You Actually Want To TALK To The Doctor?

Nearly a month ago I took one of my teenaged children to the best of the best doctors. We'd been trying to get a diagnosis for a few years regarding recurring abdominal pain. I was charged more than $1100 for the initial office visit. When I got the bill, I called to see if there was some mistake. There wasn't.

What surprised me next was that after informing me with palpable urgency that my daughter needed an endoscopy, we've been waiting for nearly four weeks post-procedure to hear back from the doctor.

I've called three times. Finally someone got back to me. "No, they had not lost the results," she assured me. But she didn't share them. "Had I called about something specific? A problem?" I felt like screaming, "THE TEST RESULTS!!!!." She would have the doctor call me. That was last week.

Two people I've shared this story with have said, "If there was something wrong, he'd call." But, that's not good enough. Why should it be?

Now, let me just say that if this doctor can help my child, that's the main thing. He's brilliant and seems pleasant. And I am grateful to be able to afford him -- this time. But these events sure made me yet again aware of how difficult it is going to be for President Obama and his team to figure out how to deliver quality healthcare to all Americans. Even when you're spending an outrageous amount and know your way around medical systems, you can't get some doctors to return your call. Oh, and did I mention that this facility is part of the president's alma mater, Harvard? Surely they can do better.

If my daughter were in significant pain right now, we would be camped outside the doctor's office. And that may yet happen as the pain often comes on without warning. But while I anticipate closure soon, one way or another, I thought I'd share this frustrating medical misadventure. They happen every day to thousands of people - many not knowing where to turn. It reminds us that cost is only one factor in the quest for quality health care, that patients may need to do with fewer options but on the delivery side there need to be some changes too, and in a small way - as real life stories do-- it exemplifies the monumental, multi-sided nature of the important task before us.

Prof. Reardon also blogs at bardscove-- (continuation of story posted there).

 

 

 

Follow Kathleen Reardon on Twitter: www.twitter.com/comebackskid

Comments

[lgillooly]

03:52 PM on 07/02/2009

Over 70 percent of Americans want a Public Health Option....What happened to a Government for, by and of the People....What a Joke! The only socialism now is for the Banks. Funny thing is the Republicans continue to try and prevent what the majority wants.

[TRex86]

10:03 AM on 06/27/2009

As a physician I find my colleague's behavior (and charges) quite unprofessional and recommend reporting him to the State medial board, the hospital where he practices, and the county medical association's fee committee. (CC to the doctor). You may not get any specific action from those agencies, but you will get his attention in a hurry. These blemishes on his record will sting.
No matter how smart and pleasant he might be the information that resides in is head and on his charts is worthless until transmitted to his patients. His arrogant indifference is inexcusable. If he does not immediately meet with you, apologize and thank you for your feedback you MUST demand a refund of his fee and take your business elsewhere. Super-smart jerks are a commonplace in medicine, an unfortunate consequence of the sadistic way that we physicians are socialized to our roles. I can only apologize for this all too common occurrence.

[SEQUOIABISON]

08:19 AM on 06/27/2009

Thanks for stating the obvious Kathleen.

From a very early age I grew up having a suspicious distrust for doctors, even to a child accustomed to being ignored, they seemed aloof, condescending and arrogant.

As a result of this "healthy" mistrust I decided to educate myself about how the body works and what is required to sustain a healthy body.

I have not been to a physician for over 30 years and consider myself very healthy, I live a simple Vegan lifestyle and never seem to have any serious physiological ailments and I have not taken any type of medication, even an aspirin for over a quarter of a century.

I think it is incumbent upon all of us to educate ourselves about nutrition and proper exercise if we are truly serious about maintaining a healthy body.

Trust your body to heal itself when it breaks down, you simply have to provide your body with a peaceful quiet setting to heal, and eliminate the causes of bad health, which are sometimes disputable.

Bottom line, eat a predominantly vegetarian diet and exercise regularly and skip a visit to the doctors office, if you want to avoid humiliation and medication.

[Jm Cutright]

03:35 AM on 06/29/2009

hey SEQUOIABISON: your lifestyle sounds much like mine except i wasn't a vegan, merely vegetarian. and i also would have to add avid exercising starting at age 19 to my regime. did you ever try yoga? i began my regular practice with a 10 minute headstand. and i also attempt to practice the principles of buddhism.

i just turned 49 and my doctor recommended a motorized scooter because he feels my multiple sclerosis has made my arms too weak to operate a manual wheelchair. don't let your good clean living go to your head. you may very well start sounding aloof, condescending, and arrogant.

