Gastroenterology

Bodily invasion of the elderly

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Guest: Why few of us get to die peacefully at home | Opinion | The Seattle Times.

“Mr. Desonier, I think you can stop scheduling an annual colonoscopy from this point forward.  You’ve been very diligent about this aspect of your health care for many years, but at your age, I think this procedure provides inconvenience and discomfort that you can do without.”

My dad was 84-years old when his gastroenterologist made that declaration.  I never thought I’d say this, but that gastroenterologist is my hero.  My father had one suspicious colonoscopy a decade or so earlier, and was advised to undergo that test every year to be certain that no cancer was present.  If you’ve ever undergone this test – and you should have a baseline one after the age of 50 or earlier if you’re symptomatic – you’ll understand when I say that I’d rather have a root canal than have my colon flushed and probed every year.  Here’s TMI for you:  I’m 60 and had my first exam of that sort seven years ago and passed with flying colors.  I’m on the ten-year plan so I have a couple years left before I hop on that table again.  But I digress.

The above article will shock you to your senses as to how incentivized doctors are to keep prescribing outlandish medical procedures on their elderly patients.  Most, but not all, such procedures benefit medical professionals and facilities and provide no benefit to the patients that undergo such procedures.  Here’s a quote from the above article that is sickening in its implications:

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(Photo credit: Wikipedia)

Medicare spends a quarter of its $551 billion annual budget on medical treatment in the last year of life.  A third of Medicare patients undergo surgery or an intensive-care-unit stay in their final year (of life.)

The author’s 80-year old father had a “stroke-blasted” body and underwent the surgical procedure of having a pacemaker installed to correct a slow heartbeat that gave him no health problems.  Medicare paid $12,500 for that procedure.  Her father’s family doctor didn’t approve of the cardiologist’s decision to perform that surgery.  Medicare would have only paid that doctor $54 for a medical consultation with the family to weigh the pros and cons of such a procedure.

What’s the lesson here?  There needs to be a greater focus on slow medicine in the form of palliative care, rather than fast medicine that dictates quick consults and immediate – and oftentimes drastic – medical intervention that robs the elderly patient of living on his own terms, and dying when its the body’s time to do so.