Medical Care in Your Easy Chair

Edwards was the place to buy shoes.  For decades the store in downtown Harriman was the place to find men’s clothing and shoes for the entire family.

The staff seemingly never changed.  Bob was the salesman we always used, but there were the women who catered to the lady’s shoe sales and two other men who assisted with the sale of suits and fine hats, usually Stetson.  

They knew their clients when they walked in the door.  What they liked, what they had purchased, who their family was and any other gossip that small towns know but don’t put in the paper (with the exception of Rachel Goldston’s column in the Harriman Record which routinely listed birthdays, anniversaries, and who attended funerals and if “a good time was had by all.”)

It was personalized service.  

When the first Pic ‘N Pay store opened in the Big K shopping center, it was a puzzle to me when mom took us in.  Rows of shoes displayed with sizes listed.  No funny device to put your foot in to see what size I had grown to.  No help at all, really, until we wanted to pay.  

No one told us anything about the shoes, the manufacturer, and we certainly didn’t have to wait.  It was cold and impersonal, and either real or imagined, the shoes didn’t fit as well.  But it was cheaper.

Banking was the same.  We routinely had the same teller and used the same branch.  Then the Bank of Roane County opened an Automatic Teller Machine.  It was so unwelcome that it had to be put in a separate building in the parking lot.  

Grocery stores, too, went through this change.  The standard for the industry was a clerk who would reach for all the items behind the counter, total the purchase and collect the money.  Then Clarence Saunders’ Piggly Wiggly Stores in Memphis began a trend in 1916 that allowed customers to use self service.  

Then Sam Walton, Krogers, Food City, A&P, White Stores, and IGA all followed.  

Now we can order anything from toothpaste to televisions with our phones from anywhere.  

Yet medicine, the old fashioned fill out a blue million forms sit and wait in the lobby to enter an exam room medical care, really hasn’t changed that much.  

Medicine is basically simple.  A person has a problem, symptom or worry, wants to know if it is serious or minor, and needs to know how to remedy it either on their own, with a medicine that has risks but may be beneficial, or if a specialist’s care will be needed.

It is the figuring out of what the problem is, how to test for it, how to interpret it, and what to do with that information and where to go next that is the complex task requiring years of training.  

Or, maybe not.  

A new device from the Imperial College of Medicine and DNA electronics has been developed that plugs into the USB port on a computer and will test one drop of blood for the presence of the HIV virus. The small device creates an electronic signal which is interpreted by the computer with a greater than 90% accuracy.  

This is momentous.  We are accustomed to following blood glucose levels and home and this has enabled many individuals to have a very active role in controlling their diabetes, but to actually test for the presence of a virus at home?  

This is similar to walking into that first Piggly Wiggly in Memphis.  

Imagine being able to check to see if symptoms are the flu, common cold, or strep at home.  Or to check cholesterol levels at home along with red and white blood cells.  Or maybe thyroid levels.  Or liver and renal function.  That, along with Dr. Google, has an exciting potential that will inevitably occur.  

All this information would be transmitted to either the local medical office, or to the Big Health Care Insurance Company (Big HIC).  Need a personal interaction with “health care provider”? The real time video consult for the test results can occur with “Nurse Sally” or “Doctor Ed” can be accessed from the “trusted professional group” of Big HIC’s Health Care Team.  

Digital doctoring is already occurring as many have learned through their employers for sore throats, cough and sinus issues. That form of blind doctoring across state lines has a lot of risks, yet the convenience and price is appealing.  Some is good and some is bad.  The question is, how do you know who you are trusting?

The ability to actually obtain blood tests at home is a completely new threshold.  This, along with collected weight, blood pressure, sleep patterns, memory testing, gait analysis and oxygen levels can all be gathered and transmitted to either the local physician who has adapted and can manage the care over the computer or to the Big HIC who will assign a health care provider (of some level of training) to the patient randomly.  

Whether or not the local physicians adapt to the new digital age is the question.  Big HIC will, and will quickly.  Otherwise the local physician’s office will be the dark shell of a building like Edwards was when I drove past it last month.  Full of memories, but empty of any current relevance.  

Eric J. Littleton, M.D. (@DrEricLittleton) is a musician and Family Physician in Sevierville, TN.  Topics covered are general in nature and should not be used to change medical treatments and/or plans without first discussing with your physician. Send questions to askdrlittleton@gmail.com