For many doctors, including Dr Da Vinci, the line between patients and friends is very blurred. People in her neighbourhood i.e her neighbours attend their local hospital therefore become her patients, sometimes patients become friends and all of her friends ask for her medical advice before going to see their doctors, so most of her friends are patients.
Dr Da Vinci has diagnosed her housemate with diabetic nephropathy when she saw his urine, after he forgot to flush the toilet one day. She also diagnosed him with sleep apnoea when she crept into his room whilst he was asleep to steal a razor to shave her legs.
Many members of Dr Da Vinci's family prefer to have their cosmetic surgical treatments done by her as well.
However, 99.9% of the people who ask Dr Da Vinci for ad hoc medical advice have nothing wrong with them. They are the worried well.
For example; take her beloved friend and valued mentor the Tech Guy (TG). TG is a tech entrepreneur approaching his 40's he has run several highly successful Tech enterprises and is continually brain-storming new ideas. His take on life, skills set, cultural awareness, openness and intellect make him a pleasure to be around.
However, he suffers from back pain. There are no red or yellow flags, he is in his forties and has spent a large part of his life in front of computers. Any doctor could tell him after examining him that it is highly likely this is mechanical back pain. Any doctor could tell him that most back pain is not due to any serious disease.
Mechanical back pain is pain originating from muscles, ligaments and small facet joints when they are strained. This can follow injury, poor posture or inactivity.Sometimes aches and pains can last for a long time, but that doesn’t mean it’s serious. It does usually settle eventually – even though it is frustrating that no one can predict exactly when.
Most people can get going quite quickly even when they still have some pain. Your back is designed for movement: it needs movement – a lot of movement. The sooner you get moving and doing your ordinary activities as normally as possible, the sooner you will feel better.The people who cope best with back pain are those who stay active and get on with life despite the pain.
Every doctor knows this. But because TG is in the top tax bracket it is lucrative to offer him unnecessary tests, for diagnoses that can be almost completely ruled out by a thorough history and clinical examination.
You see the actual cost of an ECG(Heart Trace) is about £1, but many private clinics charge over £100 for this test. So it makes doing tests profitable.
Therefore, because my friend TG was able to pay for his X-ray, CT and MRI, he got them. The doctor knew they were going to be normal, but he got them anyway, because it makes the practice money to do these tests.If you have pots of money and you demand a scan somebody somewhere in the world will do it for you. They really should weigh up the risks and the benefits on your behalf before embarking on loads of tests, but money talks.
Big Business has never succeeded in making a profit from the medical care of poor, sickly folk. If you are looking for profitability in health care you need to contrive to make the wealthy worried well even more worried and in the process milk as much money as you can out of them.
Mr TG's kitchen is lined with an array of various snake oil's to promote 'physical and mental well-being' you can find everything from the extract of Antartican polar bears liver to the exlir derived from the bill of a platypus, all promising 'increased concentration', 'improved circulation' or 'enhanced lymphatic drainage'.
Dr Da Vinci thinks that making her company a social enterprise: applying market-based strategies to achieve a social purpose, is an ideal model for providing healthcare solutions as it ensures that any profits gained are funnelled back into healthcare that benefits those i.e the elderly,the poor, the dying, that need it, the most as well as creating initiatives to improve the quality of medical education in the country.
So Mr TG dear, the doctors prescription is keep your back moving, 2 weeks of ibuprofen, perhaps some massage therapy, less desk work and NO more radiation!
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