A Happy Healthy New Year; or, Cowboy Diplomacy in the Doctor's Office

by cowboylands

Medical tools from the Civil War

There is something to be said for a high-deductible health care plan: This year, thanks to a likely financial crunch in my chosen field, I will certainly be reviewing my health expenditures carefully. No more mammograms willy-nilly–squishing boobs for fun has gone the way of tinkering with stocks. No longer will I drop in on my dermatologist to have a chat, and then casually disrobe so he can check for moles and spots. That funny feeling in my stomach that comes and goes with the seasons? Not as important as sonograms for tracking cysts. I will have some choices to make this coming year, and as I am pro-choice, it kind of fits. 

Having a health insurance is a luxury, I am aware, and so I won’t bitch too much about having to cough up an unholy amount of money for the privilege of seeing doctors I respect and who know my internal organs. I’m one of the fortunate ones. The National Coalition on Health Care estimates that nearly 46 million Americans, or 18 percent of the population under the age of 65, were without health insurance in 2007. Lest anyone pull out the boogeyman of illegal aliens, note that according to the NCHC, 80 percent of the uninsured are natural or naturalized citizens. Also note (before someone trots out the laziness of Americans) that the increase in the number of uninsured in 2006 was focused among working age adults. 

So even being a hard worker can’t necessarily save one from facing crippling medical costs, as employment-based health insurance is going the way of the dinosaurs and the beluga whale. Both small businesses and part-timers can’t stretch their dollars enough to cover premiums, and thus we have a situation in which the best plan for many (those privileged with health insurance) is to pump up their deductible and crank down their expenditures. In the words of a once-upon-a-time candidate for the highest office of the land:

John McCain Believes The Key To Health Care Reform Is To Restore Control To The Patients Themselves. We want a system of health care in which everyone can afford and acquire the treatment and preventative care they need. Health care should be available to all and not limited by where you work or how much you make. Families should be in charge of their health care dollars and have more control over care. 

That would be me. And what has this to do with cowboys? I will be taking a page from our nearly invisible cowboy president in making sure that the quality and quantity of health care I receive is the best it can be. I plan on cowboying up every time I walk into the doctor’s office. 

I will:

♣ wear cowboy boots. As in Cowboy Fact #40–Even when you feel like shit, cowboy boots make you a little taller. 

♣ dress for success. That may not include a belt buckle the size of Texas, but it will include the kind of put-together look that comes with getting your way. The boots will help. But I will not, for example, be wearing this:

♣ speak softly and carry a big stick. I take that cue from Teddy Roosevelt and the Virginian. My stick won’t be a Colt Peacemaker but knowledge that will allow me to ask the right questions to the right doctors at the right time. In addition, a relative’s medical billing background will help crack codes; Internet searches will arm me with info (and hopefully not make me freak out); and a virtual and real-world support system of people (the interdependence that is the true Western ideal) will bring me community. And when the receptionist tells me I don’t have paperwork or the right attitude, I’ll reply, “If you want to call me that, smile.”

♣ get back on if I fall off. When I am confused about medication, procedures, a doctor’s advice, symptoms, prognosis, the bill, facility vs. non-facility, “medically necessary,” co-pays, co-insurance, premiums, excluded conditions, inpatient, outpatient, impatient, PPO, and EOB, I will have to remember that if I fall off this bucking bronco of health benefits I have to get right back on again. 


 Click here for more great pics from this photographer

Like a cowboy, I plan on being tough-minded and honest, polite yet fast on the draw. Unlike a cowboy, I hope not to get saddle sores and broken bones. I’ll have to wire together the truck and buddy up with a rodeo pal. Taking the cue from the cowboy, I will arm myself with self-assurance and confidence, elements of the cowboy can-do attitude. Lemme just call my relative in medical billing to crow about my plan….

Rats. Not to be a bummer but she said it’s tough to take control over your care when doctors have fifteen minutes average with each patient, a nonsensical arrangement that only makes sense when you consider that they often have to pay the staff and rent and insurance out of their fees. In her words, in that space of time, how can doctors possibly explain the diagnosis, possible procedures and tests, compare costs, and plan for the next step in enough detail for you to make a considered decision? 

Ride ’em, cowboy, ride. 


3 Comments to “A Happy Healthy New Year; or, Cowboy Diplomacy in the Doctor's Office”

  1. Real cowboy blogs and websites are rare as frog hair. I’m talking about the real ones, not the “I’m a rodeo bum so I must be a cowboy” ones. I’m talking about the ones where the cowboy rides off into the sunrise each morning, spending the day in the saddle, and hoping to make it home by dark. I’m talking the ones who live and work 100 miles from the nearest town. The ones who, when their horse is falling on them, cogitate about how their life would have been if Mama would have listened to Willy in mid fall.

    If this is the kind of cowboy you are looking for, visit http://cowboyreality.blogspot.com/

  2. Frog hair is rare indeed. You have a great site: as a poser cowboy I appreciated the long-overdue cowboy lingo post and the rough-and-tumble, hilarious post about chaps falling off. A common problem, I am sure.

  3. Actually that is the ONLY time I’ve had that happen in over thirty years of working as a cowboy/buckaroo. Of course I’ve had a lot of other mundane things I’ll be posting there as well….
    boB Kinford

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