I stumbledupon Violent Acres and read her most recent post that describes among other things her aversion for doctors. (For those of you who might have read Violent Acres you know that the language can get pretty offensive. The part I'm referencing from the post is below, and it's clean.) From the post:
I can explain my aversion to Doctors quite simply: they’re ineffectual. If visiting a Doctor made me feel better, I’d go all the time. Unfortunately, they never do. Perhaps my expectations are high, but I envision my appointment going something like this: I show up on time. My Doctor sees me reasonably close to my scheduled appointment time. I sit down with him and explain my symptoms. He asks me questions and examines me. If any tests need done, he does them. Towards the end of the appointment, he has a reasonable idea of what is wrong and prescribes me something accordingly.
Of course, my appointments rarely go that way. Instead, I show up on time. My Doctor is busy and overbooked, so I have to sit in his waiting room for an hour, sick and miserable. Then I’m escorted into another room where I’m forced to sit, sick and miserable. Finally, he will enter. I will explain my symptoms while he is only half listening to me. He’ll jot some stuff down and inform me that I need some tests done. Since we can never do the tests that day, I usually have to schedule another appointment. I do and when I come back a week later, I take my tests. Then, a few days after that, I have to come in to get the results of said tests. Then my Doctor decides that he’s just going to refer me to a specialist and I have to repeat the entire wild goose chase with some other guy I’ve never met before.
I’m sorry, but when I’m sick, the very last thing in the world I want is a list of $#&^!$ errands to run. Besides, when all is said and done, my sickness has usually run its course anyway and all I have to show for it is a list of wasted co-pays.
And her point is … ? This kind of whining is starting to wear on me.
The last word explains it all: co-pays. If the doctor accepts insurance and all of its associated headaches in order to get you in the door, this is the kind of service to expect. This doesn't surprise me. The clinic has chosen a lower common denominator for its patients. It pushes its doctors, and its patients, as far as it can to extract the most money it can. Expect to have your time wasted. Expect them to rush you through, because yes, they are overworked and they have another 40 patients just like you to see that day. Expect to chase down prescriptions. Expect to be shuffled around like a part on an assembly line to where you can be worked on in batches at low cost. Expect to write letters to your insurance companies when they deny payment. Expect to get over your illness before they figure out the treatment.
You're not paying enough to get better treatment. If you want better treatment, go to a cash-only medical practice, pay the price, and get treated. These doctors are catering to people who have money, and they're providing a premium service. Or fly abroad and get treated there if it makes sense. Money talks! Otherwise, the line starts over there across the street. It's not that doctors are ineffectual. It's that your wallet can't afford, or you're not willing to pay for, anything more effectual.
In town we have several options for groceries; two of them are the Wal-Mart Supercenter and Ukrop's. Sometimes I wait in the checkout line at Wal-Mart for over 15 minutes, only to be hurried through by an harried cashier that seems to actively stave off my attempts to be friendly. At Ukrop's, there are lots of staff around, they're always helpful and friendly, I get through quickly, and they even take the groceries out to my car for me.
What's the difference? In many cases equivalent groceries are noticeably more expensive at Ukrop's than at Wal-Mart. If service is important to me, and if I can afford it, I can choose to shop at Ukrop's. If not, there's always lower-cost Wal-Mart, but I should accept a less relaxed shopping experience, longer waits, two open checkout lines, etc. I pay in money or pay in time and aggravation.
Decide how much you want to trade time and aggravation for money. Once decided, Bon appétit! But don't expect a seven-course meal off of the dollar menu.
Excellent post. I totally agree that it's about what you are willing to pay for. Insurance makes it seem so much cheaper to see the doctor that people go too often and clog up the offices with "quality of life" issues which don't allow the doctors to focus on those who are ill. I often wonder how much of a doctor's day is spent on presriptions for ED drugs, Restless Leg Syndrome, and other designer drugs like that.
I've posted more than once on my blog about health insurance and that I'd like to "self insure" someday. I would much prefer to have just major medical for the big ticket items and pay everything else out of pocket. That way I can make the decision what my medical dollars will be spent on.
Im dissapointed in your atitude.. Not all of us can afford to pay cash for a doctor… try having a permanent condition (Diabetes)… And your atitude is that i dont deserve quality medical care cuz i cant afford the visits, that are *required* not a luxury?
In your grand scheme i deserve everything I get and would be cheaper if i was DEAD.
john: Probably I missed my mark a little. (Actually I'm in the same boat; I can't afford to pay cash either.) What bugged me was people actively complaining about their medical service and calling the doctors ineffectual, when those doctors are probably doing what they can, and more. The economics usually restrain them from giving the care that they'd like to give.
It's not a slam on people who can't afford better, just people who complain loudly about it and blame doctors whose hands are tied.
