Because my experience = the world

Two nights ago, the Better Half and I had dinner with the triage nurse in my office. Despite my best intentions to avoid talking about work too much, thus boring her loving family, talk about work we did. (Confidential to George and Alexis -- um... sorry about that.)

This is usually the Season of Horrible Insanity for pediatricians, also known as cold and flu season. I typically expect to be booked with about 25 patients a day, most of whom have coughs and colds and various other ailments of a viral and snotty variety. And I tend to hate cold and flu season, because there is nothing so demoralizing as having to explain to a cavalcade of frustrated and sleep-deprived mothers that there is nothing that one can do for little Peyton's cold, and good luck with the vaporizer and "tincture of time." (I have never actually said the phrase "tincture of time" to a frustrated and sleep-deprived mother, for fear of being summarily throttled to death. Cutesy-poo medical phrases are, to my understanding, not comforting.)

This year? Not so much. The last few months have been sloooooooow. The triage nurse is fielding more and more calls from parents who simply want management advice over the phone, and are reluctant to come in and cough up the co-pay. She's getting the sense that a lot of people have switched to high-deductible plans in an effort to save money. (I will get around to decrying high-deductible plans one of these days.)

Now, from a cost-benefit perspective, this is probably a good thing. If people are deferring unnecessary medical visits for problems that will go away with no intervention anyhow, this costs everyone less money. Obviously, one hopes that they aren't deferring care for serious illnesses, but there hasn't been a huge upswing in admissions for untreated, smoldering pneumonia and such. Most of these visits are probably ones that the patients didn't "need" in the first place.

On the other hand, this is not great for business. (For those of you clutching your pearls at the revelation that medical offices are businesses, and medical providers did not enter the field because of an undying desire to cure illness with no thought to compensation, I hope that you can rebuild your shattered belief in the goodness of humanity over time.) We kind of look to the late fall and winter as "bread and butter" time, so the bottom line starts to look a little shaky when the schedule has lots of openings.

I can't find numbers about how people access health care during economic downturns, and it's far too early to get any kind of big picture about our current crisis. But there's a lot of commentary out there that makes it look like my experience is likely to be typical, and a change is probably not going to come quickly.