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以下是网友jennyxy在美国看病的亲身经历：

因为最近身体不太舒服，就去医院看病（我在加州）。我买的保险是先到家庭医生（据我的体会有点象我们国内的分诊台）那，再由其refer到专科医生。总的感觉是-----美国看病太不方便（除非生死攸关的急诊）！即使你有医保！
挂号，生化检查，物理检查什么都要预约！这样一来，普通的病可能的花上至少半个月！
举个例子来说，我要求我的家庭医生给我做一个“annual check”。因为初来乍到不熟悉美国的医疗体制，好家伙！从挂号（今年10月下旬）到验血到体检，总历时三个月！我的体检竟然预约安排到了06 年2月！说句不好听的话，要真有什么临床前期的，或是cancer早期的，岂不是就这样耽误了？
而最让我觉得费解的是美国的annual check包含的项目远没有我们国家的周全！下面的表是我打印给我的家庭医生看的，因为想弄明白为什么这里的annual check项目那么少！后面方框里是这边不包含的常规体检）
Annual Health Examination（CHINA）
Usually includes
BLOOD WORK：
BLOOD REGULAR TEST
BLOOD SUGAR
BLOOD LIPID TEST
LIVER FUNCTION TEST
KIDNEY FUNCTION TEST
HBsAg TEST （美国Annual Health Examination没有）
AFP (alpha-fetoprotein) TEST（美国Annual Health Examination没有）
CEA (carcino-embryonic antigen) TEST（美国Annual Health Examination没有）
URINE REGULAR TEST（美国Annual Health Examination没有）
PHYSICAL EXAMINATION：
ECG（美国Annual Health Examination没有）
B-TYPE ULTRASONOGRAPHY（美国Annual Health Examination没有）
Liver, Cholecyst, Pancreas, Spleen, Kidney (general)
Uterus , Ovaries (For Female Special)
Thoracic X-ray（美国Annual Health Examination没有）
Physical Check-up：例如眼科医生看眼底（美国Annual Health Examination没有）
FOR WOMEN SPECIAL：
Gynecologic Examination
Leucorrhea Test， PAP
Cervical Scraping Smear

然后，我的医生回答如下：
1．  〉HBsAg TEST，AFP ，CEA 完全没必要
2．  〉ECG----------心脏病患者及有症状的才考虑做
3．  〉B-TYPE ULTRASONOGRAPHY和Thoracic X-ray也是有症状的才考虑做
4．  〉Physical Check-up 专科体格检查要做就要各个专科分别预约！！

我的亲身体会告诉我，美国号称医疗体制完善，怎么连我们国家的一般都比不上？
据我所知，仅就年检来说，我国至少市级以上医院都可提供我上面列出所有的项目！三甲医院更是将这些项目列为常规体检。号称医疗体制完善的美国，竟然是如此境况，实在让我觉得费解和不屑。如果美国50 多个州都是这种情况，那我可以下结论：美国的整个医疗系统是以治疗为主，而非预防！相比之下，我国的体检更注重预防！至少这个方面远比美国做得好！

我想究其原因，无非是美国的医疗保险公司想要尽量节省医疗费用的支出。但如果是这样，那美国的医疗体制实在是存在太大的弊端。仅就年检来说，预防做得薄弱，反而把更多的经费花到治疗上（尤其费时费财的顽症，cancer等等上了）。

 
我是怀着复杂的心情写完这些文字，同时我不由得为我们国家的医疗（当然也有弊端）至少我今天提到的这一点感到深深的自豪和欣慰！

网友lovexuexi的评论：

这正是美国的高明之处啊，例行体检多为自我感觉身体无异常的（有异常也不会等到例行体检再去做检查了），美国这样做是符合经济规律的，做这些对正常人来说没有必要的检查肯定会花很多钱，全部做了也逮不到几个阳性的，还不如把这个钱省下来不做这些检查，就算有阳性的发展到就诊的程度治疗也花不了多少钱，但是如果对正常人都检查就会浪费很多钱。一级预防应该是考饮食、运动、生活行为方式的改善吧，不是完全靠检查。

