<p>I had a Dr. that thought they were hooey, too. Her quote was “I could feed you hormones to fix a measurement today. But, we could get a different measurement tomorrow. Hormones fluctuate.” She did help with a few other things before my insurance changed and now she is history, anyway. C’est La Vie.</p>
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I was gong to say the same thing, but you got to it first as I think I fainted dead away. Even if my PCP bills $250 for an office visit, its probably only reimbursed at maybe half that at best, and aside from the copay the rest has to be written off per the contractual agreement. Our MH rates are probably about what shrinkrap said. </p>
<p>iirc mine was paid $125 for annual check up + $25 copayment. And for just regular appointment probably somewhere around $60-$70 +$25 copayment. Not $250.</p>
<p>Oh, shoot!cI was about to send my CV! :)) </p>
<p>That was before ACA. I don’t know if it changed since. I’m going to see him again for my annual check up to see what he gets now.</p>
<p>Send it to Busdriver’s carrier!!</p>
<p>That’s why my brothers are so eager to send their kids to medical school and I’m not. I know better. :D</p>
<p>Physicians do not have customers- we have PATIENTS! I hate they way the business model has invaded medical care. We don’t “work for” the patients either, we work with them so they can get better. Also- feeling one is overpaying for just an antibiotic, 5 minute visit … You are only seeing the tip of the iceberg. All of that long education is to rule out as much as rule in probable diagnoses. Experienced physicians can be quick because they have seen things enough times to quickly realize what the likely problem is (and often without extra tests). If you think you know exactly what you need- why see a doctor or other medical person? There is a reason many drugs, especially antibiotics, are not available over the counter. </p>
<p>That said- insurance companies have truly invaded the doctor-patient relationship. Instead of practicing medicine (regardless of the specialty) we are spending time jumping through hoops set up by third party meddlers.</p>
<p>EMR’s. I was frustrated when the MA had to find the proper procedure on her list when I had a surgical history of a classical procedure every medical person should know by its acronym ( several letters instead of many long words). I had to make sure she didn’t mis-input a wrong phrase that would indicate the wrong diagnosis (not everything is cancer even if it needs to be removed). Check off boxes have their merits but don’t tell the whole story, either. Now physicians are busy facing the computer/tablet instead of looking at the patient much of the time. </p>
<p>Be leery of talkative lawyers- their pleasantries cost you money! A note about some posts awhile back.</p>
<p>Sorghum- you may have some long ago experience with US health care but it has change a lot in recent times. We retirement age/approaching it physicians learned a very different system- pre insurance company dictates and HMOs.</p>
<p>btw- when I was a kid there were house calls. It is so much more efficient (doctor’s time and ability to do things) when the patient goes to the office. </p>
<p>Concierge care would be luxurious but if too may physicians opt for that there will be even fewer for the rest of us and wait times will be even worse.</p>
<p>Well said, wis. Especially this:</p>
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<p>Between the demands of insurance companies, and the demands of the corporations which most doctors now work for, it must be very frustrating to be a doctor now. I know you didn’t go into medicine with the goal of serving the shareholders of your various corporate masters, but that is what you often find yourself doing. And often to the detriment of both your patients and yourself.</p>
<p>You can hate it if you want, but I think the practice of medicine has a LOT of customers right now, and patients might only one of them. There are government agencies, congressman, labs, hospitals, pharmacies, hospitals, consultants, therapists, support groups, internet forums…And some patients seem to like this model, which is perhaps less paternalistic, and more responsive to a patient satisfaction model. I SOMETIMES like the fact that patients have to accept more responsibility for cost. Far fewer “allergies” to generics!</p>
<p>I am not a huge fan, but have not had the good fortune of retiring yet. Fortunately this model works for my husband, allowing me the option of working in one that works for me. When my D’s college fund tanked in 08, I did have to take a part time “job” but it has taught me some things that are sort of priceless, and changed my tune about what I thought I “knew”. </p>
<p>“Be leery of talkative lawyers- their pleasantries cost you money!”
I once got a bill with a line item that said " six minutes casual chit chat-no charge"!</p>
<p>@busdriver11.
