Medical insurance company RANT

[LivingAlmostLarge]

Sorry Steve but I LOVE the idea. I am frigging fed up with DOCTORS! I hate them and I work with them ALL the time. I am surrounded by MDs, but I can't even see one.

I am currently trying to see a family practice doctor (DH switched jobs in June) so I needed a new doctor with the insurance. Um I called last week for an appointment after finding someone online?

And WHAT HAPPENED! They didn't call me back all week, then I called again and was told they couldn't see me for at least 6 MONTHS! Tell me WTF am I supposed to do?

How am I supposed to see a doctor? I'm sick, I go to work and get someone to write me a script. I self-diagnose or the MD I work next to just looks me over and says "sure looks like a cold". Yeah, what the heck do I need to be sitting in a stupid GP's office for 2 hours to be told I have strep? I can do the damn test myself.

Worse yet, I never know what it will cost. I have $10 co-pay. But above that? I never know what things will cost.

So what do you want me to do? Hell yes I'll be going to the clinic. It's faster, cheaper, and more convient.

[disneysteve]

I am currently trying to see a family practice doctor (DH switched jobs in June) so I needed a new doctor with the insurance. Um I called last week for an appointment after finding someone online?

And WHAT HAPPENED! They didn't call me back all week, then I called again and was told they couldn't see me for at least 6 MONTHS! Tell me WTF am I supposed to do?

You're supposed to call a different doctor. That's insane. First, the fact that they didn't return your call is unacceptable. Then, the fact that they wouldn't see you for 6 months is ridiculous. In fact, I'm willing to bet it violates the contract they have with your insurance company. I'd suggest reporting them to the insurer. They shouldn't be listed as a participating provider if they aren't accepting new patients.

Sick visits should be same day or next day at the latest. Routine visits should be within a week or so, maybe 2 weeks tops. Anything beyond that is unacceptable in my book.

[disneysteve]

I called last week for an appointment after finding someone online

This is a whole other issue. Patients shouldn't have to switch doctors every time their employer decides to change insurance coverage. Folks also shouldn't have to pick their doctor out of a book or off a website. You should pick your doctor by speaking with friends, family and coworkers and getting personal recommendations for someone they like and trust. You get references for mechanics or contractors or babysitters. Heck, you probably even checked out the guy who mows the lawn. No way should you be forced to pick a doctor out of a book.

[Snave]

Steve,

I know you were ranting about the minute clinics, but what about those behind it - the CVS stores or other retail pharmacy chains or grocery strores with pharmacies that have similar clinics. They saw the dollar signs. They are the ones that hired the NP's, PA's, etc... and set up the clinic. They are the ones that benefit from the patient being diagnosed in the clinic and then filling a script in their pharmacy.

As for the insurance companies, they have done one hell of a job shifting the blame to everyone but themselves. They set co-pays higher for a doctors visit and the doctor gets blamed. They set the co-pay higher for a prescription and it is the drug companies fault. They have done one heck of a job passing on the blame to others. Rarely do we get upset with them, but rather with the doctor or the drug manufacturer.

[moneybags]

I don't have a co-pay, just a high deductible. I pick the minute clinic for $60 vs. the doctor at $120+ when it is something I know is minimal. If I know I have a sinus infection, I can wait 10 minutes at the minute clinic & get my prescription. I usually can't get into the dr. office on short notice, and if they can "squeeze" me in, I'm waiting over an hour.

That said, I can see your point about the unfairness in removing the co-pay.

[Scanner]

Snave,

I agree with you. . .I personally support the idea of putting them all out of business with national health care. Medicare is 97% spent on health care and for the most part, it is answerable to the people, rather than shareholders.

My colleagues, who often lament louder than Steve here about ins. co.'s, call me a socialist for even considering the idea.

It's a funny love-hate, co-dependent, dysfunctional relationship doctors have w/ ins. co.'s.

[Snave]

Snave,

I agree with you. . .I personally support the idea of putting them all out of business with national health care. Medicare is 97% spent on health care and for the most part, it is answerable to the people, rather than shareholders.

My colleagues, who often lament louder than Steve here about ins. co.'s, call me a socialist for even considering the idea.

It's a funny love-hate, co-dependent, dysfunctional relationship doctors have w/ ins. co.'s.

And to think, we could have never had this conversation as you would have had me thrown out of your office as a sales rep...actually, I am a manager for a medical equiptment company. Anyway, I hear it all as well. I'm just trying to sock as much money away before we are all out of jobs.

[Beccagold]

While I can definately appreciate Steve's frustration from a business perspective I feel its unfair to categorize the NP or PA for providing "lesser" care. How many physicians employ these same NP's & PA's in their practice? The care is ok then? My personal doctors all employ NP's & PA's and I actually think in some cases they do a better job since they are not rushing on to see the next patient to rack up the reimbursements. Usually they are salaried. It must make good financial sense for the practice to employ them as well.

