How to be my doctor: Part one of a rant in two parts.

The BBQ Pit
1

How to be a doctor: Part one of a rant in two parts.

A bit of background. Several years ago, around the time I became a parent for the first time, I thought I might want to see what my health was like and go about trying to improve it. You see, nobody in my family lives very long. My father died at 57, his father at 54, before that they all died in their forties. Almost all my living relatives are young, and all my old relatives are dead. I wanted to see my daughter grow up.

This doctor, the first one I’d seen in several years, was gruff and annoyed by my presence. He gave me some scrips, told me “eat less, exercise more”. This was obviously great advice- pity he didn’t take it, he had a figure like an egg. Each time I visited his office I felt as if I was disturbing his routine. As I had to take off work to get there, it always meant extra effort for me as the work just doesn’t stop. After a couple of years of this, fired.

Doctor #2 was a bit better, at the outset; he was and is my wife’s doctor and I know him to be a decent human capable of compassion. His office staff, on the other hand, left tons to be desired. Each time I visited, I would leave a business card with my cellphone number theron, and ask to be called with any results on my cellphone so I might be informed of any developments immediately. Each and every single time, I got a message on my home answering machine, to this extent: “This is Doctor #2’s office. Please call the office as soon as you can for your test results” This invariably is a message I received on Friday at around 8:00 PM, making for an interesting weekend of anxiety, waiting for his office to open on monday.
“Hello, Dr. #2’s office. Yes, Mr. Rubin, we have your test results back. The doctor wants you to continue taking your medication” For this I agonized all weekend, wondering why I was supposed to call right away. Then there was the time I called to make an appointment:“Hello, Dr. #2’s office. Oh, Mr. Rubin? You want to make an appointment? Are you not going to make the one you have for today? Oh, you didn’t know you had an appointment for today? Ah, here, the doctor made it last week. No, we never call anyone to tell them they have an upcoming apointment. You’re supposed to call.” So, you arranged an appointment for me which I was supposed to know of via osmosis? Fired.
These two doctors were a prime example of what I’d seen in my life from the medical profession. I watched my father suffer and die due to the general lack of concern by the medical profession, and I wanted nothing to do with it. After firing my second doctor in five, six years, I was ready to tell the entire medical profession to pound sand up it’s tight sphincter.

But then there’s my optometrist. Yeah, Dr. M.

Dr. M. is the absolute salt of the earth. His father was an optometrist, and his son is as well. They are all the salt of the damned earth. Dr M. will take you into his examining room, and for the time you are there with him, you have his complete and undivided attention. For all you know, you are his only patient. You never feel rushed, you never feel as if he doesn’t have time for you, and he learns about you and your life so he can help your specific needs. A gem, is Dr. M.

Dr M. is sitting staring into my eyes (remember, sickos, he’s an optometrist!) and I’m relating the story of my most recent physician firing to him. He tells me, hey, you might talk to this guy. He gives me a business card. Someone he knows. Someone he likes. I think, hell, it’s worth a try.

So I go see Dr. #3. So far, so good. He seems to listen to what I have to say, he seems to be a decent guy. He’s a little rushed, but hey, we all have gigs to do, so I cut him some slack and think, I’ll see where this goes.

In a week he has me on a stress treadmill. I weigh 340 lbs, and he wants to see for himself that I’m not going to keel right away. Great, I think, he might actually be interested in taking an active role in my healthcare, and not just being an accidental tourist of my PPO.
Next thing he does is tell me to go have a sleep study (that’s another rant I’ll be working up very soon) which I have been told to do before; so far nobody has given me any indication that there will be any purpose to this. Dr#3 explains that he feels a great deal of my weight problem lies in my sleep apnea. Since I’ve done everything else to lose weight, I think, well, at least here’s someone who can give me a good reason to do it.

So I go have the sleep study. Dig around and find that rant if you like, it’s a good one. The people at the sleep center are after me to go back. I’m not too excited about this. The doctor says, hey, we’ve got the information, we’ll keep it in your file. What? I went through twelve hours of the new, improved spanish inquisition so you could place a document in my file? You ARE shitting me, right?

