Diagnosis, Treatment, Follow Up — and Nothing Else
It's pretty amazing how the healthcare system in this country works. I fractured my fifth metatarsal on my left foot, which was confirmed on x-ray this past Wednesday during a visit to my insurer's orthopedic office. I saw a PA (physician's assistant), who explained what he saw on the x-ray and what he assessed while poking and prodding my foot. I never saw a doctor, although when I view my records online I saw that the doctor had signed off on the PA's work.
The instructions were to keep the walking boot on until my follow up appointment on October 12th, approximately 5 weeks from the injury, when they will do another x-ray to see if the fracture has healed.
There was no mention of best practice for walking in the boot (which is 1 - 2" taller than any shoe or sneaker I own, creating a dramatic hip imbalance with every step I take). There was no mention of ankle exercises I could do to maintain some level of mobility in my ankle once I come out of the boot. There was no mention of proper sleep hygiene and the important role it plays in healing. No discussion about diet. No mention of things to avoid like drugs, smoking, and alcohol, all of which can dramatically impair the healing process.
There was no mention of anything other than: fracture —> boot —> follow up.
And I just wonder why we wonder why the health of our population is so poor. Because while a foot fracture is about as benign a diagnosis as it comes compared to other diagnosis doctors of all specialities give out on a daily basis, I know from experience that it is the same no matter what the diagnosis. Whether it's a fractured foot, cancer, or heart disease, the script is the same.
Diagnosis —> Medicine/Treatment —> Follow up.
And the huge disservice this does to our population frustrates the shit out of me. Because it doesn't have to be this way. It doesn't have to be that we are only focused on the narrow scope of whatever the "treatment" is, and that we can't consider additional lifestyle advice because it is out of the "scope" of the "treatment." Especially when poor lifestyle is very often a leading reason we end up in a clinic to begin with.
It is possible to do both, but we've chosen only one. And that choice, made by the people who run the healthcare systems, is one of the fundamental flaws that prevents people from ever truly getting better.