<p>I know I have mentioned this before, but in the defense of physicians, I have to mention my older son’s psychiatrist, who is a saint. My son is on state insurance, which the doctor doesn’t take in his private practice, but DOES take at the clinic he works at a couple of days a week. So I was prepared to have my son drive an hour round-trip to see him at the clinic, but the doctor said, “Oh, I’ll just keep seeing him at my local office, at no charge. I wouldn’t get compensated any more by the clinic for seeing him, so I don’t mind.” !!! Yeah, but my son is taking up an appointment slot! And the doctor also lets us call him whenever we need to, even when he is on vacations. We email each other whenever we need to (my son signed a release form). I just try really hard not to bug him much. In the email subject line, I will include “URGENT” or “Not Urgent.”</p>
<p>And yes, my son has to wait sometimes for his appointment, but of course we don’t mind in the least.</p>
<p>jym, I meant they all take insurance of course but I get to decide who to go to. I no longer go through middle man anymore, I talked to the nurse about who to see for minor surgery and got some information about the doctor and contact him. I don’t have to go through the family practitioner for referral anymore.</p>
<p>I don’t have to go to my GP for a referral anymore either, DrGoogle. I can see any specialist without permission, however sometimes I ask my doctors office for a reference. I think my insurance company figured it was a waste of money to pay $250 to my GP just to get a referral to a specialist. It’s not like they discourage us from seeing them, but why pay that extra money for an unnecessary appointment when I’m going anyways?</p>
<p>And it was the insurance company that decided what was a “waste of money” ( $250??? seriously?). They might make a different decision depending on the specialty. How many folks here have wangled with their mental health benefits? (You don’t have to answer that.)</p>
<p>“jym, I meant they all take insurance of course but I get to decide who to go to. I no longer go through middle man anymore, I talked to the nurse about who to see for minor surgery and got some information about the doctor and contact him. I don’t have to go through the family practitioner for referral anymore.”</p>
<p>DrGoogle, unless you are paying the cash fee out of pocket, then accepting whatever your insurance wants to reimburse you as payment in full, that insurance company is as much the “customer” as you are. In fact I can’t imagine too many situations in which the only “customer” a doctor has to answer to is he patient. </p>
<p>“They all take insurance, of course”, suggests you are not TRULY deciding who to go to. You are choosing from among doctors who take insurance, and all that that entails. </p>
<p>This is for my husband, like most men(or maybe some) he hates to go see doctors and recently found out his doctor also moved away. So instead of finding a new one or drive 30 minutes to the old one we bypass the GP. We called the nurse from our insurance and select the best doctor. Sometimes the doctors that we received referrals are not always the best. I think insurance companies tend to have the best doctors, they knew who to trust. That’s how I found out my acupuncture doctor.</p>
<p>A doctor who truly seems to care and takes their time with their patients is increasingly rare, and would be well worth sitting in the waiting room for. By the same token, a caring doctor would be likely to be polite enough to acknowledge that you have had to wait, perhaps with a quick apology, but if not, a caring demeanor could make up for it.</p>
<p>I just recently heard about the concierge type services. I have no idea if any doctors in our area are doing that yet, but it feels a bit more like what we’d all like in health care: personal, comprehensive care. My in-laws have a doctor who just switched to concierge. It does limit the number of patients and is costly for the patient, so not everyone will be able to make that choice.</p>
<p>The thing that bothers me is that I have never had a doctor call (or have staff call) to follow up and see how I am doing. (My D’s pediatrician did a couple times over the years.) I often wonder how reports of complications from medications are skewed (minimized) because the doctor has no idea if their patient is actually taking the meds, doing well, feeling worse and went to another doctor…etc. I suspect, if they think of patients who haven’t returned at all, they might assume the patient improved, but it’s also quite possible that the patient switched doctors, or even passed away. I think follow up calls should be a regular part of the practice, not every patient, every time…but certainly every regular patient, sometimes.</p>
<p>" I think insurance companies tend to have the best doctors, they knew who to trust. That’s how I found out my acupuncture doctor."</p>
<p>That is awesome, and I hope that is true. In my experience the insurance companies tend to have the doctors who accept the rates the company can afford to pay. It’s a simple contract for solo or small practices, but it is a major contract for larger groups. There is a name for it, but it escapes me right now. I don’t fault them too much. They have a business to run. And many employers believe their employees want the cheapest benefit, not the best doctors. </p>
<p>Open enrollment is around the corner! We shall see. </p>
<p>So…some people expect an apology from the Dr. that is running late because they were meeting other patients needs, but do the same people hesitate to call that same Dr. at 3:00 a.m. often for an unneccesary thing? </p>
