I see patients with similar symptoms almost every day. Here’s how it works in a physician-run and owned primary care practice.

You call the office with back pain radiating into your leg. You’re given an appointment that day. History and exam confirm a herniated disc, identify the level of the herniation, and assure that there is no emergency neurologic deficit. You start on oral steroids, adequate pain meds, and physical therapy that day, and are given a follow-up visit in one week.

“no health insurer in America seems to be bothered to create such a system–which is my point”

That’s not what health insurers do. That’s what a good family doc does. No pain doc, surgeon, or chiropractor needed.

Stewart you are right, although there didn’t appear to be any effective way to get me pain relief (which I did need) without going to the ER. And the issue is that MY incentives (in order to figure out what was going on which can only be done with an MRI) were absolutely for me to go to the ER. Especially when the alternative was 2-3 weeks of agony in bed not knowing.

There has to be a better way of guiding patients and providing diagnostics that don’t cost $10K. Apparently no health insurer in America seems to be bothered to create such a system–which is my point.

You’re correct but I doubt Kaiser would have let me get an MRI. I wanted one because I wanted to know what was going on with my back. My point is that there must be a better way than incenting me to spend $10k+ of somone else’s money to get me one.

I mean we could rely on me being a good citizen but THIS IS AMERICA!!!