Managed Care, a good thing?

My postings today are cranky. This is mostly from my recent experiences with managed care and because my foot hurts quite a lot. Back to managed care. I wonder what the hell does , "managed care" mean? They certainly do not manage my care well. I believe it should be labeled mismanaged care.

You see, twice in the past year, when I go to the doctor for a cold that has lasted 3 weeks with 1 week of laryngitis (I have to sing for a living so that is not a good thing at all), they tell me, "It is a virus; you need to rest." I know that; this does not help me! Peaches went in a few months ago with what turned out to be a sinus infection complicated by cellulitis in her nose (!!!) and was told it is a virus, to rest, and drink turnip soup. Now let me clarify one thing, this advise was from a MD doctor in a reputable clinic associated with Massachusetts General Hospital, a very good hospital. Peaches got a second opinion and was accurately diagnosed and given antibiotics, not soup recipes.

3 or 4 weeks ago, the joint between my second toe and my foot started hurting. I thought it was nothing and it would go away. I then thought I just have pulled something and it will go away. It did not. Finally, I called my doctor's office to get an appointment Friday. They had terrible times so I tried to get a referral so I could go to urgent care in the evening. The referral lady said it would take 4-5 days to do the referral. What use is a referral system if you cannot use it in a timely manner? So I decided to call again on Monday.

Monday, I called and went across town and I saw a doctor for less than 5 minutes. She sent me to get an x-ray, which was back across the street from my work. So I took the T back and limped over there. Tuesday morning, I got a call from the doctor, saying I have a stress fracture in my foot and that they would be setting up an appointment with an orthopedist. I call at 1 to check on the referral and the referral lady hadn't even started working on it. At 4 pm, the referral lady calls to tels me my appointment is Friday. Now, I am kind of freaked out because it is a broken bone and I have never had one. So I ask to chat with the doctor's nurse about how to care for a stress fracture. The nurse emails the doctor my questions. The doctor calls me back and sounds perturbed as she tells me to wear good shoes, don't run, and that I should be fine until Friday.

This evening, I have learned that there is not a lot one can do for stress fractures. Mostly RICE (rest, ice, compression, elevation) and wear good shoes. I am ok with that, although it is much like the virus thing which irritates the hell out of me. But hey, I can deal. I just want to know that if it is not a big deal and if I just have to avoid running (like I do it much more than running to catch my train), then why do I have to go to the orthopedist, use up my PTO, pay the co-pay, possibly miss part of a special training on Friday, just to hear "rest, no running, wear good shoes" again. Am I asking too much of the medical system to want to have patient education by doctors or nurses, good customer service, and quality interactions with no mention of turnips?