So this is a solid strike against Doctor #3, and I sort of like him so far, and on the off chance that he(or anyone else with an MD after their name) might read this, here are a few suggestions aimed at helping you connect and not strike out.

  1. You are NOT God Almighty. No matter what they may have said to you at medical school, You are a human being. You are not better than me, you are not smarter than me, you are simply a person just like me, with a different job than I have.I may not be able to do your job, but I know damned well you can’t do mine. hell, in North America there are only about forty people who do my job.

2)You didn’t go to medical school to become fabulously wealthy. True, if you do your job really well, this is a possible outcome. Whatever thoughts you had in mind when you started school, the fact remains, that the primary purpose of a physician is to help improve the quality of his/her patient’s lives by repairing or improving their health wherever possible. I’m sorry if I don’t have this exactly right, but the idea is sound enough.

  1. I am not your Job. I am not your career. I am not Case #KBZ-10Troy. I am a human being. I deserve your respect. I am paying you for your advice and your expertise, and I expect to get it in a manner which is useful to me, and which I understand. It is my money, or the money of the insurance company who is acting on my behalf. Earn it.

  2. If I act a bit odd in your office, remember I am a bit apprehensive. Remember my family history, the Rubins tend not to live long. Am I something of a hypochondriac? sure, remember my father had a fatal heart attack when he was 57. I’m worried about every unexplained ache and pain. Does this give you leave to tell my wife “You certainly have your hands full”. If this is meant in jest, great. Nobody can take a joke better than me. If it is not, and when I confronted you with it you acted as if it was not, it seems a serious breach of professional ethics. Can it. If I want comedy, Sam Kinison is far better, and he’s dead. I want healthcare from you.

  3. I pay your house payment. I pay your car payment. I put clothes on the backs of your children. I am your source of income, your customer. Other of your patients may feel as though they are stuck with you; I am not. I know I can throw a football into a mall parking lot and hit at least one doctor’s car. There is only one of me. If you don’t answer my questions, act as if you care about me as a person, give me practical advice that I can follow as to how to fix my problems, I’ll pick up the phone book and search through the twenty-eight odd pages of doctors and find another one. And I’ll keep doing so until someone listens to me and helps me. You may be hot shit, mister, but unless you step up to the plate and treat me with the respect I deserve as a paying customer, you’re out. A mediocre physician with a good ear and the ability to help will earn my respect before the first-in-class board certified god’s gift-to-humanity who won’t listen to a “mere patient”

  4. Don’t give me advice unless it’s advice I can follow. I’m not going to all of a sudden get a job close to home so I can have three hours a day to walk around like some dipstick in a purple haze- I just don’t have time for that, and it’s not going to happen. And look at me. I weigh 340 lbs. Do you think I’ll be able to stick to a reduced-fat reduced-sodium 900 calorie diet? Give me something I can use. Don’t tell me to have a test and then fail to explain the results of that test. Don’t tell me to have a test and then do nothing at all with the results. Explain my options to me. Make time to spend with me, and make the time you spend with me count. I have maybe six total hours of your whole year, on average, make them worthwile for me- you’ll get paid regardless, so why not do your job regardless?

  5. If I was as late for work as you regularly are for your appointments with ME, I’d be fired on the spot. And I’d find it impossible to get a reccomendation for another job. If your schedule prevents you from fulfilling all your personal and professional obligations, drop a few of them. You can still get bloody wealthy on a couple less patients. We’re all busy trying to make a living, but if I treat my customers as if I’m in too much of a rush to give them the time of day, they’ll go somewhere else. In a new york minute.

  6. The manufacturers reps for the pharmaceutical companies who fill your office with notepads, pens, clipboards, lunch, perks, etc. etc.etc. are doing what they do so they can make money. They rank right up there with used car salespeople in my book: annoying and disinterested in my health, in fact disinterested in doing anything but pushing their patent potions. Do me a favor. Write me a scrip for something that will work for ME, and not line the pockets of your local representative.

  7. Be my advocate. If someone you reccomend me to does a test (like the sleep study, covered elsewhere) and does it wrong, or doesn’t do it the way you think is right, don’t make me call them and deal with the BS, call them yourself. Raise the riot act. Fix it. This was your idea, make it right.