I don’t think my D’s and my husband’s doctors gave us their cell numbers so we can have personal conversation. Of course, once in a while these doctors will talk about their children but rarely. The cell phone # is for emergency and they trust that we do not abuse that priviledge. In fact, I still have another doctor’s cell phone number and he’s not my husband’s doctor any more. If you approach a doctor like you’re looking for attention and some people do (especially older women, love to talk to doctors and preachers), or you have the attitude because doc is late, that- <em>ME</em>, <em>ME</em>, <em>ME</em> attitude, he should run far from you. You should not be able to get the number to the only pay phone left in his town, let alone his cell phone…
I don’t mean you literally @busdriver11</p>
<p>What does whether or not doctors actually own their business or how many patients they’re expected to see each day have to do with how they treat their customers? And since when does working for someone else or being overworked mean you no longer have to observe common rules of courtesy? Most people I know work for someone else and many are having more work piled on all the time without earning any more money. Does that absolve them from being respectful of each other? </p>
<p>The doctors I know who work for managed care companies know they’re being overextended. They’re told they have to push x number of patients through in a day, so it’s not hard to figure out service is suffering. However, it’s basic customer service to be respectful of your customer’s time and doctors are no different than anyone else. If you’re running late, why not offer a word of apology? If you don’t know your patients are routinely left in the waiting room for 15 minutes or more, then spend another 10 with the nurse getting vitals, followed by 30 minutes in an examining room, it’s nobody’s fault but your own. I’ve spent lots, and I do mean LOTS of time in medical facilities over the years, first with my dad and later with my mom. I have family in the medical industry up to and including a physician in a major hospital. Doctors are not as ignorant of how their offices run as some people on this thread make out, and many are wonderful people with excellent bedside manners. But like so many things, that’s a choice. </p>
<p>The beauty of our country is that there aren’t two separate sets of etiquette rules – one for the elite and a separate one for the hoi polloi – we’re all supposed to follow the same basic set of standards. Nobody’s supposed to get a pass because they have a particular surname, or a large bank account, or were able to pursue a career they felt was their “calling.” Those rules your mom taught you before you went to kindergarten would probably serve you pretty well now too, no matter what your vocation.</p>
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<p>I had an attorney charge me for ONE postage stamp!</p>
<p>Bless you, @austinmshauri, for expressing my thoughts more cogently than I was able to.</p>
<p>As for the cavalier advice to switch to a concierge practice, 15 years ago when my then internist converted his practice, it cost $4000 per person just to join. I shudder to think what it would cost now. </p>
<p>"What does whether or not doctors actually own their business or how many patients they’re expected to see each day have to do with how they treat their customers? "</p>
<p>If we are still talking about saying “I’m sorry for the wait”, I can’t disagree. And when I worked for someone else, I took at least two courses on improving my patient satisfaction. It didn’t “take”. 8-| . I could say I was sorry all day long, but that wasn’t really the problem. </p>
<p>When it comes to how doctors treat “customers”, I think I’m going to check out what “customer” means. I THINK it means who pays the bills. </p>
<p>BTW: Watching “Airplane!” and there are plenty of jokes,stereotypes, and apologies for all!</p>
<p>I had a high risk pregnancy. My ob-gyn doc did give me his home phone number (this was before cell phones). He promised me he would come to the hospital whether he was on call…or not. It never dawned on me to call him at that number. When my water broke five weeks before my due date, I just went to the hospital. I figured whomever was on call would be fine! Well guess what, they called my not on call doctor, and he did come in for my delivery. To be honest, I was pleased, but surprised. In fact, I wondered why they even called him. Apparently it was noted in my chart. Who knew!</p>
<p>I don’t love waiting in doctor offices, but I always know it’s for a good reason!</p>
<p>So I told my Dr H about this thread last night, and his first reaction was, “I absolutely agree it is common courtesy to apologize if a patient has been waiting a long time.” He told me that if he is running behind by 15-30 minutes, he will ask the office to notify everyone in the waiting room and ask them if they want to reschedule; he does this especially in mid-afternoon because he knows other children could need pick up from school or the bus stop.</p>