在中国就不同了，宁可枉杀一千也不能放掉一个，国家出这个钱也不错，算是资源再分配，搞点钱流动到医院了；医院也不觉得医疗资源浪费，反正仪器闲着也是闲着（国内医疗资源配置应该了解吧，闲着的多），不如赚钱喽，君不见各大医院都在建体检中心而且还是豪华型的，医院肯定是能赚到钱的；如果这钱自己出估计老百姓什么都不做，谁愿意花那个闲钱，没见到老百姓都是到病痛折磨的不能再捱了才到医院吗？
中国为什么查这么多？肯定有经济利益在里头了，不过好像不如美国的那样更符合经济规律。国内的例行体检好像变成有钱有权人的特权了。

网友xatrixer的评论：

Hi All:

LoveXueXi’s analysis isn’t unreasonable. “Economics”, “Business”, “Profit” and “Incentives” are the Guiding Principles for running any kind of enterprises, including Health Care “Industry” in the US.

Frankly, I had similar experiences before like yours now, I have gained a lot of more experiences in dealing with such matters over the years, and , still, I am always reluctant to seek “professional help” when some “minor ailing” disrupting my daily, because IT IS a PAIN on the butt to get “help” anyway!

Now, there may be another “factor” contributed to your frustration. It is that you are a medical professional; you know what should, or could be done, and may be you had done that before at the time as you were in China for your patients. And now you are in the US, a country you have thought to be a much better place for many things, what you have “imagined, or expected” is completely different. You have been treated as a patient. Yes, a regular, an average patient who just likes everyone else walking down the street and asking for “medical attention”. This dramatic change could cause a negative response, if not “anti”, to the reality you are facing now.

What to do? Is there any way to get out of this moody situation? Yes, there are things you can do to balance off the unbalanced.

First, be positive and know who you are. When you’re seeking medical help, you are a patient, even though you have been formally trained as a medical doctor yourself.

Second, your (medical) needs will be met as long as you know how the system works.

In the US, health care “industry” is mainly made of three components --- Medical Professionals, Patients and (medical) Insurance Co. There are very “complicated schemes or deals” going on between the “professionals and Insurance Co”, but those are far beyond what we can reach. Those “schemes” are business “decisions” ultimately affect all the “clients” (patients) the “Industry” serves.

On the other hand, as a patient, you have a choice in picking up a health insurance coverage plan when you are employed. Different plans labeled with different “available services” at “different prices” --- meaning money does “talk”. Most of young, average employees are more likely picking up a plan based on their “financial status”, which may directly influence the availability of medical services. Such as the situation you mentioned that --- “everything has to go through your primary care physician (PCP) first”. There are other plans that allow patients to see any specialty care at patients’ choice with or without simple prior notification to their PCP. What is the "trade off" for such "high abalibality services"? High Premium (cost). That’s it and that’s ALL.

Is there anyway to get a better service than what I have now, even I have a low cost coverage? Yes, you bet!

There are things you can do to make things better. Here is one of the “trick” you can excise to eliminate multiple “scheduling and trips” for different “routine or diagnostic tests”. Next time when you are asked for renew your health insurance coverage; think about choosing a different PCP for you or your family. What to look for when picking a PCP? Please don’t choose a doctor who is running a small clinic independently, or several small offices in town. Picking a doctor belongs to a relative “bigger” medical practice group which encompassing different medical specialties in a larger facility. In this situation, the group will have more capital (money) to put into the facility (equipments and tests) and make it a more diversified medical service “center”, while still keeps its “Primary Care” identity in the communities. PCP can order a battery of routine tests for patients, such x-ray, “sampling” of blood, urine, even small biopsies, etc. under the “one single roof” without sending patients running around the town to visit different medical offices.

Health care is a “big thing” in the US … It has been a “never-die” hot issue among politicians, business groups, health care professionals, and average ones like you and me. There is nothing should be labeled as “the best”, but the care you can have will be “the best” for what you can afford and what you have knowingly worked though.

Aright, that’s all for now. Let us know what else you have being concerned. “Consultation" via DXY is always available, free of charge, isn’t it?