It helps if they actually look at the chart when seeing you. Granted this was my dentist, but on my last visit I said very clearly that I won’t floss or use washes, and I will brush my teeth once in the morning. That is why I put myself on a three-month visit schedule instead of six. Next time I go in, during his 30-second glance at my teeth, he suggested I use a wash. :smack:
My doc on the other hand takes time to sit down and talk, takes the notes on her laptop as we talk, and walks out to print out prescriptions at the central desk. I like her.
In fact, my grandmother just did this. Doctors were hard to come by in Kingston, Ontario… unless you went to a private practice doctor (e.g. one who isn’t part of the Medicare system.) Her doctor caps the number of patients she sees and spends a lot of time with her patients. My grandmother pays about $200 a month but gets much more attentive care that most family doctors, who rush you in and out at top speed so they can bill the government for the maximum possible number of visits. It’s worth it at her age and in her condition.
I would be if the medical professionals were actually doing some or any of those things. My sleep specialist reviews my file once he walks into the room. While I sit. And watch him read it on the laptop in the exam room. He is completely unaware of my history, or when treating my daughter, her history. How do I know? I constantly have to remind him of what my history IS, what the last thing that was done is, and so on.
My Dr. has never, ever called me back. In fact, he didn’t call me at all after my first sleep study to discuss the results. He simply ordered a second study. After the second study, he never called me at all to discuss THOSE results. He simply ordered a CPAP machine. Know how I knew? The company that delivers them called me.
He has a person whose job it is to contact insurance companies. In fact, I cannot think of a single doctor I’ve met in the last 15 years who makes their own calls to insurance providers.
Another example, so we don’t just think it’s one bad apple? Sure. I broke my back in 2000. I decided from the afternoon of the accident that I would own everything about my case. I would own my personal set of films, and own all written records. Easy enough to do, the Federal Government now guarantees that my records are my property. Every shot taken, I got a dupe.
First Dr. could not figure out why I wasn’t healing so I went to a second one. I told them, make sure you get ALL of the films, ok? The nurse for Doc #2 was mighty haughty about it. OH yes Mr. Toons, we will have all of your films". I knew better. I showed up with my entire set in an envelope. That same nurse walked in, saw me holding them and said, " Dr. Jonesy will review your films first before meeting you". I informed her that A) Those films were my property and would not leave my sight, and B) Since it was a first consult, Dr. Jonesy would pay me the respect of examining MY films in front of ME. She was furious and argued. So, I put my coat on. Who needs to be yelled at when the nurse blew it and didn’t order my films?
Dr. Jonesy caught me in the hallway, apologized for his nurse and asked permission to see the films. We walked, and tried to work on my case.
Another large practice- and yet they couldn’t be bothered to order in my films from the library. We all have these stories, and the sameness is appalling, not comforting. Utter lack of respect. Utter lack of professionalism. Utter disinterest.
We are, truly, A Billable Unit.
I believe what you have said, no doubt you are extremely conscientious. Just know that you are in a small minority.
My doctor (in my post above) does this with us (and other patients) under full insurance without any opt-outs, and no extra fees or workarounds. I don’t know the details of how she runs her internal billing, but she seems very successful without having to do impersonal high-volume churn.
She works in a partnership with a few other docs in a private practice though, and they make their own administrative policy as a result, without the overhead of a larger hospital. They are smaller scale, so in-depth procedures (MRIs and the like) get referred out since they don’t have the equipment and labs on site. Could this be the difference?
That was basically the Dutch healthcare system.
People below a certain income brackets would be “Sick Fund Patients”. A GP wouldn’t want too much of those in his circle of patients, because a few patients with a lot of complaints might easily take up a whole chunck of his time, and he wouldn’t be paid any more for them then base level. Patients above a certain income bracket would be “private patients” and for them the doctor would be reimbursed per treatment. There was, among the Sick Fund Patients, some resentment that “private patients” would receive better care and more respect. But realistically speaking, that wasn’t the case.
They changed the Dutch healthcare system 2 years ago, but I don’t know enough to describe what changed.
My doc seemed to be not listening, but fussing at his desk. Then I realized he had a glass top on his desk, and a monitor bositioned under it, with a keyboard drawer in his lap.
He was happily taking computer notes while we talked, not looking at me most of the time. Usually I feel they don’t care about me when they just take notes on a clipboard, but this was too much. I never went to him again.
Living in Canada, where health-care is public, this is all a little terrifying. Maybe this happens here, too, but whatever the case, I’ve never run into a situation like this. My doctors have given me all the time I’ve needed in examining me, building up a relationship, explaining what they’re doing and why, and in letting me know what they think might be wrong.
I’m sorry, but what exactly are you expecting in terms of taking notes? For the doctor to perfectly remember all of the salient points of the visit perfectly and to transcribe those onto the chart later? Not only will that doctor probably forget half of what he or she meant to write, that visit will take up twice the time it otherwise would have. If you’re willing to pay twice what you currently pay for a primary care visit, by all means, go ahead, the option is there with “boutique” doctors.
This doesn’t apply to the majority of situations, when someone just needs a routine visit and there’s no specialist to call, no procedures to schedule, or anything like that. Perhaps you’re more ethical than the majority of your colleagues, but in my experience the rush is because they’ve scheduled five different appointments for the same time slot.
I once saw an eye specialist who worked in his own private practice, alone. He had three exam rooms there. The first time I went he had seven people scheduled for a 2:00 appointment. I walked out at four and rescheduled; when I finally did see him, he spent about five and a half minutes with me - I timed it. And, no, there was no “reviewing my record” or scheduling further appointments.
I work in OB-GYN in a very, very, busy hospital and I can say with confidence that our Docs are very busy. I am also frequently impressed with the Docs memories, but I usually assume the case is a stand out in their mind for some reason. No one could remember all that stuff!
Our Docs see the hospitalized patients between 7 to 8 am and then go to their clinics where they see their scheduled patients. Sometimes they come back during their lunch hour and sometimes return again in the evening for a final round, usuall about 7 pm. They don’t usually see every patient during their second and third rounds- just the ones who are having trouble or need extra attention. Of course, being OB-GYNs, they are frequently called to a delivery that can disrupt their schedule. None of our Docs would hesitate to come right away from the clinic or from home if a problem required them to do so.
A couple of the high risk maternal-fetal medicine folks are kinda guff sometimes. I allow them some slack for this because they deal with some pretty nasty problems and I think the gruffness and/or alloofness they sometimes show is a way to separate themselves from some of the devastating defects and problems they encounter. After 15 years in OB-GYN (most with these high risk Docs), I still encounter cases that leave my head swimming on occasion. I often wish I could write about some of the more unusual things I’ve seen at work, but several reasons prevent me from doing so. Fortunately, my sister is also a nurse so we can speak privately to clear our minds of difficult cases.
