Monday, September 17, 2012

1071 The Doctor is In

1071 The Doctor is In.

How is it dentists have figured out to keep appointments on time, but doctors haven’t?  Maybe it’s the fluoride in the water at dental schools that irritates incoming freshmen in ways that makes them more likely to look at their watches.  Maybe it’s because most dentistry doesn’t have to be done all at once.  Maybe they’ve discovered that you don’t have to fill all five cavities today... that three of them can wait a week and you get a second appointment.

The sign in the doc’s waiting room says “If you’re more than ten minutes late for your appointment, we may ask you to reschedule.”  That’s not a real quote.  It’s much too clear for Medical Officespeak.  And it doesn’t work both ways.

Doctor: “Sorry, kid, I’m running late, but you’re free to reschedule.  We have a few openings at around this time next week.  And don’t worry, that bleeding will stop on its own, eventually.”

We’ve seen amazing medical strides since the days of leeches and cocaine-laced snake oil.  Well, from the days of leeches, anyway.

Medical office practice has strode in the opposite direction, ignoring the one-way signs and the patients.

Kindly Old Doc kept his patient records on 3x5 cards in that infamous “doctor handwriting.”  He never missed a trick, never failed to set up appointments with specialists and never forgot about following up on his patients’ progress.

Of course in those pre-computer, pre-insurance company days, the whole of the medical conversation and action was doctor and patient, maybe augmented by an office manager who knew everything that was supposed to happen and knew most of the people who walked through the door of the waiting room.

Only a few years ago, medical records were kept in huge files on office walls.  Sloppy, slow and with occasional mis-filing, mostly accurate.  Today, it’s all computerized.  And it doesn’t work.  There are virtual cracks for the virtual records to fall into.  Sometimes it’s lemmings heading into the cracks.

Here’s a perfect example.  Recently a patient was prescribed a complicated test which was to be performed at a hospital and required “authorization” from the health insurance company.  Weeks pass and the patient calls the medical office and is told “the insurance company hasn’t approved it yet.”  More weeks.  Then a call to the insurer: “we don’t have any requests on file for you.”

Oh.

Another call to the medical office:  “The insurance company won’t authorize this without a date from the hospital.  The hospital can’t schedule the appointment without approval from the insurance company.

This sounds made up.  It isn’t.  It sounds atypical.  It isn’t.  It happens every day.  And you can’t make this stuff up.  Or do much about it.

Shrapnel:

--Happy 25th anniversary, “Weekend Today,” a staple of NBC’s Saturday and Sunday morning lineups (or is it lines-up?)  In the early years, we worried that it wouldn’t live to see the following weekend.  That worry is long gone.

I’m Wes Richards.  My opinions are my own but you’re welcome to them. ®
Please address comments to wesrichards@gmail.com unless they’re an invitation to a vocabulary wrestling match over “strode” vs. “stridden.”
© WJR 2012

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