcare professionals not only earn something resembling competitive wages (even accounting for the increasingly socialized environment of today’s medical profession), but are able to practice real medicine. When I say “real medicine,” I mean the actual diagnosis and treatment of patients who have something actually wrong with them, rather than tweakers who are just seeking their next fix.
Well, OK, maybe “tweakers” is the wrong word to use here. Contrary to popular belief, the most popular substance abused in Tucson is not methamphetamine, but prescription drugs. Most of the health care “professionals” here (I’ll illustrate shortly why this term does not apply to most medical employees in Tucson) spend most of their time fending off people who mistake clinics, hospitals, and doctor’s offices for pharmacies and who haven’t ever actually been sick, in the clinical definition of that term, at any time in their adult lives. For this reason the doctors, nurses, physician’s assistants, and medical assistants here do very little real medical diagnosis and treatment. This means that most of them are out of practice in and unfamiliar with this area of medicine, and therefore cannot recognize genuinely ill patients when they see them.
My wife’s bout two years ago with valley fever, a common and sometimes fatal disease of the desert southwestern United States, provides a perfect illustration. Almost two years ago to the day, she began suffering symptoms of what at first appeared to be the flu, followed by painful and difficult breathing that resembled pneumonia. We suspected from the beginning that this was the onset of valley fever, but of course needed medical confirmation of this fact, thinking (foolishly, it turned out) that we’d get answers right away. Thus began the dreaded process of dealing with Tucson “medical care.”
Step one was to visit what was then her general practitioner, an H1-B doctor from India who worked at the same clinic where my medical assistant daughter then worked. Not being either a native Arizonan or a long-term resident, this woman had no clue what valley fever was and attempted to first tell my wife that 1) she had a bad cold, 2) she was suffering from stress, and then, finally, when all else failed , that 3) she was suffering from depression! Being not only a medical ignoramus, but a Big Pharma whore (aren’t all doctors these days?), this doctor then actually prescribed Zoloft – for a whole year! My daughter, a mere medical assistant, had already figured out what the problem was and begged the GP to send my wife for a chest x-ray, which would have immediately detected the damage valley fever does to the lungs. Of course no self-respecting quack, especially one from India, could ever allow a mere medical assistant to show her up, so she of course refused to prescribe the chest x-ray. End of step one.
Step two was my wife progressively getting sicker and sicker for the next two months, her energy draining, her breathing becoming more and more difficult, and her skin breaking out in lesions, another prominent valley fever symptom.
Step three was me taking my wife to the emergency room at around dawn one spring morning after she became so weak with fever and chills, and her breathing became so labored that she could barely move. I dreaded this step because the nearest hospital to us, the one at which our doctors all practiced, is also, sadly, one of the most mediocre (OK, let’s be honest and drop the euphemisms – worst) hospitals in town. That said, I simply had to imagine that SOMEBODY on their emergency room staff would have recognized her symptoms for what they were.
My wife nearly died that day in the ER. In fact, one ER quack, a shaved-headed prick-with-ears who looked and acted more like an off-duty copthug than a doctor, actually told her “I don’t think there’s much we can do for you here.” My daughter, who had taken the morning off of work to meet us at the ER, looked this doctor straight in the eye and told him what was wrong and what needed to be done, the first order of business being a chest x-ray. Once again, of course, no “doctor” could ever let a lowly medical assistant show him up and this cop-masqerading [ineptly]-as-a-doctor was no exception.
Fortunately, there just happened to be, among the losers that “staffed” this underperforming excuse for a hospital, a pulmonologist on duty that day who actually knew what he was doing and what he was talking about (he’s probably still the only one of his kind in town. I wonder when he’ll get fed up and move out). He immediately ordered a chest x-ray, looked at the results when they came back 20 minutes later, and said “valley fever, no doubt about it.” He then proscribed the proper medication that had my wife on the fast road to recovery (as much as anyone can “recover” from valley fever, as it stays in the body permanently and can resurface at any time over the course of one’s life). My wife still sees that pulmonologist once per year for a checkup.
One doctor, the ONLY competent one on that hospital’s staff, stood between my wife and death! I still shudder when I think of what would have happened if this doctor had not been on duty that day. I would now be a widower – with a very large lawsuit against that hospital. I also wonder how many others not as fortunate as my wife, unable to find a competent doctor able who recognized a very common Arizona disease, have lost their lives under similar circumstances.
