The Muffler Shop of Medicine

The little 5-year old was sick with fever. From his safe, warm bed he could see out the ice covered window overlooking his backyard. The garage roof was smothered with yesterday’s snow. Drips of it hung frozen like slaughterhouse meat from the drainpipe. It was bitter cold outside, and the little 5-year-old boy shivered at these sights, with his fiery forehead and runny nose.

The doorbell rang around 4 PM. Moments later, a scarf still dangling from his neck, Dr. Alicandri brushed into the bedroom. The once scared little boy now felt safe; secure in the fact that his doctor (the man mommy said pulled him out of her tummy) would defeat the sickness holding him prisoner.

The year of that incident was 1955. I was the little feverish boy, and my hero, Dr. Alicandri, did “housecall” our apartment and help make me better. You see, in those days doctors all made housecalls, just like the postman they went “through rain and snow…”.

Things are significantly different in this modern “hi tech age”. Not better, just different.

Yes, I know there are many doctors nowadays who do care. Sadly, methinks they are the minority. Today’s MD is usually a businessperson first, a caring practitioner second. Why?

Let’s look at things from the MD’s perspective first. Those who have no wealthy family usually are “loaned up” to the tune of $100-$150 grand before they even get to hang their shingle. They then are required to pay high malpractice premiums. This is after having to work as an intern in some hospital for “chump change”.

So, the system is already predicated on the MD needing intensive and quick “payback” after the shingle gets nailed on the post.

And what a “monster” this economic system has created. We have many doctors who are more concerned about the bottom line than they are their patients.

Investments in “limited partnerships” consume many of these practitioners, not the ills of the waiting room. They regularly overbook appointments as a standard procedure, and spend less and less time with each patient. A nurse or “physician’s assistant” does much of the doctoring, as the MD “pops in” for a few minutes to wrap up an examination.

Playing the insurance game, many MD’s choose procedures that are neither relevant or necessary, due to the lower and lower repayments the insurers pay on the necessary ones. It becomes a game that we, the “yo-yo” are bounced around in. Does this have to be the way it is?

Currently, I suffer from stress related anxiety aka “panic attacks”. Recently I was having a treatment for stress by my Chinese acupuncturist. I told him how the night before, at 1:30 am, I woke up with a terrible stomach ache and anxiety attack. Without a thought he asked “why didn’t you call me?” I said that it was too late at night to bother him. He quickly answered “you are my patient and my friend- never too late for you to call”.

Months ago, I visited my chiropractor. I related how I had badly injured my groin muscle playing racquetball two days earlier. I told him that I was in so much pain, and had some internal bleeding causing skin discoloration down the leg. He just sighed and said ” you have my cell phone #. Anytime you are in that much pain you call me, any hour of the day or night. I mean it.” Flashbacks of Dr. Alicandri.

In 1978, when medicine had already become the business it now is, I severely injured my right shoulder playing football. While in the emergency room, the orthopedist came to see me. He looked at my X-rays and offered ” I can fit you in for the surgery on Friday morning.” Like a haircutter, or a manicurist, he could “fit me in” for major surgery!

The solution? Well, we cannot legislate or teach people to be more caring when it comes to health. What we as a society can do is simplify things a bit. We can have “universal medicare” for all. Those that earn would contribute as they do now to Social Security. We would pay the doctors a fairer fee structure, with less paperwork. On the other hand, the penalties for fraud would be very severe.

As far as the “$150k shingle”, the government would subsidize medical schooling costs, in return for participation in the system. On top of that the government could help with malpractice premiums, and continue to do so for as long as the doctor was free of legal judgments. Adding the “one insurance form fits all” into the mix would substantially cut down on overhead costs as well.

Can we go back to the days of the housecalls, the “call me anytime” and the time well spent with each patient? Honestly, probably never. But. I say “but” because perhaps if the MD starts out debt free, has less insurance hassles, perhaps…..

The nap he took awoke the little boy refreshed. Must’ve been the medicine the doctor had the drugstore deliver. Really knocked him out. He felt his forehead. Not as hot. He looked out the window. It was nighttime now. He could barely see the snowy roof. He was hungry. He called out to his mommy. Minutes later she came in carrying a bowl of his favorite soup; chicken rice, with saltine crackers. As he slurped it up, his mommy remarked about the time. It was 6:30. “Daddy should be home any minute,” she said. “I wonder when Dr. Alicandri will get home tonight–said he had three more calls to make. Hope he drives carefully. It’s a mess out there”.

It certainly is!

Philip Farruggio, son of a longshoreman, is “Blue Collar Brooklyn” born, raised and educated (Brooklyn College, Class of ’74). A former progressive talk show host, Philip runs a mfg. rep. business and writes for many publications. He lives in Port Orange, FL. You can contact Mr. Farruggio at e-mail: brooklynphilly@aol.com


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Philip Farruggio, son of a longshoreman, is “Blue Collar Brooklyn” born, raised and educated (Brooklyn College, Class of ’74). A former progressive talk show host, Philip runs a mfg. rep. business and writes for many publications. He lives in Port Orange, FL. You can contact Mr. Farruggio at e-mail: brooklynphilly@aol.com.

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