<p>If is he running over 30 minutes behind, especially early in the day, he will ask the office to call people on the schedule for the afternoon and either offer a new appt or just tell them to come later so they are not cooling their heels in the waiting room. He operates on kids, so obviously gets a lot of questions and concerns from parents in his pre-op and post-op appts—you can’t shut these people down even if they are asking the same question for the 4th time. You just have to reassure them again, even if it takes an hour and you know 5 people are now sitting waiting to be seen.</p>
<p>On the more general subject of practicing medicine today—he has spent time on the phone with insurance companies trying to get operations covered and approved; talked to parents in the middle of the night about various symptoms; and not a night goes by where he is not answering emails and finishing notes at home, even though it is much easier to do at work, just so he can see the kids’ faces. He often has no time to eat all day. While his call schedule is not as bad as Pizzagirl’s husband’s, it did restrict where we could live as he has to be within 15 minutes of the hospital. I too have gotten used to the phone ringing multiple times a call night, and him leaving to do an emergency procedure at 3am with a full schedule of either surgery or clinic the next day.</p>
<p>It’s not a profession for everyone. I couldn’t do it myself. He tries very hard to do right by his patients and their families, and I like to think most (and yes, there are bad apples in every barrel) doctors feel the same way.</p>
<p>I don’t care to get other people cell phones even for emergency. I did have an emergency pregnancy situation like Thumper and I just went to the emergency room of the local hospital where the doctor used for delivery. I think that was the days when cell phones were available but not as prevalent as today. I also rarely give out my cell phone number to anybody. I got cell phone for me and my kids so I can get in touch with them. If the cell phone rings I know they are my immediate family. I personally don’t like to intrude in other people life too much. There is procedure for emergency, call the ambulance.</p>
<p>austinmshauri,
There is an assumption being made that the physician was discourteous. I disagree. Its quite likely, in fact probable, that the Dr was polite and cordial and professional and congenial and affable, even if he/she was exhausted, hungry, worried about his sick kid at home, late for a dinner meeting and knew he had files to review before a procedure the next day (these are hypotheticals). Just because one person proclaims that the lack of an apology for the day being long and running a bit behind schedule for what may have been the last appointment of the day is “discourteous” doesn’t make it so. And maybe he/she meant to and simply forgot.</p>
<p>Wis75 said it well, and many things that I’d thought about earlier but was not ready to post before a morning cup of coffee… Healthcare is a TEAM approach. Drs and patients work together to address problems. Patients are expected to share important, pertinent and accurate information about their clinical/medical/medication history, their family history, etc, they are encouraged to ask questions about their diagnosis and care options, and they are expected to follow treatment recommendations. If you choose not to take the meds prescribed, or take more or less than prescribed, or don’t do the exercises that are prescribed, or don’t take supplements as recommended (eg Vitamin D, B-12 or what have you) then you are not a good team player. You have a sore throat? Maybe its infectious, and needs a strep test and antibiotics,. Maybe its GERD and you need something for reflux, or maybe its Barretts esophagus and you need an endoscopy or other testing. Or, most likely its viral and will run its course. And you (general you, not speaking to anyone in particular) will not get sent home with a Rx, even though research has shown that 42% of patients expect to be given a prescription. <a href=“http://www.fda.gov/downloads/AboutFDA/CentersOffices/CDER/ucm109875.pdf”>http://www.fda.gov/downloads/AboutFDA/CentersOffices/CDER/ucm109875.pdf</a></p>
<p>Lets not even talk about the patients who are not honest about their history, who may, for example, minimize their alcohol consumption, take their kids Ritalin and present with symptoms of tremulousness or heart racing and are referred to a cardiologist. Please, be a good team player. And if your “team coach” is a few minutes late, well put it in perspective. This is your health and your life we are talking about. </p>
<p>"Please, be a good team player. And if your “team coach” is a few minutes late, well put it in perspective. This is your health and your life we are talking about. "</p>
<p>Amen!</p>
<p>Common sense 101.</p>