One of the challenges of any move is the process of establishing new relationships with health care providers. In our case, we had just begun to establish new relationships with doctors and physician’s assistants in Mount Vernon, where we lived for one year when we made the move up here, which has meant establishing some new relationships. It has been a bit complex. There are some doctors who are not accepting new patients and others who are so busy that scheduling an appointment means a wait of months before being seen. We have not been suffering in any way, but the process has been time-consuming. In general, I have the perception that medical practices in the area are under staffed. Wait times of more than half an hour to get a response to a phone call are not uncommon. Web pages are incomplete, not up to date and frustrating when they crash or fail to work for simple functions such as making an appointment.

The shortage of physicians in the United States is due in part to intentional practices of the American Medical Association which, in the name of maintaining high standards, has consistently worked to keep admissions at medical colleges and universities low. Many well-qualified students are denied admission because there is pressure on medical schools to keep the number of graduates low. Low supply and high demand translates to high prices in a capitalistic economy and the ever increasing gap in pay between physicians and other health care employees is dramatic. It is common for a medical practice to be struggling to find employees to work as receptionists and office workers at near-minimum wages while guaranteeing income for physicians in numbers approaching a million dollars per year.

Health care prices in our country far exceed those of other countries while health care results are worse than those of our neighbors. We are paying more and receiving less. It is not a good trend and it has resulted in a severe erosion of trust in the medical professions.

All of that translates to a struggle for us to find health care providers. Part of that process has been filling out a lot of forms. Despite the trend toward electronic medical records, our move has illustrated how poorly various medical providers are at communicating with each other. We have had to become the stewards of our medical records and personally responsible for getting information from one practice to another when it should be easy for one provider, with our permission, to transfer our medical records to another provider.

So last night I was once again filling out health history, medication and immunization information for an appointment with a doctor’s office that will occur in January. I am not ill and this is not an emergency visit. I simply need an annual check-up and want to have the prescriptions for the medicines I take come from a provider who has actually seen and examined me. Medicare pays for an annual wellness check, but moving twice in two years has resulted in the span between check-ups lengthening.

Providing information to be entered by hand in the computers of the new practice required me to fill out eight pages of forms. This was pen on paper work that could not be accomplished by a computer and it was all information that I have previously provided to other medical offices, but in order to receive care one does what needs to be done and I was filling out the forms. One of the forms asked for birth year, age at death, and cause of death of close family members. Filling out the form was an opportunity for me to remember my parents and siblings who have died. I miss them and always will. My father died before he met my son, but I know they would have enjoyed each other. If nothing else, the fact that they both have raised chickens would give them a topic for conversation. My father would have really enjoyed our grandchildren. He reveled in the children of my older siblings and he would have enjoyed being grandpa to more children.

One of the things I remember my father saying repeatedly to me and to my brothers and sisters is “A family is hard work, but it isn’t a job. You can’t resign from a family.” He stressed over and over the obligation to stay in relationship with each other even when disagreements entered our relationships. I’ve thought of him and his lessons about family unity often over the span of my career in which I have witnesses many family estrangements. I’ve watched siblings argue over inheritance and rifts between family members open up that never heal. I've witnessed the break-up of marriages. Sometimes relationships have been so abusive that estrangement is the best choice for those involved. Having made the best choice, however, doesn’t heal the pain and loss that come with the breakup of a family. Just as I have learned to live with the grief of the loss of family members who have died, some families have to learn to live with the grief of the loss of family members due to estrangement. Often I have not understood the dynamics of the families I have witnessed break up. There are a lot of things in this life that are real even though I don’t understand them.

It may be a little thing, but I am very grateful that recalling my family’s medical history brings a smile to my face and a longing for those who have gone before me. I’m grateful that I miss my mother and father and sisters and brother. It would be so much more painful to record the medical histories of those with whom I had suffered broken relationships. We certainly didn’t always agree, but we were always family and that has made a big difference in my life. It is a value that I hope we have taught to our children and I will strive to teach to our grandchildren as well.