[2sunny]

10:04 AM on 06/29/2009

double Hey, Hey to SEQUOIABISON.
"i LIKE YOUR (LIFE) STYLE"

[Kassandra]

06:07 PM on 06/26/2009

Call him up and Demand the test results again and say that the next call he gets will be from your attorney. That'll get 'em jumping
He prolly wants you to come back in for another $1100.00 appointment. I've never heard of such excessive charges for an appt. who does this guy think he is? God? Oh...yeah.

[kathy001]

04:26 PM on 06/26/2009

What a rotten experience. And it is a great counter to the argument so many try to give about the slowness of the Canadian and UK healthcare systems. You paid through the nose for this treatement and still can't get to talk to the doctor.

[sunnydee07]

03:22 PM on 06/26/2009

I have read so much dis-information about the Canadian one payer system that I've moved past being insulted, through frustration, and now I just don't care if you guys choose a single payer system or not. It's your loss if you don't. I'm Canadian and would pay $72/month for my family's basic health care (if my employer didn't already pay for it for me - thanks!). I also have low cost extended health to pay for dental, vision care and prescriptions (maybe $100 a month). I have NEVER been denied access to ANY doctor I want to see, ANYWHERE in the country. I can visit ANY clinic I want. Where this rumour about rationalization and restrictions started I'll never know. Oh wait, it was probably the American health care providers....hmmm.....

Yes, for those "socialist fear mongers", I probably do pay more tax than Americans. But all in all it's probably less than you pay from your own pocket, and I have the added bonus of not worrying that I will have to declare bankruptcy if anyone in my family requires care. If you tried taking the universal health care away from our citizens, there would be rioting in the streets. Every time the Canadian gov't even THINKS about making changes to the system, the backlash is huge.

So please keep debating if you like. Like I said, it's your country, your decision. Just get the facts right if you talk about another country's system. Cheers and good luck!

[kitkatborn]

04:36 PM on 06/26/2009

Thank you for sharing. I wish you could shout it from the mountain top. But, as I've said before on other subjects, perception trumps reality.

[fabricnthreads]

11:31 PM on 06/27/2009

The majority of us in the USA know you are right and that your system should be a model from which we draw.

The vocal minority, and the bought and paid for lawmakers in DC are spreading the thick, ugly propaganda about your system of health care.

We are trying, we want to get the word out. This fear-mongering is going to kill our opportunity to really, really reform health care. Thank you, dear neighbor to our North, for speaking the truth and trying to calm some fears. If you have changed even one mind about the radical dangers of the dreaded socialist health care system (sarcasm), those of us demanding single payer universal for all in the US will be grateful.

[derrick99]

02:59 PM on 06/26/2009

It has always struck me that doctors offices must be the worst run businesses on the planet. What other business relies almost entirely on paper files, treats customers terribly and is so incredibly slow to respond to cusomers needs? Serioulsy, even the Post Office does a better job. The healthcare debate is out of my league, but I don't see how the government could do a WORSE job than private practitioners already do.

[Mark Diaz]

02:38 PM on 06/26/2009

While I sympathize with you, you and your family have insurance and I don't. At age 55, I have great concerns about my future. Our currrent system is terribly dysfunctional. Care is not "even" in terms of quality or application, regardless of who you are, with rare exception.

WE NEED UNIVERSAL HEALTH CARE in the US.
Until then, I suggest you quit complaining, and DEMAND a system that actually provides reasonable care to ALL and is equitable.

Until then, we are all one illness away from bankruptcy or homlessness. This is unjust.
Greedy Insurance companies (and their CEO's) drive this corrupt system. I suggest jailing such CEOs until they get the message.

Canada, France and the UK all have decent systems. DO NOT call the USA an economic or democratic powerhouse until we have a system that incorporates the best of universal health coverage, please.

Hang in there.

[llisa]

03:39 PM on 06/26/2009

We do need universal Health care. But it won't be a cure for negligent doctors.

[sciphy]

01:29 PM on 06/26/2009

Doctors are compensated highly for first visits, especially consults, and for procedures such as endoscopy. Doctors are paid nothing for phone calls, emails or other communication unless there is a face to face "laying on of hands" visit. While the bill may have been $1100, the insurance company is likely to paid less than half of that amount. With medicare, less than 25% will be paid. This compensation may still be considered quite high, but in a nutshell, this is the problem of health care in the U.S.
And yes, it really, really, really needs fixing.

Doctors could do vast amounts of business by phone and email, but until there is some compensation for such activity, this will not happen.

[llisa]

03:39 PM on 06/26/2009

And, if he doesn't let his patient know the results of her test, he should not receive even one penny.

[fabricnthreads]

11:38 PM on 06/27/2009

OMG, they are compensated enough by insurance to communicate by phone or email. It takes seconds, minutes, and usually is done by office staff.....even if the physician does make the call himself (as mine does, thank goodness), it is overhead, completing the loop (or in crude terms, closing the sale in marketing lingo). It is the doctor's RESPONSIBILITY to follow up.

