After I posted my list of things that respectable "under 90s" should consider owning, Jack (a retired demographer/physician) sent me some additional suggestions that we should consider for living our lives more fully and for dealing with problems that arise as we age.
- I would add becoming familiar with driving license requirements and travel medical insurance restrictions, and attempting to work around these.
- The theme all ageing people eventually embrace is practicality. Fortunately, this is easier as one loses superficial ego.
- I am thinking that one of the most important items for the list would be finding appropriate medical care, and knowing how to work the medical system.
This is, unfortunately, also one of the most difficult to achieve because of the disinterest and even aversion, of most primary care physicians, to geriatric care. (Can’t fix ‘em, too many problems, too many forms to fill out, etc. etc.)
Ideally, we should all have a geriatrician looking after us. Rare birds, especially in Canada. Second best is an internal medicine specialist who does primary care – common in the USA but again rare in Canada.
Characteristics of a better physician would include interest in old people, internal medicine talent, availability for emergencies, and house calls. These folks do exist but will take a long time to search out (ratemds.com will help) and seduce into taking you on. Persistence pays in the latter situation, as they are always losing patients despite their good work, and need to take on more.
Folks living in small towns are screwed.
Assuming one is interested in being temporarily patched up when at the abyss, living in proximity to a good ambulance service and emergency department is a must.
This means residence in cities. Further, one has to be aware that calling the family doctor in a real emergency is of no avail. Most are not equipped or trained to deal with these, and if contacted will simply re-route you to the ER. Of course there is bad care in ER as well, as the recent case of the 90 year old woman in B.C. illustrates . But it’s your best chance.
Further re: characteristics of a primary care physician is the age issue: ideally you want one not as old as you as they will bow out before you do. But not so young that they have no real life experience either.
The gender issue gets less important as we age, as medical issues become more similar. But avoid women in childbearing years as they often bow out for extended time, and re-enter the workforce part time.
There is much that is worthy of consideration in what Jack writes.When Ms Eclectic and I moved to Clinton, a small town an hour north of London, Ontario, nearly 20 years ago, we made sure we selected a town with a hospital and a medical clinic. We always had very speedy service any time we went to the emergency entrance of the Clinton hospital; it was far quicker than we have received now that we are back in London. And we knew several of the physicians in town socially, which made our interactions a shade more pleasant than they might be for many people in larger cities. We never needed or wanted a house call, but we'd have been more likely to get one there than we could in the city.
In all these senses, we were not "screwed" at all. Yet it turns out that wasn't enough.
We also learned fairly quickly that the testing facilities and the specialist expertise available in London is far superior to that in Clinton (or in Stratford, Ontario, where the Clinton physicians sent people). Indeed that was, as Jack implied, one of several reasons we moved back to London.
And, fortunately, the wife of one of our friends in London is a highly rated family physician, and she was able to add us to her patient list.
Interestingly, after the original list was posted, our former family physician from Clinton, wrote, "Hobbies are good, too." He's right (or at least I hope he is, since I have so many!). One of my best friends, the late BenS appeared to have no hobbies, but he most certainly did: he loved meeting people, talking with them, pulling their leg if they hinted at being the least bit pretentious; and he spent hours on the internet, reading and forwarding items to the rest of us in "the quartet".