My medical assistant daughter has not escaped Tucson’s health care nightmare unscathed either. Suffering from a permanent physical disability, a congenital bone disease that causes stunted growth and leaves her susceptible to orthopedic problems, she has visited three orthopedists in Tucson over the last five years, none of whom had either ever heard of her disease (it’s not an uncommon one and should be known by anyone daring to call themselves an orthopedist) and who could offer her no medical help for her aggravating symptoms. In short, actual diagnostic medicine was too much trouble for these bottom-of-their-graduating-class losers. Far easier to deal with drug seekers and recklessly issue prescriptions while collecting subsidies from their Big Pharma pimps.
Needless to say, my daughter is trying to get the hell out of this wretched town. She not only has been on the receiving end of of the abominable medical care that this town offers, but she also fed up with the utter disdain with which the local medical establishment treats qualified and competent medical assistants, what few that there are.
Speaking of which, I don’t know how my daughter was able to abide nearly four years of the medical clinic at which she worked. While the doctors for whom she worked were actually relatively competent, at least in Tucson terms, and were very supportive of her efforts to support them, it was the medical administrators and her fellow MAs who were insufferable and who finally caused her to throw in the towel and walk away.
From what my daughter tells me, and from what I’ve witnessed first hand, in order to “work” as an “administrator” of a medical services establishment in Tucson, one must be one or more of the following:
• A complete and hopeless moron who is absolutely devoid of any interpersonal, leadership, or managerial skills whatsoever
• Completely and hopelessly ignorant of actual medicine, medical terminology, medical practices and standards, or medical administration, to include patient scheduling, billing, referrals, insurance claim management, and patient outreach
• Hostile to anyone knowledgeable of, qualified to practice, or experienced in the medical profession or medical administration
• An arrogant, backstabbing, ass-kissing egomaniac
• Barred from working as a medical administrator in any other city, in any other state in which actual demonstrated competence and standards are demanded of a medical administrator
• A miserable and consistent failure in every aspect of life
• Openly and unashamedly contemptuous of both patients and medical staff
Before you dismiss these as the ravings of a disgruntled employee, let me assure you that, based on my and my wife’s personal interactions with such people, my daughter’s assertions are one hundred percent accurate. In fact, if anything, she probably omitted a few key attributes from the above list. The fact is that I would not allow any of the “medical administrators” of my acquaintance in this town to flip burgers at a local fast food joint of my patronage, or to take my garbage can out to the curb, let alone run an establishment that might be responsible one day for saving my or one of my loved ones’ life. The fact that they are allowed anywhere near a medical services organization tells me that not only does the “medical establishment” of this town –hell, of this state—not care one wit about the well-being of patients, but that it is openly contemptuous of them and sees them as nothing but dollar signs to be milked and discarded. Given the criminal Establishment that runs every other aspect of this corrupt, disgusting, hopeless state, I do not think that such an assertion is mere hyperbole.
Concerning medical assistants in this town (and probably just about anywhere else in the country in this standards-free day and age): they’re almost universally lazy and incompetent, a direct reflection of everyone else in this cesspool of a city, as well as the so-called “training” they received.
Just watch TV ad testimonials on behalf of local fly-by-night diploma mills that milk gullible and talentless morons out of thousands of borrowed dollars that they’ll never be able to repay because of the “great jobs” they won’t get after they graduate. You get the impression that “medical assisting” is a field staffed by bright, ambitious young people who are on the first rung of a career ladder that might lead all the way up to a prestigious position as a senior medical administrator, or even a career as a doctor.
The typical “medical assistant” here in Tucson (and probably everywhere else) is a single woman –usually a single mother—who is generally a member of a racial or ethnic minority group or a lower-class white family. In most cases she either 1) dropped out of high school, later to get a G[ood]E[nough]D[iploma]; 2) has a criminal record, a drug problem, or some other issue that has kept her out of the productive, gainful workplace for most of her adult life; 3) is academically hopeless and functionally illiterate, not even able to survive a two-year community college program; 4) all three of the above. One thing that is common to almost all medical assistants in Tucson, whether they work for a public clinic, a private practice, or a hospital, is their complete inability to do simple tasks, follow simple directions, think critically, or get anything done without being micromanaged. Some of the recurring problems with Tucson MAs, no matter where and for whom they work, include:
• An inability to communicate with patients. Granted, most Tucsonans in any profession can’t communicate clearly with other human beings, but these people are in a class by themselves. I cannot tell you how many times my wife and I have tried to either schedule appointments, get exam or lab test results, or verify insurance co-payment or update information with doctors offices or clinics in this area, only to meet a brick wall. Granted, a very big part of the problem with the MAs in this town is that many of them are Mexicans who can barely communicate in English at a functional level (yes, it’s un-PC to say this, although that doesn’t make it any less accurate), but that’s only an aggravating factor. The truth is that most of these creatures simply do not know how to do their jobs, do not know how to talk to patients, and are not the least bit interested in helping patients get the proper care or information that they need.
