Coyote Blog

A while back I wrote about how hard it was to get in to see an ENT here in Phoenix.  I finally got my ear infection diagnosed by one of those local walk-in emergency clinics that are popping up in malls.  They prescribed antibiotic pills and drops, which I took diligently for 10 days.

My ear stopped hurting, but the hearing did not clear up.  Eventually, it started hurting again and my hearing was really blocked.  Fortunately I had held onto my appointment I made weeks ago with an ENT, and went in yesterday.  Apparently, I had an enormous fungal infestation.  The bacteria competes with the fungus normally and keeps it in check.  Once the bacteria were temporarily wiped out, the ecosystem in my ear canal was out of whack and the fungus went crazy.

The doctor vacuumed out an absolutely disgustingly large chunk of, uh, gross stuff from my ear and it was immediately better.  He put some topical cream on it, and it feels great this morning and my hearing is back.

Update:  I am not trying to make any point about the health care system.  I got perfectly good service from both doctors, though I was frustrated it took so long to see an ENT.  I find the whole microscopic ecosystem on and in our bodies fascinating, so I overshared on this experience.  I saw something the other day about twins, one of whom was fatter and one of whom was thinner, with the differences attributed to differences in the bacteria in their gut.

A couple of weeks ago, I started losing hearing in one ear.  A bit later, it started to hurt.  Suspecting an infection, I called my ENT's office.  They said they couldn't see me for four weeks, and would not let me switch to see anyone else in their 10-person practice (against their practice rules, which raises the question of, from a customer point of view, why there is any benefit to a large practice at all -- the large pool of doctors provides the illusion of more customer service capability but in fact the sole logic of the practice is cost-sharing of overhead and support staff).  So eventually I just went to one of those walk-in urgent care clinics in a strip mall near me and had the GP there look at it.  I found that I did in fact have an infection and got an antibiotic scrip and some drops and was told if it did not get better in 7 days, go see a specialist.

So it has been a week and the pain is mostly gone but I still have lost most of my hearing in the ear.  So I tried to make an appointment at my ENT again -- 4 weeks.  I described my situation, and said something seemed wrong.  4 weeks.

So I talked to two friends who are both semi-retired ENT's.  They said to get my butt to a doctor ASAP because it could be nothing or it could be something really bad that needs immediate intervention.  But no ENT would see me for weeks.  So one of my friends said they would help me, but they needed audiology tests.  Turns out, those are being scheduled 3 weeks out.  I finally called in a favor with a friend of a friend and found someone to test me next Monday, just four days from now.  Four days seems a long wait for something that could be an emergency, but it beats the hell out of 4 weeks.

This is what we have done to the practice of medicine.  With a myriad of professional licensing requirements and regulatory burdens that raise the fixed cost of opening a practice, we have managed to simultaneously raise prices while limiting supply.