Today we received a letter from this pain management clinic indicating that we have an appointment, but they will not be prescribing any pain relievers for at least a month and that we should see.. you guessed it.. our doctor for a refill.

One hand doesn’t know what the other is doing and I’m stuck in the middle.

I remember when docs made housecalls.
I remember when you could call and speak to a doc directly.
I remember when returning a phone message or refilling a prescription was no problem.
I remember when they asked “cash or insurance?” at the front desk.
I remember when saying you’d pay cash meant a better attitude from a staff, not as if you’re homeless.
I remember when the staffs gave you your own medical info and test results.
I remember when the docs knew their own rates, what their staffs say and other reasonable expectations.

After about 5 docs, I can assure you none of these things are done here.
My wife is convinced these are the reincarnated ghosts of Buchenwald guards. 😉

But this is what happens when you take three popular career disciplines- law, medical and business management and group them together.
Rules and laws can then be ignored as standard operating procedure in that the expected law suits cost less than implementing policy changes.

In other words, it’s built into the managerial framework to deliberately break laws and rules because they’re rarely prosecuted or they’re protected from claims.
I haven’t seen a doc or dentist in the past 10 years that doesn’t make you sign your rights away at your first form filling session.
It’s business as usual to deny all claims and grievances upfront or state arbitration-only contests should there arise a problem.
The ones that make it through to courts are almost always wrongful deaths and other major screw ups where good lawyers can use a sympathetic jury to win huge awards and then even those are paid by a doc’s insurance.
So there’s no incentive to treat people for problems.
They’re there for money. Period.
It’s a natural progression when business, law and medicine have so many patients available.
If they do their jobs right, they get paid high sums from insurance companies.
If they do their jobs wrong, there’s little or no penalty and any suits are paid by insurance companies.
From the top managers to the bottom of the office staff, this is how medicine is practiced today.
With me having no insurance, there’s no one to bill and no one to sue.
No incentive to even see me.

For those folks that say “Go to an emergency room. They have to treat you.”
No. You’re wrong.
They don’t have to treat me.
The emergency room is for life-threatening medical condtions.
Spinal stenosis is extremely painful and delibitating[sic], but it unto itself is not directly life-threatening.
If one is suicidal, that’s an emergency, but this is treated very differently from the underlying problem.
Rarely is there any help at all for the underlying conditions that cause suicides.
An emergency room will not perform the surgery I need either.
The normal price in the US for this is $60K to over $100K.
One will not obtain such treatment at an emergency room.

So for all the people that gawk over what a nice Minimoog I can produce, please understand there’s another side of the coin to work like that.
Namely, very little profit and little wiggle room to charge clients more.
There may be guitar luthiers who can charge $30K to fix up a late 50’s Les Paul, but few are willing to spend several thousand restoring a synth.
If you read synth blogs today, you’ll see all sorts of complaints regarding prices of synths offered today, yet they’re priced much lower than decades ago and provide more capabilities.

Many of the vintage instruments I work on cost a fortune when they came out new, but today people are considered crazy to spend the same amount even though they’re getting so much more.
It’s rare to see a synth cost more than $5K today. In the 70’s, not so much.

And yet back then, making $35K a year was considered good.
Today you couldn’t raise a family on $35K / yr.