I’m sure there are a lot of physicians who are great. There are a few on this board who seem pretty decent. I’m not talking to those.

The entire focus of the medical profession seems to be missing the patient. More, better tests, more, better drugs, more better doctors, but the patient is lost in the shuffle, a manila folder with colorful stickers. If I wasn’t so fat and ugly, my doctor probably would not even recognise me outside his office. I’m really sick to death of it, and there isn’t a damned thing I can do about it, but surf doctors until I find one I like. I’ve about lost my patience for that. If the average business was run the way a doctor runs his practice, they’d be out of business in a week, because consumers will find better providers. People have been conned into believeing that doctors are some noble untouchable profession who are of a different class than us mere mortals, and that we are to bow to their superior knowledge and take everything they hand us with thanks, and oh, by the way, make damned sure to pay the bill on time. Bullshit.

B.

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Yup yup yup…

I’m glad that you are willing to leave doctors who are not to your liking. It sounds like you are being proactive in finding acceptable medical care. Keep trying, and don’t get discouraged. It’s taken me ages to find doctors that I like, but I have found some.

Have you considered female doctors? There are plenty of exceptions to the rule, but overall, many people have found that female doctors are more willing to listen and get to know their patients. They also are frequently more reassuring.

Another option is a nurse practitioner. I see a nurse practitioner who works in my doctor’s practice for all routine stuff. In fact, over the years, all the best “doctors” I’ve had have been nurse practitioners (I ran into a lot of them because they tend to be common in college health services). IME, nurse practitioners are even more willing to listen and create a reasonable and practical treatment program than MD’s. And of course, any good nurse practitioner will kick you over to her consulting physician if she feels that the problem is outside her ken.

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Thanks, Green Bean. I can use all the encouragement I can get.

I have not ruled anyone out in my search for a doctor. Hell, if someone directed me to a haitian midget voodoo practitioner with a plate in his/her lip and a live fish in his/her pants, I’d go willingly as long as I thought they were doing something useful.

b.

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Nothing to add Billy other than my hope that you find the right someone. I’ve left a few doctors too because they were always prescribing the same shit that was on their wallclocks, pens, notepads, etc. Everybody in their office would temm me “yeah, that stuff is great… our whole family’s on it.” What the hell, a blanket fix for the entire community? Don’t think so.

Btw, seeking weight loss advice from a guy with a plate in his mouth seems very… umm… optimistic? :slight_smile:

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I have to say I’m not all that inclined to offer you much sympathy, BR. I work in a doctor’s office. First of all, the cellphone# story: you gave it to them on a business card? Now picture for me that card’s itinerary. And remember, you must somehow get it from your hand to the person who will be calling you with the lab results. It’s quite possible that the lab results are printed with your primary phone number on them; quite possible too that the lab results are given directly to the person who will call you about them, without first going through the reception area. In other words, short of taping your card with a note to the phone of the person who will be calling you, handing them a business card and leaving it at that is hardly the best way to get them to call you there. Suggestion: ask them to change your primary number on your record. That way, whenever anything prints out, your number will be right there for them to call.

And this:

I’m sorry, I just can’t believe this. Either you spoke to someone who forgot to call you and was covering his/her own ass by lying to you, or you were right to “fire” them: I can’t imagine that a clinic with that practice as general policy will be open for long. For one thing, we call to remind patients of their appointments for purely selfish reasons: there’s nothing more annoying to a clinic staff than a patient who blows off an appointment.

Sounds to me like you’re blaming individual doctors for the kind of general problem’s caused by today’s penny-pinching healthcare practices. Most clinics nowadays are under constant pressure–from insurance companies, from hospital administration, from all sides–to cut down costs and increase productivity. Every employee of the clinics you deal with is probably overworked and underpaid. Remember, we not only have to deal with patients, but with doctors and insurance companies on top of you. The . . . horror!

And as for your sleep study story, let me get this straight: you’re pissed at the doctor for not finding anything wrong? All that trouble you went through, and he’s just gonna toss it into your file? The noive! A diagnostician who works by eliminating possible causes for your problems! He should only have you tested for things he already knows the outcome of! Demand this now!