I see it both ways.
My time is valuable. I despise having to wait in a crowded waiting room with coughing people and runny nosed kids. Then, the doctor takes 32 seconds and writes a prescription. There is very little diagnosis going on, just a quick once over and it's done. I have to come back in six months to renew my allergy medication because he wants to get in another office visit bill.
On the other hand, we are so dependent on medical insurance that we aren't really that involved in our health care system. We have no idea what the costs are BECAUSE of insurance.
We have become insurance sheep, but no one knows what to do about it. Socialized medicine is not the answer, since no one wants to wait 6 months to get a needed operation. I'm not sure what the answer is.
The self insured thing sounds good though.
Way harsh. One side-ed & incomplete.
A patients' time *is* valuable – having to blow anywhere from 1/2 day to a whole day due to booking issues is unacceptable.
Doctor: At the very least, during busy times/seasons have the front desk post a sign reminding patients that each person will be heard, even if that means waiting. Also clearly post what your office can do in-house & what must be lab-ed out.
Patient: If your doctor makes this waiting & shuttling habit, change the doctor &/or lab if your insurance allows; if it doesn't, chose a different one next open enrollment or go to one of the newer walk in clinics or Urgent Care.
Insurance: stop cheaping out on reimbursements.
Dropping in to just write a prescription w/o listening to & examining the patient, while again common, is a great way to get sued for missing issues that could well have been caught & cured, or effectively treated before death. Doctor: Why risk one's professional reputation, malpractice rates & conscience? Why continue to be 1/2 the reason so many drugs have lost &/are losing effectiveness by taking the easy out writing prescriptions instead of communicating with the patient?
Patient: if you can change, why are you still tolerating this? Why continue to be the other 1/2 of the aforementioned problem by not taking the time to be an informed patient (ie: one who knows the basics flu vs. cold etc.)?
Yes, the medical system is broken in many respects, but all parties involved share the blame. "Whining" is done by both doctors & patients. If the groups worked together, they might actually create improvements to the very system both have come to despise.
Bluntly and well-put. There is always another side to the story. We couldn't afford to pay cash for medical services(goodness, could anyone?) but we think the money for the PPO plan offered by my employer is worth the extra money over the HMO. For us, it's less of a value of time thing, and more of a value of health thing. I like being able to pick a specific doctor – it gives us the freedom to find doctors that we trust, and we've done that.
I can change myself way more easily than I can change the medical insurance industry or a doctor. Regardless of which organization deserves the most blame, the most effective difference will be made by me making more money and being able to buy myself out of the system. Jumping to another doctor might help a little bit, but they're under the same constraints as the one I just left.
Where is this secret medical system where you pay cash for superior care? We receive care from one of the country's best-ranked health systems (paid for by insurance), and we still have to make extra appointments for tests, etc. If I were paying cash, I would see the same doctor, and be treated exactly the same.
Maybe there are boutique doctors you can pay to come to your house and give you a foot massage while they diagnose you, but the complaints this person is making are not a sign of poor standard of care. Health insurance does pay the doctor a decent fee for the care he gives you. Just because the doctor doesn't give you what you want out of the appointment (emotional validation?) doesn't mean that he's not giving you good care. As for making extra appointments for tests, that's just SOP. General practice physicians don't keep CT scanners in their office just so they can save you time. If you are getting better before you get a chance to see your specialist or get the tests that are ordered, consider that your doctor was being extra vigilant, and that he may actually have ordered unnecessary tests in response to your complaints. Maybe you should stay home next time, and see if you get better on your own. That would save the most time. Unfortunately, being seriously ill is never going to be fun or convenient. I have heard some horror stories about people being treated poorly by their health care providers, but this isn't one of them.
An interesting thing to comment on is that if people think it is "bad" right now with people clogging up offices with low copays, just imagine if we had a socialized medicine system (like many countries do). There is a reason canadian doctors come here for specialized healthcare…
Great to read your post , honestly i have phobia of getting medical check .
But will change attitude after your post ,
Thanks
tracy ho
wisdomgettingloaded
I'm not sure that doctors are ineffectual, it's the whole system that's a problem – maybe they are simply not enough doctors per person.
I also haven't seen the place where you can go pay with cash and avoid lines. I'm pretty sure I couldn't walk into Mass General or Brigham and Women's in Boston and do that. If I did find this place, I'm sure my wallet can't afford it in the same way that it can't afford a Ferrari – it'll probably cost you more than $500 for a simple strep test.
I'd like to say that there is an option. When you go for your appointments it's basically assumed that you will pay with insurance. Instead ask if you can pay without using insurance. I can't say that I go to the doctor much (I'm sick right now ) but I know you can pay clinics cash.