[wrightthewrong]

01:17 PM on 06/26/2009

When we hear the lobbyist's representatives in Congress telling us how the government might come between our doctors and ourselves, remember the above story. There are already many layers that exist between the doctor and the patient. The office staff of a physician can prevent you from ever reaching your doctor. They are the first layer of gatekeepers. In addition, your insurance company can and will prevent you from receiving the recommended care, be it lab work, procedures, or prescribed medications.

That aside, there is no reason for not receiving the results of a test after 4 weeks. As a parent and as a patient, you are going to be forced to become more proactive. Your daughter's doctor has no excuse for failing to call you. I would call every day until he does. Ask for a copy of all of the medical records to be mailed to you or to be prepared for you to pick them up. They have to do this. I have been doing this for years, as my family moved so much that I had to keep records on my children, my husband, and myself for continuity of care, proof of immunizations, etc. These records should belong to your daughter's complete home medical records. You and everyone else, should keep a full set of medical records at home. You will learn far more about your care and become a proactive medical manager only if you have your records.

[JuliaRain]

11:59 AM on 06/26/2009

Conflict of Interests.

[GreatNews27]

11:58 AM on 06/26/2009

I'm not holding my breath. There are just too many openly corrupt Senators for this bill to pass. There is simply too much money to be made keeping the American population sick, stupid, and in debt. We are virtual slaves to corporate interests. And Congress is making millions keeping us that way.

[Gidster]

02:07 PM on 06/26/2009

Far to much lobbyist and corporate cash flowing into the pockets of politicians!
Here are the top 12 offenders:
John McCain (R-AZ)- $2,885,602
Ben Nelson (D-NE)- $1,210,299
Max Baucus (D-MT)- $1,182,613
Arlen Specter (D-R-PA)- $1,037,205
Joe Lieberman (D-CT)- $1,035,302
Mitch McConnell (R-KY)- $928,007
Chuck Grassley (R-IA)- $888,724
Kent Conrad (D-ND)- $825,337
Jim Bunning (R-KY)- $793,999
Orrin Hatch (R-UT)- $664,057
Kit Bond (R-MO)- $644,571
Dick Shelby (R--AL)- $637,748

[mjc]

11:53 AM on 06/26/2009

I had the fortunate experience of working with a nurse practioner on my health for 15 years but as I got older she worried that perhaps I needed a local doctor to oversee my health care. It went steadily down even with expensive tests that the doctor thought would help him know my health problems better. In fact, he always has to be reminded of when this was done and what the result was even though he has the complete file in his hands. The info is in the file, not in his head. Ten or fifteen minutes every six months or so isn't really going to do much to improve your health....unfortunately.

[Idytme]

11:21 AM on 06/26/2009

Do you realize that in some states you can order your own medical tests without going through a doctor? Imagine that, being in control of your own health care, not needing a doctor to be the intermediarty between your health and the tests you want. They say that the general public is too stupid to interpret these results, and maybe that could be true in some cases, but the internet has changed *everything*. If you are smart enough to research, you are smart enough to find out results. If you need a doctor to interpret later on, then that is what they are for. I really, really, hate being classified into the Joe Smoe general category. And if you think this is off, just know what a doctor in the family will do for your health care once you get into the hospital. I have seen it first hand, and while on the one side it disgusts me, the extra care for a family member does give some comfort. Everyone should have that same comfort.

[mellowrant]

09:29 AM on 06/26/2009

I always thought it was a law that doctors or their staff are required to inform the patient of their test results?

[CharmiO]

10:11 AM on 06/26/2009

Several years ago I was given the same runaround on the phone (if there were a problem, the doctor would have called you) by a specialist's extremely rude office staff. The specialist himself was very rude to me during the office examination and lengthy, rapid-fire interrogation (some call it "taking a patient's history"). After several weeks of receiving no information, I remembered the Freedom of Information Act. I wrote them a letter, requesting a copy of all my test results and the letter the specialist wrote my physician. They did comply. When I received the copies, I learned that, although the specialist had not notified me, there were some somewhat abnormal blood test results. Also, the letter actually contained some specific concerns on the part of the specialist. The referring physician did not notify me of any of the results. I would not have known had I not requested the information for myself.

[LindaCat]

01:27 PM on 06/26/2009

Federal Law is clear -

http://www.privacyrights.org/fs/fs8-med.htm

All medical records are the property of the patient. I always obtain copies of tests, exams, radiology etc and review and research them BEFORE reviewing them with my doctor. I get these results from the lab or facility that performs the test. I do not rely on the doctor for access to these records. I learned the hard way. I have terminated PCPs and specialists whenever there has been a problem, or even hesitation wrt access to hard copy of any medical data.