Secrets to a smooth doctor's visit

From Kevin MD some common sense suggestions.

This is of particular interest to me as I'm in the process of writing an article about the 5 things patients wish doctors (and their staff) would do to make for a better patient experience.

I can't deny the logic in these suggestions, but they perpetuate one of the most annoying factors, for me, about doctors visits. I am expected to know when to be passive and when to be proactive. There is no burden on the service provider to lift a finger to help in that process.

It's no different than the problems I have with how comment spam currently gets dealt with.

What? Does that seem a bit off-the-wall?

Read on...

Right now all methods to deal with comment spam set up obstacles and barriers for all potential commenters, knowing that the comment spammer will likely by unable to overcome those obstacles.

But it means that legitimate readers are treated the same as spammers. And it's annoying, restrictive and all the rest.

When I read the list of logical suggestion provided in the article in question it's all about my job as the patient.

I wish there was some even tiny, slight acknowledgement that the service provider is getting paid to perform this service and that that makes me a customer.

Please don't tell me how medicine is a professional service, completely different than other kinds of services. In this age of technology I want to know why there is never any sense that the doctor's office could damn well call me when they're running late. I mean, they're the ones who know, right? Wouldn't it make sense to call people along the way during the day when you set up the time to do so, rather than field calls from patients...which you can't schedule. It's basic GTD principles no?

You know why they don't? Because I am being treated like one of the people who makes them late. When in fact I'm scrupulously punctual. (Which after years of seeing me you would think they know.)

[OK, well, it's true, I've recently started with a new medical facility, so I'm actually ranting about my last OB/GYN who kept me waiting and who was not there at all on several occasions when I showed up.]

Anyway, no denying the suggestions are reasonable. But don't think I won't bring up this idea that it's all the patient's job in the article I'm writing.

Comments

[hgstern]

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Elisa: Good post. David Williams, over at Health Business Blog, had a post on this a few weeks ago. It's worth a read, as well:

http://www.mppllc.com/pages/2005/09/planned-patienthood.html

Have a great weekend!

[Elisa Camahort]

Thanks Henry. David's post had a slightly different angle on it, but what I find interesting about this push toward Consumer Directed Health Care is it's all geared toward what the patient should do...well, how about the doctors treating us more like the customers we are too!?

No other industry gets away with the stuff doctors do (except maybe contractors...from the nightmare stories I hear about that!)

[hgstern]

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Actually, I'm glad you asked that.

[Shameless self-promotion follows]

I just concluded an interview with the Medical Director of a VERY large carrier, and we focused entirely on this issue.

I'll have it polished and up on my blog next week.

[Elisa Camahort]

Oh, goody! Can't wait.

[hgstern]

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You'll have to! :-))

[Stephanie Siegrist, MD]

If your doctor's office treated you like the fine customer you are, would you be willing to pay for that service? You might choose to do business with another professional based on an excellent level of service (accountant, designer, architect...), but chances are that you're paying directly to receive those services.

My staff and I do our best to stay on schedule, anticipate your needs, accomodate your requests...and I wish my small business could expect to be paid on delivery. But alas, there's the godforsaken rigamarole called "third party payor."

Elisa--I'm eager to hear from your readers: would they be willing to pay cash at the time of their doctor's visits, if their doctor's office provided the amenities you seek (phone access, secure online messaging, excellent teaching...what else?)? Thanks

[Elisa Camahort]

Well Stephanie, here's the disconnect. I *already pay* almost $3000 a year in premiums, not to mention co-pays and other charges until I hit my deductible. So from my perspective I'm paying quite a lot for medical services, which I use pretty rarely.

So, yes, the third party payer system creates this big disconnect. Because no, I wouldn't want to pay tons of cash ON TOP OF the thousands of dollars I pay on a schedule, medical issues or no medical issues.

[Stephanie Siegrist, MD]

Your premiums go straight to the insurance company's pocket. The payors make your doctor play mother-may-I and jump thru their diabolically designed hoops before they'll reimburse him on their terms for his time and expertise after the fact. They've been busted trying to get sneakier and greedier, witness the number of lawsuits several payors have lost this year: http://www.mcms.org/contents/rcipaaward.pdf, http://www.cmanet.org/publicdoc.cfm/4/0/GENER/600, http://southflorida.bizjournals.com/southflorida/stories/2005/09/26/daily22.html

It's a common misconception that you'd pay tons of cash for a doctor's appointment. An office-consultation fee isn't sky-high and unaffordable when compared with many other consumer costs: one month of digital cable? "Sports collectibles" on ebay? Dinner for 2 at Red Lobster?

We've allowed the health insurance companies way too much power--not just economic power, but we've allowed them to get between doctors and patients, and de-value us both.

[Alice H]

It would be nice if most visits just required an in-house consultation, but many do not. There's no way, for instance, for my doctor to tell that my thyroid medication needs adjusting without running a blood test. I can tell her that I'm feeling lethargic or jittery, that I'm having intestinal problems one way or another, or any other number of symptoms, but in order to diagnose and treat, I think she probably has to run a test - which turns a $120 doctor's visit into a $250 doctor's visit in a hurry.

Dr. Siegrist, you may resent insurance companies as a burden, but for many of us there's no way we'd be able to afford health care if we didn't pay for coverage. As a doctor, you have the choice of which insurance companies to deal with. I suggest you stick with ones you consider scrupulous.

Having waited in a doctor's office for upwards of two hours, and then being treated as if it were a PRIVILEGE to be waiting so long to see an OBGYN who walked in, told me I had an abnormal Pap smear, and then walked out without giving me time to process what I was told or to ask any questions, I am fully in agreement with Kevin. I'm lucky with my current doctor's group that they nearly always run on time, and how they pull this off I have no idea because I have never felt shortchanged for time.

[Stephanie Siegrist]

Alice—I couldn’t afford to insure myself or my family against significant health costs without insurance, either. The problem lies with the fact that the payors have brainwashed their policyholders into thinking the premiums can cover everything, all the time. Those days are long gone, but don’t begrudge your doctor for requesting additional information in order to give you an accurate diagnosis and specific treatment plan. That precision is what you get for the additional $130.

Indeed, I don’t have a choice of which insurance companies to deal with…in a town where one vendor covers 75% of the market. Please understand that when physicians refuse to participate with certain insurance companies, those patients have trouble finding a doctor. This is exactly what the elderly will face if the threatened cuts in Medicare reimbursement become reality in 2006.

Fortunately, you had the opportunity to find another OBGYN practice—they’ve mastered the art of service that your former doctor hadn’t. Many happy, healthy years to you.