• An inability to communicate with the doctors, nurses, and physicians assistants for whom they work. This is an especially dangerous shortcoming. After all, it is essential that the information imparted by doctors to their MAs, information often vital to a patient’s understanding of their condition, and therefore there ability to accurately assess the need for treatment, along with the ability to update patient care records correctly, be as accurate and clear as possible. Sadly, as with their communications skills with patients, too many Tucson MAs simply cannot comprehend the information that doctors, labs, pharmacies, and other clinics provide them. Far too often information that needs to be handled in a timely manner falls through the cracks. As I mentioned in the previous paragraph, part of this is due to language barriers, but the predominant cause is simply poor education and training, as well as careless apprenticeships by practitioners of newly trained MAs, who tend to pick up the bad habits of those providing them with on-the-job training.
• Laziness and apathy. This is the great Tucson “occupational plague” that is causing the local economy to implode. MAs are not the most common sufferers of this disease, but are arguably the most dangerous, given the nature of their work.
• Substance abuse. To a great degree, this is probably the cause of the previous three paragraphs. While they don’t necessarily have greater access to prescription drugs than any other health professionals in the area, MAs tend to come from the same local population that is notorious for abusing drugs and alcohol. Given Tucson’s reputation as the unofficial “Substance Abuse Capitol of the American Southwest,” odds are that the gal (or, on rare occasions, guy) updating your medical record, calling in your prescription to the pharmacy, taking your vitals prior to a doctor’s exam, or drawing your blood is high on something, or hung over from a bender the night before. I have literally refused to have blood drawn by specific MAs on two separate occasions because the individuals in both cases were obviously under the influence of some kind of drug, prescription or otherwise. (For those of you who wonder why I didn’t report them immediately, just TRY to do that here in Arizona and see how far you get.)
Admittedly, a great deal of this mess is the fault of the “managers” and doctors for whom these MAs work, in that these experienced professionals fail to hold their MAs to a high standard of performance. This isn’t surprising, since these so-called “professionals” seldom ever hold themselves to a high level of professionalism. And why should they, given that the average Tucsonan who is their patient doesn’t know what professionalism is, nor do they show any particular concern for their own health. The inferior “colleges” in which these MAs are “trained” also share a great deal of the blame, as most are interested in only two things from an applicant for their MA programs: 1) that the applicant have a pulse, and 2) that the applicant have money for tuition, its source not being a particular concern to the school administrators and stockholders.
To be fair, I should make it clear here that there are also exceptions to the rule. In addition to the rank incompetence, we’ve also had instances where we were served by truly fine, upstanding, and thoroughly competent doctors, nurses, Pas, and MAs. Sadly, however, they are the rare exception to the rule. The majority of people in the medical profession in this town would simply be fired, and probably stripped of their licenses or certifications to practice, if they ever performed elsewhere in the nation as they do here.
All of the above said, the bulk of the fault for the sorry state of medical care in this town lies, of course, with the medical “professionals” themselves, whether they are doctors, nurses, physician’s assistants, medical assistants, or administrators. Just as today’s society as a whole is a collection of helpless, whining victims who feel that they are owed a job with benefits, regardless of their performance and whether they’ve earned them or not, so the medical field reflects that society. When the majority of a city like Tucson consists of individuals reflective of this attitude, then the attitude will infect all of that city's businesses, health care being no exception. Until the medical community here in Arizona, and in the city of Tucson in particular, either cleans up its act by shedding incompetent “dead wood” and starts staffing itself with able professionals, the rot will continue and more sick and injured citizens will be victimized. Sadly, given Tucson’s unstoppable descent to the bottom of the socioeconomic abyss, that’s unlikely to happen.
As my title advises, don’t get sick or injured in this city. If you have no way of getting out now, pray that good health and good luck follow you and keeps you safe as long as you have to remain a resident. Your life depends upon it.