And as far as the stereotypical doctor’s arrogance, I’ll agree that that’s the way it often comes off. But most of what I see as abruptness and aloofness is due to the same pressures and constraints that the staff have to deal with: the demand to lower costs and increase productivity. A doctor’s time is extremely valuable to you, the patient; the customer. He’s getting paid what breaks down to $buttload per hour, so, for your sake (i.e., to keep costs down) he has to use his time as efficiently as possible. He has to be able to flit from exam room to exam room, with no wasted time in between. This means that, yes, you have to do the waiting, not him/her. If your time was given priority over the doctor’s time, the doctor would spend half of the day waiting around in between patient appointments, the cost of which would then of course skyrocket. In order to keep costs down for you, the customer, the clinic has to cram in as many patients as we can, with no wasted doctor time in between. There is simply no way to do this without having the doctor constantly running late, since we basically have to overbook slightly to run at maximum efficiency. If we don’t overbook, then every patient who is late, or early, or missing, or requires more time, would result in wasted doctor time. This would drive your bill up. Additionally, since the doctors I work for get $buttload per hour, and I get $pittance, anything–anything at all–that I can do, the doctor will not do. So he delegates everything that doesn’t require rubber glove and a sheepskin. This too can come off as arrogant. But if he didn’t, your bill would increase.

In other words, pretty much everything you complain about–with the bizarre exception of the clinic that doesn’t tell its patients about their appointments–are necessary evils in these days of market-driven healthcare. Talk to the insurance industry: in my opinion, it’s their fault.

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I offer the previous post as exhibit A in the case against doctors. Blame everyone else, but god forbid you take it on yourself to do anything to change or make it different or better.

Thanks, Lissener.

b.

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I offer the previous post as an example of someone who has read a carefully written, example-filled, very specific argument, and has absolutely nothing intelligent to respond with.

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Would you like me to argue with you, lissener? how could I do that? of course you are right on all counts. It’s inconceivable that I, a mere patient, could have anything true to say, as you have so eloquently stated.

thanks for making my point, and driving it home.

b.

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Ditto my previous post.

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I think many doctors are pretty darn good at their craft, although you’d have to look pretty damn hard to find one of the calibur of our Quadop here. But sometime a little weeding through is necessary to get the right fit.

I was having a lot of trouble with my stomach a number of years back. I described the symptoms and told the Doc that about the only time it didn’t act up is when I didn’t overeat and was working out very strenuously.

He signed me up for 2 or 3 days of tests in which they had me drink Alberta’s yearly export of Barium, stuck the Hubble Telescope up my ass and xray’d me like a package shipped on El Al. After enduring the nausea of all that his advice was… don’t overeat and keep working out.

Der.

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Hell, I’ll respond.

So, lissner, handing the office a card with your number on it and giving specific instructions to call this number is not enough to even remotely suggest that that’s the number you are to be called at? IF the test results are happeneing at an entirely different place why can’t the office personel at least say “Sorry, sir, the test results can only be called in to your home phone.”? If this has happened multiple times there isn’t an excuse on the part of the office. Not without some explination. Patients shouldn’t be expected to be psychic about the system, just as offices shouldn’t be expected to be psychic about the patient. That’s why patients talk and do things like give written instructions. Why is it too much to ask for the same courtesy back from the medical profession? If the office couldn’t follow the instructions, it would know ahead of time, and should have said something. We’re not asking for a lot just the basic level of professionalism that is expected from every other profession

I think that was my favorite part. WHY THE HELL NOT? Unfortunately, crap like that spews from the mouths of far too many health care workers. I thought it was pretty straight forward, the office sucked so Billy left. Nothing hard to believe there.

No, as far as I can tell (and I’m making these assumptions based on my own pissy experiances, Billy feel free to correct me) He’s pissed that he was told that the results were vital to his health and then that they didn’t prove anything. If an expensive and uncomfortable test is going to be taken that conculsively does absolutely nothing, why take it? (This exact instance resulted in me walking out of my last doctor’s office. He wanted me on heavy medication for a year “to see if it would help” a condition we didn’t know I had. This was after a bunch of tests for said condition came up negitive…evidentally the tests had no real way of adjusting his reaction. If they had come out positive I’d be on the same meds, since I was negitive…I needed the meds anyway?) No. If there is a reasonable thought process going on in there, share it with me. Its my body, my health. You may have the degree, but that’s why I’m hiring you as a consultant, consult with me now.

