Healthcare that's the cat's meow

(Robert Grossman Illustration for the Boston Globe)

I WAS THINKING about my geriatric cat, the 22-year-old with the unoriginal but apt name of Old Cat. I recently took her to the vet for a routine checkup, with a manicure and pedicure. Given her age and the condition of her remaining teeth, blood work was done. That afternoon her veterinarian left me a voice mail with her blood test results and follow-up instructions, plus when she would be in should I like to talk with her.

It struck me that it takes me two to three weeks to get my blood test results after an office visit with my primary care physician. They're always in writing. No one calls.

I got to thinking about my healthcare versus the Old Cat's again recently. I had a fairly routine one-day surgical procedure that included a biopsy at my local community hospital. In the preadmission testing, the nurse had asked if someone would be staying with me that night, and I said no, as I am a widow and live alone (with the exception of Old Cat and my younger cat).

One of my friends was enlisted to take me to the hospital at the crack of dawn, and then wait around to take me home later that morning. I was sent home with preprinted, generic written instructions, and a prescription for pain medication. In my general anesthesia-induced haze, I vaguely remember the surgeon telling me what she had found during the procedure.

Two days later I received a voice mail from the surgeon telling me the pathology results showed nothing to be worried about. Good news. Still, it made me think.

Six months ago the Old Cat had to have a surgical procedure to remove a tumor on her side. She, too, had general anesthesia. Before I brought her home later that day, with personalized care instructions, the vet had warned me to keep her diet light, that she would not be interested in eating, and would sleep all day (so what else is new) and be quiet. Instead, Old Cat walked into the house, hissed at the younger cat to stay away, ate from her food bowl, used her litter box, roared at me a bit, and went to sleep. She continued to be her normal self the next day, and never attempted to touch her stitches. The following day, a vet technician called to see how she was doing and to see if I needed anything. How nice; I told them she was fine and how much I appreciated their concern. She had her stitches removed two weeks later without missing a beat.

Now that my medical procedure is over, I wonder: The Old Cat got a follow-up call; I did not. Where is the "care" in my healthcare? I am fine, yet what if I weren't? How would my healthcare professionals know? Shouldn't the hospital have a policy (like the vet) to have someone call that evening or the next day?

I believe Old Cat gets better care because her veterinarian is paid by fee for service, while my care, which is provided by a wonderful and caring primary care physician, is paid for by managed care, which looks at how many patients are seen. I've often noted managed care takes the "care" out of healthcare.

One question has stayed with me, though: I was born in the midst of the baby boom. What is going to happen as I and my peers get older - who will care for us? I would be better off if I was my cat. Scary.

Mara Klein Collins works for Hebrew SeniorLife.