I hope that I never need any kind of surgery again, because I've undoubtedly alienated a significant proportion of the office staff at my surgeon's office. I finally badgered and browbeat and just generally annoyed the woman I usually got on the phone to simply freaking pass on my request to the doctor himself. I mean really, is that unreasonable? Yes, it was complicated by the fact that he was out of the office - out of the country - but for heaven's sake, either feel empowered to make a decision or pass me on to somebody who can. It's not tough. It should also not come as a surprise to anyone that, hey, patients will occasionally need care when the doc's out of the office. Have a plan in place that does not simply consist of, "We'll ask when he gets back."
I mean, here it had been impressed upon me that one of the most serious complications of an out of whack thyroid was irregular heartbeat, it had been made clear to me that irregular heartbeat was to be avoided, and now hearing, "This medication is giving me irregular heartbeats" was met with a collective yawn. When I asked to go back to the old dosage, I was told, "Oh, you don't want to do that. It would be a huge shock for your body, to cut it way back like that."
"Was it a huge shock to my system when I went up from the old dosage to the new one?" Silence. "I mean, that happened all at once." More silence.
As I suspected, the doctor okayed my request to go back on the dosage of my thyroid meds that I'd been on previously. I got a message on my machine from him, saying, "No problem. We'll switch you back."
THANK YOU.
The pharmacy had been faxing my requests for literally weeks, and the pharmacist had said, "It really isn't a big deal, what you're asking." It didn't feel like a big deal to me, either. I wasn't asking for new medication, narcotics, addictive substances, a diagnosis over the phone - anything outrageous. It was just, "This new dose makes me feel miserable. Can we please go back to the previous one, at least until I can actually come in to the office?"
When I went in to the pharmacy to say, "My doctor called; he okayed the switch back to the old dose," I assumed that someone would have sent a notice of this to them, so that I could get the meds. No. It took 24 hours and another call to the nurse. (Gee, that was fun for both of us.)
This conversation marked the second time I had said to the nurse, "Do you actually have my chart in front of you?" and been met with silence. When someone asks me things like, "When was the surgery?", says, "Generally, what happens is..." and draws a blank when I ask, "What was my old dose?", I think it's a pretty good bet that they do not have my chart in front of them.
Health "care" providers: I don't care if your employer or the federal government or your mother requires you to have a patient's MEDICAL (not billing) info in front of you when you speak to them. It's just generally a good idea. Before you call me to talk about my treatment, pull my file. Realize that if you do not have info about me and my body in front of you when you give me advice and "care," I will think less of you, and of said advice and "care."
Since I don't need to see the surgeon again, barring any more needs to remove any more bits of myself, now this conversation will be taken up with my primary doctor. I don't think it'll be as maddening (but maybe I'm wrong).
I love our family doctor, I really do. There's reasons we chose his practice, and there's reasons we eschewed a pediatrician for our kids in favor of a GP who sees the whole family. Still, I occasionally feel overlooked or unheard. I've had repeat tests ordered more than once, even though I've pointed out that they're repeat, because the doctor has said, "Well, let's just see if anything's changed." In a way, I get that, because my symptoms have tended to be at odds with my test results. The doctor is both trying to make sense of things, and to justify treatment to the insurance company.
It's that last bit that tends to annoy me. Last time I griped to the receptionist because the insurance mandated a repeat office visit instead of simply relaying lab results over the phone, she said icily, "We do have to comply with the law, you know." Yes, I know. I just think that the law cares more about documentation than about people.
I have been referred back to the same endocrinologist I saw (inconclusively) years ago. I hear that she's very good. I remember liking her. Her office staff is also making me furious. In fairness, it's not entirely their fault. It's the culture of Documentation as King.
I was referred nine months ago. Let's say that again - I was referred nine months ago. I have yet to see the doctor. I could have created an entire human being, from scratch and from items I already have around the house, in this amount of time, yet I can't seem to get an appointment with a doctor.
I phoned her office, nine months ago, and predictably got voicemail. (Do not ever tell me that current technology means that people are "constantly connected.") I left a message - "My name is X. I have been referred by Dr. Y. I need to be seen for (list of symptoms)." I got no response - no call back. My kids blamed this on the fact that I don't carry a cell phone, but if they did NOT call back my home number, I think it's a safe bet that they would NOT have called back a cell phone. I left increasingly irritated messages as the weeks, then months, went by, and I still didn't hear back from them. Twice, I finally got a message on my answering machine. They said, "This is Dr. So and so's office, returning your call," but nothing else - nothing with actual content (or an appointment). I started saying things to their machine like, "Just choose any day and time. Leave the message on my machine. I WILL show up." Nothing. In five months, I never spoke to a human being.
Finally, I spoke to a receptionist, who told me, rather irritably, "We cannot make an appointment for you until we have your records."
"Can you get those from my doctors?" I mean, I signed, at each office, the freaking form that says that they may share my info with other doctors also treating me, without my suing them for breaching my privacy.
"No. You have to send those to us." Like I, personally, have them lying around my house.
"What records?"
"Any records pertaining to your diagnosis."
"I do not have a diagnosis. That's why I've been referred to your office." Honestly, I didn't think this was rocket science.
"Well, we need all your records then - all treatment you've received, any labs you've had done. When we get those, I'll call you back and make an appointment with you."
Sure you will.
So I called my GP and I called my surgeon, and had them send everything. I heard nothing back.
I have had so much figuratively on my plate that I let it slide for months. I finally called back yesterday. "Hi, my name is X. I need to make an appointment."
"OK. What insurance do you have?" I'm used to this being the first question doctors' offices ask, but it still annoys me. "Why are we seeing you?" is usually down about six questions.
I told her; "OK, that's good, then," she said. I explained that they'd been waiting for my records. "Let's see if we have those," she said. She started rattling off items received from each doctor and lab. It sounded complete to me, but I'm a layperson. How do I know if those are "complete records"?
Then she said, "What we don't have is a referral from your primary care physician." Good gravy.
"You should have received that last April. April 2012."
"Are you sure?"
"YES. April 2012."
Shuffling and tapping: "Let me look in the computer." Then, "Oh, here it is. It's still in the computer. It was never printed out. That's weird."
OK. They have it. "So can I make an appointment?"
"Well, no. I have to print out this referral and put it in a packet with your records for the doctor to review. After she reviews it and signs off on the form, you can make an appointment. Can you call back on Wednesday?"
Oh, my gosh, truly? She has yet to see documents that she's had, at a minimum, since September? There's a FORM that she has to sign before I can make an appointment? "Yep, this person needs medical care."
"Sure. I'll call back on Wednesday."
It's January 2013.
I will phone them on Wednesday.
I will be pleasant.
I WILL BE PLEASANT.
I will not particularly feel cared for. "Health care" is something of a misnomer.
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