3 minute video summarizes healthcare problem in US.

[cicy33]

Here was my doctor's visit this week. Keep in mind I have a previous relationship with this doctor. He has already seen me before and prescribed me meds and is aware of my sinus issues.

Me: call dr office: Hello, I have a sinus infection and need to get a script for antibotics. Just wanted to be sure doc doesn't need to see me.

Nurse: you have had them before?

Me: Yes, I get at least two every year, my last one was in april, you guys prescribed.

Nurse: well, let me check.... yep doc needs to see you.

Me: ok, no prob

I go in, spend literally 3 minutes.

Doc: so what is wrong

Me: I have a sinus infection

Doc: let me look at your ears, and throat, yep you have a sinus infection, I will get your rx.

so, for me I could have saved the money and just go it called in. Now, don't get me wrong, I can understand that the dr needs to see people but when you have a history of this, and trust me you know when you have one if you are used to them, then don't torture me!!!! I am actually better than I used to be, I used to get strep at least three to four times a year. started taking sinus pills to control the drainage and that helped so much!

[Aleta]

I don't know if this is the place for this, but my husband went to the CVS minute clinic about 1 1/2 years ago and he loved it. He was going to need antibiotics. Everytime we walk into our doctors office, it is no less than $100 and he is an Osteopath. We have to pay for every visit and prescription, and tests and it becomes quite expensive even though I know that he tries to work with us. Anyway, this nurse -practitioner in CVS was very thorough with my husband and it was reasoanale. He got well and that was the bottom line.

[disneysteve]

Here was my doctor's visit this week. Keep in mind I have a previous relationship with this doctor. He has already seen me before and prescribed me meds and is aware of my sinus issues.

so, for me I could have saved the money and just go it called in.

We've gotten off topic but I have to respond to this. As you all know, I'm a physician so I look at this from the other point of view. Not a day goes by in our office without patients calling and telling us their diagnosis and what treatment they need us to prescribe. Admittedly, sometimes the patient is right on the mark. Lots of times, though, the patient is wrong and had I just called in what they requested without seeing them, their condition could have gotten much worse, even life-threatening on occasion. Prescribing over the phone is always a hazard. Any malpractice attorney in the country will tell you he loves cases that involve prescribing without an office visit because they are impossible for the doctor to defend. So that's one point. It just is sub-standard care to treat by phone without an exam.

Another point, to be perfectly honest, is that doctors can't charge for treating patients over the phone. Unlike attorneys who can bill by the second for speaking to clients on the phone, doctors can not. If I spend 5 minutes on the phone asking a patient about all of their symptoms and what treatment they have already tried and such and then decide to phone in medication for them, which takes another phone call to the pharmacy, I make zero for that time. It is tough to stay in business doing that. Like it or not, doctors are business people and in a time of rising overhead and shrinking reimbursements, need to be mindful of the bottom line.

[Sissta2009]

Wow that's a bit ridiculous, good post though, thanks for some entertainment!

[Scanner]

Steve,

Okay, I'll mediate this one.

I think if the doctor actually did an exam (not saying you don't), there would be less of a beef. Vitals (of course), examine the ears, eyes, nose and throat (for a sinus infection), cranial nerves, since there is head pain, review any other meds, allergies, a little consultation on antibiotic (over)use, etc. . .you know very well better than me - of course, your exam is focused - you don't have test their lumbar spine range of motion or something for a sinus complaint (obviously).

What is usually done though is not that. . .just a few questions, don't touch the patient, here is your script.

To tie it in. . .it's like the Radiology vs. ER video above.

Orthopods (generally) are the worst. I know it's my bias showing through on this perhaps. They want MRI's and won't even do examine the patient unless they come in with one done beforehand. And from my reports, it's dicey they even examine after the MRI. They just start talking plans.

How about doing at least a Drawer's Sign on a knee? Maybe some palpation before an MRI?

Yeah, I'd complain too, and I work in healthcare, if the doctor didn't examine me.

And then everything gets a 99204 as well. . .(that's the highest level of examination/management code for the unfamiliar here - it's called upcoding).

I don't know. . .I've seen good and I've seen bad and I've seen none. I'd like to say the good outweighs the bad and the none but I think it's about an even split between Good Exam, Bad Exam and No Exam.