Doctors’ Businesses Could Use Some Practice

I’ve had two very interesting experiences with doctors and their practices in the past few weeks.

One is the general practitioner who admitted me to the hospital a few weeks  ago, after I wound up in the emergency room with chest pains.   The other is the cardiologist that treated me there, as I was in overnight as they ran some tests.   Their stories intertwine, so please bear with me.

After being discharged from the hospital I called the Dr. NoHeart’s office to set up a stress test, as per my discharge instructions.  After several days of no returned calls I finally managed to get an appointment for the stress test – nearly 2 weeks after being discharged.  I went for the test 7 days ago and have been waiting for the results.

And waiting.

And waiting.

Every single person I’ve spoken to that’s had a stress test has gotten the results immediately or within 24 hours.

I figured that no news was good news, but I finally called the office yesterday.  I was told that results are not given over the phone, and that I should have made an appointment for 3 weeks from testing.

Really? No one told me that.  Come to think of it, no one called me to tell me that I should not eat nor drink the morning of the stress test, nor even to confirm the appointment.  I had called them, the morning of the test.  When I asked why no one told me that I was told that I “should have known” because “Dr. NoHeart always puts that in his discharge instructions.”

No, he does not.  All mine says is to call his office to schedule the stress test.  Period.  Said girl was completely disinterested in my complaint.

No worries, you see, because I was given an appointment.  Now I get to wait until September 9th to get my results. September 9th!

What if the test showed an abnormality?  I told the girl, who really seemed put out by the gall I was showing in asking for the results, “Well, I suppose if the test showed that something  is wrong and something happens before the appointment,  at least my husband and son will get a really nice malpractice settlement…”

See how well I make friends?

Exasperated to the nth degree, I did what all 30-and 40-something people are starting to do – I vented on Facebook.  And turned my attention to the appointment I had scheduled for today with Dr. GoodGuyIckyOffice.

I’d made the appointment with him because I was hoping he would become my next General Practitioner ( The one I’ve been going to for the last several years is not the best diagnostician, evidenced by the fact that my last several illnesses have been diagnosed by  Son’s pediatrician as offhand comments while treating my son.  Add that to an openly hostile medical assistant and a forty-minute drive, and you can stick a fork in me – I’m done…).  In the hospital I was impressed with this doctor’s manner, impeccable appearance, confidence, and the fact that his office is less than a mile from my house.

I showed up at Dr. GoodGuyIckyOffice’s office on time, having not eaten (expecting blood to be drawn) nor peed (self-explanatory) in hopes of a complete workup.  I had a bit of trouble locating the office, as you cannot see  the sign bearing his name as it’s on the wrong side of the door, invisible through the dark glass.

The waiting room was small and dingy.  I don’t need a doctor with a huge, expensive, perfect office.  But it didn’t  even look particularly clean.  And though the receptionist was courteous,  I was immediately irritated when she said, “Just let me call the hospital for your records.”  THAT should have been done the day I made the appointment – the week before.

Irritated as I was, a brilliant thought managed to creep through.  “Do me a favor,” I said to the receptionist.  “After you call the hospital, will you please call Dr. NoHeart’s office and ask them to fax over the results of my stress test?  I’m sure Dr. GoodGuyIckyOffice will want to see that.”

Hah!

A few minutes later the receptionist told me that Dr. NoHeart’s office  said they just received the report yesterday, and that Dr. NoHeart had not signed off on it yet.

Foiled again!

So, I follow the medical assistant to the exam room, which is also dingy and though swept it does not appear clean.  We go through all of the regular motions.  She begins to take a medical history, and eventually asks me my height.

“Five feet, six inches,” I answer.  She takes out a calculator to figure out how many inches that is.

I know what you’re thinking.  You’re thinking I’m going to poke fun at her because she needed a calculator to figure out how many inches 5’6″ is.

Nooooooooooo.  Not at all.

I admit to being surprised by what came out of her mouth next.  “67.2 inches,” she affirmed.  Huh?

“No, it’s actually sixty-six inches,” I say.

After she contradicted me again, and showed me the calculator’s answer, I explained, “A foot has twelve inches.  Five times twelve is sixty.  And I’m 5′ plus 6 inches. Sixty plus six is sixty-six.”  She still was not convinced, so I had one more thing to offer.  “How can the answer have a fraction of an inch?”

G-d only knows how tall I am in that medical record.  Though being 67.2 inches – a smidge over 5’7″ – would have been nice.

At this point I’d completely given up on the idea of Dr. GoodGuyIckyOffice becoming my GP.   I have to have confidence not only in the doctor him/herself, but the office.  So very many things can go wrong in a disorganized,  poorly staffed office.  And don’t you think a doctor’s office should be nearly spotless?  I do.

Eventually Dr. GoodGuyIckyOffice came into the exam room, looking bright and shiny and impeccable.  The contrast to his office was marked.  We discussed how I’d been feeling, what I’d been doing.  He asked about the stress test, and I told him what had been happening with Dr. NoHeart, and how frustrated I was that I couldn’t get the results.

Dr. GoodGuyIckyOffice pulled out his cell phone and called Dr. NoHeart on his private line, and explained the situation.  He also was incredulous that I was told I’d have to wait until next month for the results.  Lo and behold, Dr. NoHeart was looking at my test results that very minute (thanks, I’m sure, to the impetus of the call asking for a copy of the report!)!

Turns out there was a worrisome reading on the test, though half of the time it’s a false positive.  Nevertheless I’m going to need a cardiac catheterization to find out, and Dr. NoHeart now wants to see me on Monday.

