We are reminded all the time that what we have in the U.S. is a “sick care” system.  That is because most health care resources are directed toward treating people once they get sick.  This is largely true even when you consider all the attention paid to preventing illness and disability.  There is, however, an aspect of health care that, although a crucial component, rarely receives any consideration, but one that will grow in importance now as health insurance coverage expands.  Let’s call it our “reassurance system”.  What it costs us no one has calculated.  Just what it’s worth you can decide.

Admittedly, most all of us adults worry in varying degrees about our health.  I’m not talking about hypochondriacs – they will always be with us.  I’m referring to people who are more aware and informed than ever before, who recognize that because lots of dangers lurk out there, they are vulnerable.  They understand, moreover, that our bodies normally warn us when something is amiss and that it’s wise not to ignore unusual symptoms, especially if they persist.  What that does, of course, is encourage people to be on the alert, to pay attention to whatever bodily irregularities they detect.

Still, most people experiencing physical discomfort will tend to shrug it off.  “It’s nothing”, they’ll tell you.  Persistent headaches or coughing, a sore throat that does not heal, periodic chest discomfort, recurrent fatigue, stool discoloration, blurred vision, weight loss, a growth on the skin, episodes of chills – these and other symptoms will likely be minimized or explained away.  But, typically, this outward absence of concern masks a growing anxiety.

Nevertheless, they’re too fearful to get themselves checked out by a doctor.  Maybe it will go away.  Or if it’s not formally diagnosed then it really7doesn’t exist.  Weeks, months can go by.  Meanwhile the symptoms persist, and apprehension increases.  These people are now worried sick; sure it’s cancer, heart disease, a brain tumor, a lung ailment, etc.  Others urge them to make a doctor’s appointment, but they discover reasons why it’s not convenient:  the holidays are upon us; they have an important project to complete; they’re going on vacation, the family is coming for a visit.  Anyway, the symptoms seem to have abated.

Finally, they’re out of excuses; the uncertainty and fear have become unbearable.  So they make that appointment and gird themselves for the expected bad news.  They’re examined, submit to a few tests, and then a day or two later hear the doctor declare that “There is nothing to worry about”, and explain the source of those troubling symptoms.

The months of worrying, the sense of impending doom – none of this need to have happened.  The torture was self-inflicted, but replaced now by an extraordinary feeling of relief, even euphoria.  They can go on with their lives!

So, credit our medical system, less for miracle cures, but for its daily doses of much-needed reassurance for millions of people.  Now, what’s that worth?

We are reminded all the time that what we have in the U.S. is a “sick care” system.  That is because most health care resources are directed toward treating people once they get sick.  This is largely true even when you consider all the attention paid to preventing illness and disability.  There is, however, one aspect of health care that, although a crucial component, rarely receives any consideration.  Let’s call it our “reassurance system”.  What it costs us no one has calculated.  Just what it’s worth I’ll let you decide.

Admittedly, most all of us adults worry in varying degrees about our health.  I’m not talking about hypochondriacs – they will always be with us.  I’m referring to people who are more aware and informed than ever before, who recognize that because lots of dangers lurk out there, they are vulnerable.  They understand, moreover, that our bodies normally warn us when something is amiss and that it’s wise not to ignore unusual symptoms, especially if they persist.  What that does, of course, is encourage people to be on the alert, to pay attention to whatever bodily irregularities they detect.

Still, most people experiencing physical discomfort will tend to shrug it off.  “It’s nothing”, they’ll tell you.  Persistent headaches or coughing, a sore throat that does not heal, periodic chest discomfort, recurrent fatigue, stool discoloration, blurred vision, weight loss, a growth on the skin, episodes of chills – these and other symptoms will likely be minimized or explained away.  But, typically, this outward absence of concern masks a growing anxiety.

Nevertheless, they’re too fearful to get themselves checked out by a doctor.  Maybe it will go away.  Or if it’s not formally diagnosed then it doesn’t exist.  Weeks, months can go by.  Meanwhile the symptoms persist, which makes them increasingly apprehensive.  By now they are worried sick; sure it’s cancer, heart disease, a brain tumor, a lung ailment, etc.  Others urge them to make a doctor’s appointment, but they discover reasons why it’s not convenient:  the holidays are upon us; they have an important project to complete; they’re going on vacation, the family is coming for a visit.  Anyway, the symptoms seem to have abated.

Finally, they’re out of excuses; the uncertainty and fear have become unbearable.  So they make that appointment and gird themselves for the expected bad news.  They’re examined, submit to a few tests, and then a day or two later hear the doctor declare that “There is nothing to worry about”, and explain the source of those troubling symptoms.

The months of worrying, the sense of impending doom – none of this need to have happened.  The torture was self-inflicted, but replaced now by an extraordinary feeling of relief, even euphoria.  They can go on with their lives!

So, credit our medical system, not with a miracle cure, but with daily doses of much-needed reassurance for millions of people.  Now, what’s that worth?

Have you ever wondered why so many plaques are hanging on physicians’ walls?  Enter a doctor’s private office, sit down, and you can’t miss them.  At least one wall is nearly hidden by an abundant collection of laminated hangings.  That a single individual has accumulated so much woodwork is striking.  Stranger still is the deliberate decision to put them on public display.  Upon closer inspection (since no doubt you’re being kept waiting) you notice that each proclaims individual accomplishment, whether academic achievement, clinical practice certification or a specialized skill or service citation.  Size offers few clues as to importance.  It is not readily apparent which are significant professionally, which honorific or those largely decorative.  But there’s no subtlety here:  the clear intention is to impress.

Why do doctors typically place their various credentials and awards on such prominent display?  Do clergymen do it?  Does your accountant or lawyer?  Do businessmen laminate impressive balance sheets from previous years?

Since you’re not likely to question your doctor’s choice of wall décor, let’s consider some possible explanations.  Even today it may be that doctors remember or have been reminded of bygone times when they were broadly mistrusted by the public, were considered largely ineffectual, attended medical schools of dubious reputation and were often regarded as charlatans.  Could this be an instance of an inherited inferiority complex?  Might mounting a display of credentials serve to reassure patients and allow them to distinguish between accomplished practitioners and dubious medicine men?  Exhibiting them may simply have become customary, doctors continuing the practice from one generation to the next.  They could not, moreover, be unmindful of the fact that doing this reinforced their authority, and served also to justify fees that might otherwise have appeared unduly inflated.

Patients often arrive at a doctor’s office feeling anxious and fearful.  What ails them they wonder?  How serious their symptoms?  Will the doctor be able to provide answers?  Trust and confidence is after all a critical component of the doctor-patient relationship.  Scanning the wall and sensing how well credentialed is their physician may just convince them that they’re in capable and experienced hands.