Does your mother have to gargle saltwater after you kiss her with that mouth? Does this not look like complete and utter bullshit to you? Many other highly paid professionals under lots of pressure manage to figure out time management just fine. I understand emergencies, when a doctor is simply needed to help someone else right then. But to as a rule KNOW that you are overbooking still doesn’t make any sence to me. WHy have appointments at all? Why should I have to show up 15mins early when the doctor, from the first instant of the day, knows they aren’t going to see me until well after my “scheduled” time? If every other profession on the planet, including dentists and lawyers can figure out how to use a day planner doctors sure as hell can, no matter how much they make.

Repeat after me, one person can only be in one place at one time. Why schedule more? It is not efficient, whatever you’re trying to sputter at me. If a patient doesn’t call to cancel, they get charged for an appointment anyway, so no whimpering about losing money for lost time. The only reason to schedule more is greed/stupidity/total loss of respect for patients, not some selfless attempt to lower costs.

These are NOT “necessary evils”. There is nothing unique to medical care that gives it a pass on respecting humanity, and that’s what behaviors are being called to question here. Its not necessary, but I’ll give you the evil part. I know it doesn’t have to be that way, because I’ve met doctors for whom it isn’t. They aren’t gifted by God with miraculous time management skills, they just have an office that they refuse to let abuse people. They themselves refuse to let thier patients be abused. My family doctor lives a full three hour drive from my family, he moved his practice years ago, we went with him. When the “necessary evils” of the medical profession tried to keep my newborn sister in the hospital after it was proven she was fine my doctor could not be stopped until she was released. He found a meeting of the board of directors of the hospital and yelled at them about how they were treating my mother and sister. He gave and demanded a respect for humanity and right, and my family will support him as a doctor and a person for as long as he continues to practice. That was above and beyond what I expect. Why do so many doctors think its okay to go so far below what is expected of them?

Patients don’t ask much from doctors, just some respect and open communication. Every other profession on earth has figured this one out. Why is it impossible for the medical profession at large to accept?

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Billy Rubin, good rant. You know what you want - just keep on keepin’ on until you find it. Don’t forget to do research on your own, too. It’s not against the law to be knowledgeable about medicine without a degree. :smiley:

lissener, I disagree with you that the way patients are treated is the insurance industry’s fault. That sounds more like an excuse than a reason to me. Some of the problems are caused by the insurance industry, but every doctor’s office operates within the same closely-regulated system. Differences in how patients are treated is not the insurance industry’s fault. I would suggest that a large part of how patients are treated is decided by the attitudes of the staff working there.

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lissener: You are wrong.

If all of the above were true, why do both of my doctors’ offices treat me with respect. Are they just uninterested in making money? I doubt it.

I am 7 months pregnant, so I have been in to the doctor at least 10 times in the last 6 months–checkups, blood tests, ultrasound, etc. Only once was I subjected to a long wait. The doctors take as much time as I want them to take, and always make sure to triple-check that I have no further questions. My regular doctor’s office is the same way.

These are 2 standard medical practices. They are both extremely popular, and it is nearly impossible to get taken on as a patient at either one of them. (I got very lucky to get into the regular one–it took me 2 years–and they then managed to get me into the OB/GYN) In other words, they could squeeze a lot more patients in if they wanted. These practices are under the exact same penny-pinching constraints as any other practice. They just choose not to let it negatively impact the patient’s care.

Now, contrast this with my shrink–long waits, short visits during which he takes phone calls from other patients. He often shows up at the office 1/2 hour after my appointment time. I was about to fire him when I got pregnant. I decided to stay with him for the duration because I feel that he is a very competent psychopharmacologist (and I only have to see him once every 3 months). As soon as I have the baby and am past the period where post-partum depression is a concern, he’s fired. Doctors are a dime-a-dozen around here, and I don’t have to tolerate one that treats me without respect.