And on the way out of Dr. GoodGuyIckyOffice’s I got a call from Dr. NoHeart’s office telling me that I’ve been given a 10:30 appointment, and,  “I’m telling you now you’re going to have to wait.”  Sooooo gracious, that one.

I really don’t understand why the staff at some doctors offices treat people like crap, and why doctors don’t do something about it.  I will put up with a great deal of crap if I like the doctor, but there will eventually come a straw that breaks this camel’s back.

I once fired a dermatologist after waiting well over an hour for my appointment, then hearing one staff member say to another who’d commented that people were complaining about the wait, “That’s too damn bad.  Let them wait!”   I fired that doctor only after she denied that it happened.   Her staff, “would never say that.”  I heard it clearly.  Apparently I lied.  Because really, I have nothing better to do than make up lies about doctors’ office staff.  And, by the way, she never apologized for the wait.  I understand that emergencies arise, but at least be gracious!

We also fired one of Husband’s endocrinologists after showing up for an appointment and waiting for an hour and a half, only to discover that not only was Husband meeting with a Physician’s Assistant and not the doctor, but that the other six other patients in the waiting room had appointments for the exact same time we did!  When we left four others were still waiting…

I am blessed to have an obstetrician and a dermatologist with super offices, where calls are returned, offices are clean and wait times are nominal.  Mutual respect goes a loooong way in my book.  I continue to search for a GP (and a new cardiologist after I get through this next procedure) and am hopeful to find a good one.

Perhaps I could start a business, consulting with doctors about how to improve the office experience for their patience.  Hmmmm….

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6 Responses to “Doctors’ Businesses Could Use Some Practice”

  1. Lisa Says:

    I left my OBGYN because of his office. Consistent waits that drove me crazy, and the doctor acting like it was completely out of his control how his office was run. Oh, and that his partner, who had equal chance of attending my birth, had, by his own admission, a 90% episiotomy rate. Zoinks.

    Too bad, too, because that OBGYN was H.O.T. Oh my. I did love looking at him.

    Re: the dermatologist and emergencies. Do dermatologists get emergencies? I thought that was the appeal of the specialty… 🙂

  2. Good Fountain Says:

    Every time I’ve been to a dermatologist I’ve had a ridiculously long wait.

    Your doctor situations sucketh. Good luck finding someone new!

  3. Erin Says:

    It’s not so bad seeing the P.A. (Physician Assistant). Most times they take more time to listen to you, seem to display more sympathy to a situation, and actually report office problems a lot quicker than the doctor is willing to (most likely because the doctor labors over finding competent office staff for the pennies he probably pays them to work).

    Everything you describe reflects back to a chain reaction caused by our flawed healthcare system. Allow me to explain. The doctor (this is more true for GPs than specialists) is stretched economically because insurance companies pay out often less than 1/3 of what is billed. The doctor then becomes disgruntled because the 15 minutes you think you are getting with him to explain your 8 or 9 maladies you’ve been waiting 6 months to talk about is only antagonizing him because he knows he will be lucky to get $20 for your visit, even if he bills $70. Therefore the doctor is forced to cut corners to keep the business going. He hires fewer employees, often pays them less (and we all know we get what we pay for… hence the incompetent front office and M.A. staff), skimps out on supplies in the office (making it look more dingy), and at times schedules too many patients in a day to make the bottom line. This is precisely why it would be BETTER to go to an office with one doctor and one or two P.A.’s. Because a P.A. can do about 80% of what a doctor can do, can always go to the doctor if he/she isn’t sure about something, can write your prescriptions and order your tests, and actually only gets paid HALF of what a doctor does. This means the doc can now see patients at a normal pace yet have double the amount of revenue he would have if working alone, while paying the P.A. only half his own salary.

    Until our healthcare system starts demanding doctors get paid for the functions they are performing, embracing the use of nonphysician midlevel providers (i.e. P.A.s), and until patients start getting educated about how useful these types of providers actually can be for mild complaints and follow ups, we are never going to be able to fix this broken system in our country.

    • BeThisWay Says:

      Erin,

      It isn’t that I don’t think that PA’s are competent and provide a valuable service. I just think that patients should be told they will be seeing the PA. And, insurers should be billed less in those cases…

      When I broke my arm an aide placed me in a temporary cast. When I saw that the hospital charged me for a physician to do it, and it was a separate charge from the examination, I called and told them to adjust the charge. I was not paying a physician rate for an aide, and neither was my insurer.

  4. Funny about Money Says:

    See, the “stress test” is whether you can survive the bullsh** you have to put up with to get past the doctor’s front office staff.

    I also have had to deal with obnoxious staff. And I also have “fired” doctors whose staff treated me badly.

    Thank goodness we have a branch of the Mayo Clinic here. Their staff is always 100% helpful, kind, and efficient. And I’ve never been fobbed off on a P.A. there.

    Yeah, it’s true that about 80% of what doctors see patients for could probably be handled by a good nurse practitioner or physician’s assistant. But I would be screaming furious if I showed up at an office expecting to see a doctor and found I was seeing someone with an AA or BA in nursing or “health care.” And I would run, not walk, away from a doctor whose offices were not sterling clean.

  5. Tari Says:

    Glad to have you back online regularly, but sorry to hear you’re having Dr problems on top of health issues.

    I recently fired my GP for not listening and randomly trying to change my meds without explanation. I just saw my new GP last month and feel that it’s going to be a much more rewarding relationship.

    I wish you the best of luck in your medical endeavors.


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