Well yes, but I have lots of doctors to choose from. I don’t think paying cash is any different. Or put it another way, I do get to decide who I would pay the copay.</p>
<p>" I don’t think paying cash is any different." </p>
<p>^It is different for me! There are much fewer rules when someone is paying cash. Google E&M coding and “99212, 99213”, 99214", and “99215” if you want some details. </p>
<p>“Or put it another way, I do get to decide who I would pay the copay.” I’m guessing you know that might be 10 cents on the dollar, although that is another one of those things that is evolving, and influencing what insurance you get, and what doctors are in network. I’d be curious about the range of copays folks on this thread are paying, and whether it varies depending on the specialty. </p>
<p>You might be very fortunate if you have lots of doctors to choose from. Or maybe folks around here are just UN-fortunate. That is one of the reasons I keep coming to CC. Different places can be so different! (And of course, my bias is from a mental health perspective. )</p>
<p>“I don’t think most doctors are giving out their cellphone numbers to the average patient.”</p>
<p>My husbands patients do not get his cell phone, but the call service does, and THEY connect the patient. </p>
<p>Jym - no; he’s got to deliver her anyway at the hospital so there’s no point in calling an ambulance. The hospital is 2-3 min from his office (and also 2-3 min from our home; we were constrained by that in buying a house). If the patient is by herself, he’ll just grab her, throw her in the car and off they go. If the patient is with her husband, husband drives and H follows in his own car. It would take more time (and cost $$) to call and get an ambulance there than to just get a move on. But other patients can see the commotion, see him run out of there and know that it’s an emergency. </p>
<p>I suppose technically speaking he could call an ambulance and have the on-call doc deliver his patients. But they want HIM to deliver, not the on-call doc. That’s why they are so loyal to him, because they know he will do everything in his power to be the delivering doc. I am not complaining, but our home life pretty much revolves around the notion that H cannot commit to outings, dinners, movies, family events, etc. We are trying to go away for the weekend in Oct - it would be our first vaca this year - but if he has ladies due, it can’t happen. If it doesn’t happen, the next time he can take any time off is May when our D graduates college. Til then - 24/7/365! </p>
<p>But what if there was some sort of catastrophic event on the way? That sounds pretty scary! I don’t think “we” are allowed to transport patients around here, at least not urgent or emergent ones. </p>
<p>( I am adding this so that folks don’t think NOT doing it is being rude or disrespectful!)</p>
<p>Ironically EMR requirements slow H down. He used to be able to dictate notes at the end of the day, they were transcribed (in India) and put into files. Now he has to enter info on the spot between patients. There are fines if EMR isn’t implemented on a certain schedule, and Medicare reimbursements are lowered. H is actually thinking of taking the fine versus put up with the paperwork. </p>
<p>Flossy, they may not have the personal cell phone number but patients can call and get the answering service, who will then wake up the Dr.</p>
<p>This thread makes me hope that my daughter goes into a specialty that deals with patients minimally. She doesn’t need to go to 9 years of school, then residency for paltry pay and then fellowship to have people ■■■■■ about waiting 10 minutes. The same people who will go to a nice restaurant and wait an hour. Really??</p>
<p>Oh, thanks for clearing that up. The reason I asked is I had a retired doc give me another docs personal cellphone number once for reasons having nothing to do with medical care. Anyway, I called him one morning to introduce myself and explain why I was calling and it was really weird. He was SO cagey until I managed to get out the part about the other doctor who gave me the number. It went something like this</p>
<p>Hello, I’m trying to reach Dr. Smith
Awkward silence followed by Who’s calling?
Uhm, my name is Flossy. I was referred by Dr. Jones regarding blah-blah-blah. I was hoping he’d filled you in. Laugh, Laugh.
Oh okay, It’s me. How can I help?</p>
<p>I am guessing maybe your DH has Medicare pts who are in SSDI. Or his old OB patients are now over 65 and stay with him for gyn.</p>
<p>Like shrinkrap, and am guessing its because of our backgrounds, that I’d be quite worried about transporting a patient personally. Lots of potential risk there. Wonder if malpractice would cover if there were to be an accident or the pt had a major medical emergency (placenta previa ruptured and bled out in the car, etc).</p>
<p>“I don’t think most doctors are giving out their cellphone numbers to the average patient”</p>
<p>Of course not - they call the answering service and the answering service calls either his cell or home, or texts his cell. I’m so used to this, if I see the answering service calling, I don’t even say hello, I just pick up and say “Try his cell” or “he’s at the birth center, try him there.”</p>
<p>But when he does call, patients do see his cell number. So far, though, I don’t think anyone’s abused it. </p>
<p>We try to remember keep our cell phones blocked when we return patients calls, and I didn’t even put my cell phone on school rosters! We have had acquaintances use them ( what I think is) inappropriately, and even drop by our house! But that is surprisingly rare. </p>
<p>"Ironically EMR requirements slow H down. "</p>
<p>Not ironic at all. EMR’s are not for the doctors benefit. </p>