In the interest of full disclosure, Scanner would have thrown me out, too! I'm a former drug rep & current Biotech rep.

[Scanner]

Snave/Beccagold,

Sorry. . .but I would have. . .I think it's gotten to be too much and I think it's a crime when the person selling and delivering the drugs are making more than the person prescribing them.

1 in 3 commercials on prime time TV are for drugs now.

This is America.

It shows you how much control doctors are losing - to ins. co.'s and drug co.'s.

I think family docs (and specialty docs) should "cleanse" their offices of all the tissue boxes, pens, scratch pads, soap bottles, cereal boxes, clipboards, and so on.

Put them in a big pile in the parking lot, throw kerosene on it, light a match and dance naked around it.

I know you are just pawns in the whole chess game called healthcare so it's nothing personal but I think it's gotten to be too much. As an outsider watching in (our offices are adjoining), they are swarming the practiticioners all day long.

It's got to be one reason the hapless pt. can't get appts.

Enough is enough.

[disneysteve]

While I can definately appreciate Steve's frustration from a business perspective I feel its unfair to categorize the NP or PA for providing "lesser" care.

I agree. I hope I didn't imply otherwise. I have no problem with NPs or PAs at all. I've worked with quite a few over the years who were excellent. So bashing NP/PAs is not my point at all.

[disneysteve]

I think family docs (and specialty docs) should "cleanse" their offices of all the tissue boxes, pens, scratch pads, soap bottles, cereal boxes, clipboards, and so on.

To play Devil's Advocate, though, all of those pens and pads and tissues and soap and clipboards are items that we need and use every single day in our office. Those things cost money. Getting them for free keeps our overhead down. Remember, unlike pretty much every other business in the country, we can't raise our fees to compensate for rising costs. Doctors aren't in control of fees. The government and insurance companies handle that. Taking free office supplies from the reps is a necessary evil to keep costs down.

I also happen to think reps provide a very valuable education service for busy physicians who don't get time to sit and read journals and attend conferences all the time. That's where we get most of our news about new treatments, new indications for old treatments, new warnings about products, etc.

[scfr]

Disneysteve ... This is my heartfelt advice to you: Read the book "Who Moved My Cheese? An Amazing Way to Deal with Change in Your Work and in Your Life" by Spencer Johnson, M.D.

This thread has been spinning around in my head for a bit. I thought about writing a variety of things, but what it boils down to is that you are the expert on the medical field (I cannot make any comments on the medical profession that would be of value to you), the situation is what it is, and you are the one who has to decide whether you want to "fight, adapt, or die."

Like most people who who reach our age, I've been through periods of serious change, and I found the book to be quite helpful.

So, please think about getting the book from your local library or bookstore, pouring yourself a nice glass of wine or brewing a nice cup of herb tea, sitting down in a quiet place and reading it (it's a quick read).

[PetMom]

This is a fascinating thread. I am still reading the first page of it but wanted to comment on the fact Drs. are being forced out of private (I assume private practice) practice because of costs.

This very thing is happening in the legal community. It is not too common to find a private practice lawyer with his own office.

Look closely, more often than not the ones who do usually have family members working for them. The cost of a receptionist and secretary are high. Wives, sons and daughters can be cheaper labor or take a pass on income if there is a dry spell.

Now there is a newer trend of lawyers sharing a front office receptionist/secretary for a fee and they usually do most of their own typing. Lawyers are now doing their own paperwork literally drafting it and typing it.

I had thought Dr.s had a more lucrative career, but this thread reveals the problems they have keeping a private or partner practice.

The classic being a Doctor or Lawyer is not the ticket to an automatic lucrative career.

[gladtobeamommy]

I have to agree with Steve here. This could lead to more cost in the long run for the insurance companies because if a disease goes undiagnosed. Never mind the fact that this could be fatal. I work for a podiatrist doing their medical billing and it has gotten to the point for it is 90% paper work and 10% medical. It really is sad.

[gladtobeamommy]

[QUOTE=disneysteve;153657]You make a very valid point, but at the same time, if you make it harder and harder for doctors to stay in business, what effect will that have on the healthcare crisis? I have a friend who was forced to close his office and retire a few months ago because he simply could no longer afford to operate his practice. He didn't want to retire but he had no choice. He wasn't making enough to keep the place open. Just today, I had lunch with a sales rep from a medical supply company. That rep is a licensed, certified chiropractor who gave up his practice because he couldn't survive financially. I know a pharmaceutical rep who was a podiatrist for several years before folding her practice for the same reason.




This actually happened to my cousin. He is a licensed opthamologist working in practice but he was responsible for purchasing his own health insurance and every thing else. With a new wife and baby he could not afford it being the sole provider. He gave it up and is now a NYC police officer.