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Ask Dr. Gott 9/8

How they do things in France

    DEAR DR. GOTT: I visit France every so often since my son and his family have lived there for over 10 years. I noticed some things about medical care in France. First of all, when my daughter-in-law calls her children's pediatrician (a first class one, I may add), he answers the phone and gives her advice. He doesn't have a nurse or secretary do it.
    Another thing: The medicines are given with a suppository (even for adults), which surprised even their mother, since she lived a good part of her life in England, and they don't do it there. She said in France they believe the medicine enters the body more quickly via this method. Can this be true? If so, why don't we do it here, and why don't most doctors recommend it?
    They also said doctors in Europe don't make nearly as much as they do in the states, which I understand since it is more socialistic and they have very high taxes. Malpractice insurance is out of control here and caused my gynecologist to stop delivering babies. A lot of young, very talented doctors have done this, which is very sad. In France, they say, if the doctor made a mistake (like cutting off the wrong leg) and it was his fault, he would lose his license to practice medicine and the victim would be compensated for a reasonable amount, but the lawyer would not make a pile of money. This makes perfect sense to me, since the victim is the one who should get the money. I am sure doctors and hospitals just pass off this high cost of insurance to all of us. In France, if you want to have better care, you pay the additional cost out of pocket.
    DEAR READER: With the U.S. health care system in crisis, many authorities are in the process of examining the means by which foreign health care workers deal with issues in their own countries. No system is perfect. However, if we can learn something from abroad, so much the better. I am not familiar with how the French approach health issues, so I am publishing your letter for general interest.
    DEAR DR. GOTT: I have arthritis — not the common form. I have been diagnosed with PMR, RA, possibly Lupus and others. I have problems with my body temperature. I am either sweating and hot or cold and clammy. My clothes and bed sheets stay wet as well as my hair. It's very uncomfortable. I am 84 years old and had an active normal life until my arthritis. Is this fluctuating body temperature normal?
    DEAR READER: You have been diagnosed with several disorders of your immune system, all of which involve inflammation. As with any inflammation, your ailments cause disruption of the vascular system, leading to night sweats and fluctuating body temperatures. This reaction is common but should be brought to your physician's attention so that he or she can give you appropriate treatment (such as steroids) to reduce inflammation and relieve you of your symptoms. Ask about this.

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