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03 Oct

Health Care for the Elderly…An Oxymoron

mestepanich Mary Ellen Stepanich, PhD 1 0

Yesterday, I had a most unusual experience––a doctor told me the truth. Let me give you some background…

As I have aged, I’ve noticed more and more moles all over my body. Doctors have examined them and assured me they’re not pre-cancerous, just something I’ve inherited from my German ancestors. All of my family has moles. I also recently heard that people who grew up in the Ohio River Valley have moles. I grew up just 18 miles from the Ohio River, so I guess I come by the ugly things naturally.

Recently, I asked my primary-care physician at my Medicare Advantage Plan clinic to recommend a dermatologist in our HMO system, one who would remove my moles. While I was waiting to see the specialist, his nurse put me in a short paper gown, which the doctor proceeded to rip off me, then pull down my trousers and examine every inch of my body without so much as a “by your leave.”

He then washed his hands, turned to me and said. “They’re not pre-cancerous.”

“That’s good. Now, what can I do about them?”

“Nothing. All old people have moles.”

That didn’t exactly thrill me, because I don’t consider myself to be an “old people.” There was a tone of desperation in my voice as I responded, “But the ones on my face are so big and ugly. Can’t you take them off?”

He replied with a shrug. “They’ll just grow back.”

“Well, at least they’ll be gone for a while!”

But the doctor didn’t respond. He gave me a prescription for some expensive and foul-smelling lotion, and left me, sitting in my shredded paper gown, skin red with embarrassment.

I went back to my primary care physician, told her of the encounter, and begged her to send me to a different dermatologist in the system. This time, the doctor was young––so young he was still taking exams to qualify for a specialization. I told him of my previous dermatology experience. I was surprised by his response––he was so refreshingly honest.

“About five years ago,” he said, “insurance companies stopped paying for the removal of moles that were not cancerous. It’s considered to be elective cosmetic surgery, and no longer covered.”

“But these moles are hazardous to my health––at least to my mental health.”

He assured me he could help me and would remove the moles, but I would have to pay for the procedure myself.

“How much?” I asked, almost holding my breath as I waited for the answer.

“Oh, I think I could remove all those on your face for about…four…um..,or five…,” he hesitated.

“Five thousand dollars?!” My voice raised a few decibels.

“No!” He laughed. “Five hundred dollars.”

I was so relieved that he didn’t say “thousand” that I immediately came back with, “Oh, I can do that!”

In the weeks since our visit, he has “zapped” my moles with something that resembles a WD-40 can. (I think it’s really liquid nitrogen.) He charged me half what he predicted because, as he put it, “I’m not that concerned about making money, I just want to help you feel better about yourself.”

I’m left with mixed feelings, both anger and gratitude. I’m angry at a system that treats older people as though they have no right to any feelings of pride, that they are just so much excess baggage in the health care system. But I’m grateful whenever I meet someone in the system who is honest, who will tell a person what is possible, rather than what is NOT possible, and who will treat a 75-year-old woman as though she has a right to want to look the best she can.

I’m grateful to this young doctor for helping me, and keeping the costs down as he did so. However, I now look like an English “spotted dick” dessert, or someone with a rare case of “black measles.” So, check with me in a week or so. Maybe I’ll look normal.


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