And, furthermore, what Medea’s Child said.

14

Of course I agree with you; they should have explained, or refused or whatever. I took that as a given. I only meant to shed a little light on the fact that the process is probably more complicated than you’d think. It’s likely the person who took the card made every effort to fulfill BR’s request. It’s also likely that it was a different person entirely who actually called him, with an unknown number of steps and barriers between them. I only meant to suggest that it was more likely to be an oversight on the part of a well intentioned person than intentional disregard.

Well, at least you’re not coming into this discussion with any kind of an existing bias, or anything. :rolleyes: I repeat, and I insist, that there isn’t a clinic in the country that has such a policy as policy. It’s simply not possible. The person who told him that should be fired for lying to cover his/her own ass, which is the only conceivable reason I can imagine for telling the patient such a lie.

Knowing the results may well have been vital: eliminating that possibility will help eventually to find the solution to the problem. We don’t get a commission on the tests we send our patients to get. We get paid for our services to them, period.

Well, at least you’re not coming into this discussion with any kind of an existing bias, or anything.

First of all, we are not allowed to charge a patient who blows off an appointment. As for the rest of it, think about it. If we schedule every patient for say 30 minutes, and the second patient of the day is late by say 10 minutes. The doctor either wastes 10 minutes, or, if the third patient is there early, he’ll maybe see the third. Then he sees the third as his second, but is now running late because of the confusion (med recs, setup, whatever). Then say that patient has a problem that requires more than the 30 minutes allotted. Now he’s running later. Or, say he’s done 10 minutes early. If there’s already another patient waiting for his appointment, the doc can pop right over and see them. Either way, early or late, if you have two people—the patient and the doctor—trying to be in the same place at the same time (definition of appointment, for now)—and this is happening say 10 or 12 times a day—there will be gaps: one of them will be early, one of them will be late, etc. Somebody somewhere is going to do some waiting. The system is set up so that, wherever possible, that waiting is done by the patient instead of the doctor. The only alternative is to book far fewer patients, with buffer times in between them (resulting in higher fees), and to charge for missed appointments, and to begin and end the appointment at the appointed second, zero tolerance… And tell me that wouldn’t set you complaining even loudlier. Overbooking is the only solution that allows us to keep the costs down by seeing as many paying patients in a day

And again, it’s out of respect for the patients’ demands of lower-cost healthcare that a doctor today has to run his business so close to the edge. A wide margin for error—i.e., a system that absorbs and indulges inefficiency—costs money. The reason it’s the insurance industry’s fault is that they’ve got it rigged that they continue to make vast profits, so it’s the healthcare professionals who must eat the cuts. You get what you pay for: if you want to live under a system where a huge chunk of the healthcare cash is siphoned off by the insurance industry, so be it. That’s the bed the voters of this country—i.e., the patients—have made for themselves to lie in.

15

. . . I don’t see how that follows. I’m glad for you that your doctor is not subject to these things. I never suggested every doctor was. I was only trying to explain that, when these things happen, here’s probably why; I never said they always happen. We get all the same complaints that BR outlined–but only in one out of every several hundred followup surveys. These things happen, but rarely: you’ve been lucky, most of our patients have been lucky; BR has not. And some of our patients have not been so lucky either. Last year we had to have security remove an irate father; I’d like to see what his contribution to this thread would have been. But that’s only happened here once. Last week, we had a parent (I’m in a children’s hospital, BTW, so we deal mostly with parents rather than patients) who had been told by an ER worker to take her kid to the GI clinic. Well, our doc reviewed the case and determined she did not need to see a specialist, conferred with the family doctor, and referred the patient back to that doctor. The patient called back, furious: the ER staffer had told her to see a specialist, and we refuse? How dare we? Well, our doc, the specialist (a nationally recognized leader in his field, BTW; published on the cover of the NEJM, etc.) knows more about it than the ER staffer, and further, conferred with the kid’s family doctor (for which there is no charge, BTW), and reserved his time for patients who really DO need to see a specialist. Not good enough; parent still insisting. I wanted to tell her, Look, I don’t care if the ER staffer told you we were gonna give you a color TV. It’s not up to the ER staffer which patients we see. Needless to say, I didn’t tell her that, but I’d love to see her contribution to this thread as well. So sure, we have the rare dissatisfied patient, and I’m sure your doctor has his/hers as well, Green Bean.

