Posted on 03/23/2006 3:47:56 PM PST by neverdem
WHEN politicians speak of America's health care needs, they often miss an important point: the doctor-patient relationship has become frayed. Patients aren't unhappy just because health care costs too much (though they would certainly like it to be more affordable). Rather, people sense a malaise within the system that has eroded the respect they feel patients deserve.
There has been a shift in attitude within the profession. I see examples of it every day. I was making rounds in my intensive care unit recently when one of the interns presented a case. "This is the first admission for this 55-year-old male," he said.
"Stop," I said. "He is a man."
"That's what I said," the intern replied.
"Not exactly," I answered. Clearly, the intern didn't get it. Neither do a lot of other health care professionals anymore.
The problem has been sneaking up on us for almost two decades. As health-care dollars became scarce in the 1980's and 90's, hospitals asked their business people to attend clinical meetings. The object was to see what doctors were doing that cost a lot of money, then to try and do things more efficiently. Almost immediately, I noticed that business jargon was becoming commonplace. "Patients" began to disappear. They were replaced by "consumers." They eventually became "customers."
This may seem a trivial matter, but it is not. You treat "patients" as if they were members of your family. You talk to them. You comfort them. You take time to explain to them what the future may hold in store. Sometimes, that future will be bleak. But you assure them you will be there to help them face it.
(Excerpt) Read more at nytimes.com ...
Them charging for records sounds illegal...I might make a complaint to the state or local medical boards.
Please don't take this the wrong way BUT I have experience with doctors in 'underserved' areas. Recently I went to such a doctor practicing in an 'underserved' area. I vowed I'd never see another doctor in such an area BUT doctors in well off areas don't want to see me because I don't have insurance (even though I have cash in my hand). Poor people and people without insurance have to see SOMEONE but it just sucks being treated like a factory farm cow based on the fact I don't have insurance. Supply and demand... I don't know. It may be that the people HAVE to see you because they don't have any other choices. If they had a doctor who spent thirty minutes with them instead of fifteen for the same money they're paying you, I'll bet they'd go. I contrast my experiences with my sister who has health insurance and it's just very frustrating the disparities in care based on health insurance.
How many of us have waited for two hours (sometimes with a sick child) to see the doctor for three minutes? Most of us, I'd wager. Perhaps doctors should be paid for the time the patient gets.
I will say this - it was at St Joe's emergency room in Phoenix, AZ, it is one of the hospitals all the less fortunate people go to when they have an 'emergency', (ie a cough so they can get free health care) and it's the trauma hospital that's near the center of the city, so it gets a lot of car accident victims, gun shot wounds, etc. we wouldn't go there again.
I wondered about that, one would think as you pay your bill you own the records. My other problem was that I was left a message about my meds on my answering machine . I think what meds I take is between me, the dr and the druggist. Not for my family or friends to hear. That was the final straw when this co dr left that message on my answering machine. I have it saved and am debating calling a lawyer. I just dont know if its worth the bother.
Okay, you addressed a problem I have with our PPO - Before I was insured, I went to my doctor and paid $80 for a visit. The next time I went (when I was insured), I paid a $30 co-pay. When I looked online at the charges for services, I was shocked to see that the insurance co discounted all but $15 of the charges. So, therefore my doctor has to take a cut just to accept my insurance yet hire employees to do all the paperwork to file the insurance. I think that's wrong...
And don't even get me started on the amount of $$ we shell out every year ($5,500) to go to the doctor at the most 4 times a year. It just erks me to know that I'll pay this amount year after year just because of the possiblity of having some catastrauphic problem one day..... I'm basically giving my hard earned money to the insurance company to "negotiate" 1/2 price fees for someone who has already had "the big one". Where does the excess $$ go? Or rather, whose pockets are they going in to.
My personal belief is that insurance is just another "terror tactic".... always paying for the "what if".
My husband and I are considering going to a "catastrauphic" plan only and paying cash for the "time to time" doctor visits.
One other note.... most doctors keep on hand lots and lots of samples of medication.... all you have to do is ask for them. I always ask for samples for new medications, so that I don't waste the money on the rx if I can't tolerate the medicine.
Something similar happened to me but it was a US doctor. He killed my dad.
I'm looking at all my expenses as a business man. $432 an hour is a great gig. Not that one has customers 365/24/7 and works those hours. Still, I understand why I drive a Civic and my doctors drive 50K trucks.
BTW, I don't begrudge the price; however, I wish they'd cut me a break when I pay cash out of my HSA. And some do by giving free samples.
It's funny, concerning the topic on this thread, a few of my doctors decided to use a pollster to ask questions to better their customer service quotient. I think the patients all remarked about the staff being cold and indifferent (makes the waiting room so much more pleasurable) and the wait time. My urologist fired the dead weight. My GP made an attempt to paint and carpet the waiting room.
Very interesting thread....
My husband almost had a ruptured appendix because the Dr's didn't think he was having enough pain (and no fever) to really have appendicitis.
Knowing that appendicitis is difficult to diagnose, we don't have any hard feelings or anything, but I did tell my husband that he needed to whine a little more, just in case.
I hate to sound cold, but most doctors don't treat feelings, they treat symptoms. They have precious little time to discuss the fears you might have surrounding a given condition and most aren't that good at reassuring you anyway. Don't get me wrong, some are.
I wish more people understood that it is the insurance industry that has eroded the doctor/patient relationship. They are paid for about 6-7 minutes of face to face time, anything beyond that and they are losing money.
, I wish they'd cut me a break when I pay cash out of my HSA.
When we get enought of us on HSAs things will chnage.....
Oh I understand that. Thats why I was always told come back , only one illness at at a time. Its all about making money.
"Knowing that appendicitis is difficult to diagnose, we don't have any hard feelings or anything, but I did tell my husband that he needed to whine a little more, just in case."
If he ever has to go to Johns Hopkins* Emergency,definitly have him whine big time,it may save his life.
*Johns Hopkins is rated one of the top Hospitals in the country if not the world.
And look at all the money the insurance Execs get:
http://www.commondreams.org/views05/0510-22.htm
United Healthcare's top man gets $125 Million a year.
Cost - time for employees, take message, pull chart, pull chart apart and run it through the copier, put chart back together and file it. Time for Dr. Review chart, ok copying, review copy.
Legality - In Texas, at least, the information belongs to you, but the paper (and the costs above) belong to the Dr. "Reasonable fees" are usually set by the State.
As to the phone message, most of us assume that anyone hearing your phone messages is pretty close to you. An on-call or associate wouldn't know you as well, so would make more assumptions.
"I have an HMO plan".
Ever heard of cause and effect?
Par for the course I guess. Hope he's enjoying my money... yes, I have United Healthcare. Burns my butt big time!
It turns out I had a ruptured appendix. I was rushed into surgery and pulled through.
I had a similar experience. Went to my PCP for stomach pain (which I had already self diagnosed as an appendix issue....I was heavy into medmal law at that time and surrounded by nurses). My PCP told me I could either go home and wait it out or go to the ER. I chose the ER and was in the OR 1 hr later.
Of course, I developed complications and spent 1 month in the hospital...but that is another story...
In New Jersey, they can charge you a $10 search fee per medical record (patient), and then $1.00 per page for the first 100 pages, then .25 per page thereafter (or $100 flat fee if less than the per-page charge).
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