Like all businesses, Health Maintenance Organizations, HMOs, find ways to maximize profits on their services. I wish I could spend less. What if I had a terrible cough for two weeks and couldn’t think of an alternative to the doctor?  This is what would happen:

I’d get up an hour earlier than my wife, go through traffic and wait half the day at the HMO clinic for my turn for the internist. Eventually he would be looking down my throat while I say, “Ah!” as he writes a prescription for antibiotics. He says, “By the way, you have a pimple on your cheek.” I know - I’ve been waiting for the spot to go away for days. The internist says, “You must see our dermatologist, don’t worry,” and scribbles a referral. Uh oh, a second doctor!

At the dermatologist’s office, she examines my face. She says, “It’s a pimple,” and writes out a prescription for a jar of ointment, its label has a sentence-long word spelled with all consonants. It’s her own concoction, and it can only be bought at her clinic. She writes in her pad and says, “You have to x-ray that.”

So I’m at the X ray room, red light shining above the door, as the technician presses my cheek against the plate in awkward positions while pressing buttons. “Don’t move!”  I don’t . . . *click*! Repeat five more times. Then the radiologist examines and analyzes the results, and writes his recommendation, “See orthopedic surgeon.”

I don’t want to, but I see the orthopedic surgeon, which is racking up my costs. He says, “I must examine the X rays for any chance of cheek bone or muscle trauma.” So he glances at it and says, “I have good news and bad news! You don’t need surgery on your cheek, but the strain on your cheek muscles - your smiling muscles, may lead to a more flawed appearance.” More? So he writes out a prescription for a muscle relaxant with side effects that prevent me from driving and operating machinery. Then he writes a referral to the physical therapist for care of my smile muscles, stat!

The physical therapist sticks wires on my cheek which sends electrical current through my face muscles and they twitch. So my face is trembling and quivering in horror, when the PT says I have to stretch my cheek bone muscles. So he attaches rubber cables to my cheeks and pulls and yanks, saying “One two, one two! Relax – we’re doing cheek-ups!” Then he tells me to go back to the internist for interpretation of my results.

The internist looks at all the results and says, “It’s a black head, with puss. You need proper nutrition.” I’m hungry but he sends me to a nutritionist!

The nutritionist gives me a list of foods to eat and avoid, “Follow this, it’s the ultra modern, high nutrition pimple diet!” I add it to my prescription collection, thank her, buy all the medicines, and head home.

My wife greets me at the door and says, “What did the doctor say?”

“He said I have to take antibiotics, but Honey, I also have . . .”

“Wait, you have a pimple,” and she reaches over and pops it. “You were saying?”

“I wish you got up earlier.”


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