16

Lissener: read the rant. Read it again, hell read both of them.

I have an optometrist who acts the way a doctor should act, treats me with respect. Know what? I’ll never leave him. Even if he no longer accepts my insurance. Oh, wait a minute, he doesn’t accept insurance at all. You know what? I don’t care. I still go to him, though I have vision insurance. I pay out of pocket because he’s good. Would I pay a doctor out of pocket if I got the same respect? absolutely. Does that blow your insurance as intrinsically evil attitude out the window? sure. Without an insurance system, there would still be doctors. Before there was insurance, there were doctors. Does insurance cause some of the problems? Sure. Would the tests and procedures and etc. costs continue to rise if the doctor’s attitude hadn’t been “oh, he’s got insurance, let’s send him for lots of tests”. The blame may lie partly in the insurance companies, but the doctors are clearly at fault too.

So don’t take it personally because I shat deservedly on your little corner of the world, Lissener. This was not meant as a personal affront to you. If you take it as personally as you seem to be doing, I can only imagine that it is because you treat your patients the same way and you know it.

Anybody else in the world who ran a business that way would go out of business soon. that is an irrefutable fact, hell, if you got that kind of treatment at your car dealer you’d raise the roof. And this is my health. I’m not sitting alone bitching about it. I’m actively trying to find help. And I’m getting nowhere with the so-called “medical profession”.

b.

17

You know, I really wasn’t taking it personally, because I understood that you were unfamiliar with the complexities of the issue. I don’t how you came to that conclusion. But your tone in the quoted paragraph above, and your putting words in my mouth (where did I say the insurance industry is “inherently evil”?) is undeniably personal, so first of all, fuck you you fucking fuck.

But getting back the subject at hand, the ragged-run clinic staffers you have been unlucky enough to deal with are run ragged because the insurance industry refuses to absorb some of the burden of falling healthcare costs as demanded by the public. That the doctor you’re with now is apparently not as reliant on insurance dollars, and whom you like, seems to support this.

And if the doctors you mention treat the majority of their patients as you describe having been treated, I assure you they will go out of business: doctors who are liked by their patients tend not to get sued for malpractice. This is a fact; I’ll track down a cite if someone wants one. FWIW, of the four doctors I work for, only one has ever been reported by a family for misconduct (out of a total of nearly a hundred-doctor-years of experience among them), and this was by a family whom he had already reported for child abuse. The case was dismissed because it became clear that their reporting his was malicious and unfounded. So, in other words, I work for doctors whose patients by and large do not feel the way you do about their doctors. Nonetheless, as I have said, we have had the occasional Rubinesque dissatisfied patient. This is of course unavoidable when you deal with the public: you can’t please all the people all the time.

18

No, my doctor is subject to exactly the same things. They are a standard medical practice which accepts standard medical insurance. My point is that they do not let the insurance penny-pinchers pressure them into treating the patients badly.

I made my own luck. I left doctors who were not as competent as I would have liked and/or treated me without respect. As I said, it took me 2 years to get into the practice where I am at. Billy Rubin is trying to make his own luck as well, and I admire him for it.

p.s. I love my optometrist, too. I travel 2 hours to get to him.

19

Please excuse the above coding error. My first statement was not supposed to be bolded.

20

Look, whatever.

All I’m saying is that A) those things don’t happen to everyone, and B) when they do, just try to see it from the clinic-worker’s point of view. Of course some people are assholes, and they need jobs too. So BR may well have encountered an asshole or two. I’m not disputing that. But we get the exact same complaints from time to time, and we are NOT assholes; our survey results put us way above the national norm for patient satisfaction. I’m sorry that BR was that rarity (rare at least for us) who, for whatever reason, was dissatisfied. But I still maintain it’s a rarity. (This sense of dissatisfaction can of course be exacerbated by shoulder chips, as is no doubt the case in BR’s hx.)

Over and out.