I took a lot of seniors to and from their health care appointments when I was taxi driving. After a while I started to try to get them to chuckle about their pr

I took a lot of seniors to and from their health care appointments when I was taxi driving. After a while I started to try to get them to chuckle about their predicament of being tossed from specialist to specialist. The system I observed made no effort to put people's health problems into context. Last year I went on a few doctors visits with two seniors. The one lady to her visit with the substitute PA. All she got was a referral to an endocrinologist, which went nowhere, as there is no endocrinologist in our rural community. The next visit was to the practice's new MD. After a few minutes of watching the doctor's efforts to pull something meaningful out of the woman's EHR, I informed the doctor that the woman had gotten 'sad' after her partner died about a year before (stopped eating well, etc). The whole visit changed - the MD was able to acknowledge the person in front of him. Then he went back to thinking about a drug to treat the woman's complaint about anxiety, when it was perfectly obvious to me that exhaustion was her actual problem. At least he didn't put her on benzodiazepines. The other senior's appointment was a surgery consult. The doctor considered the X-rays, said "this is exactly why you're hurting" and "surgery is the only way you'll have any quality of life". Perfectly reasonable, from his limited perspective. At the end the surgeon asked the patient if he had any other health problems. "No." I knew better, but didn't say anything. Prasad's law [0] describes the how our health care system is incentivized to provide expensive medicine instead of interventions patients actually need. I've been thinking about 'the predicaments of old people' for 10 years, since one of passenger delivered a lesson to me about his neighbors. The essence of seniors' predicaments is that they can't be honest with their doctors because they'll be shamed, and their doctors wouldn't know how to help them anyways. [0] "Which Interventions Can Be Paid For: The Explanatory Power of “Prasad’s Law”" - https://news.ycombinator.com/item?id=21728864 https://news.ycombinator.com/item?id=21728864