Have you noticed doctors are not what they used to be? I have.
My complaints with the medical system are numerous. I’m sure I’m not the only one. From insurance companies to incompetent doctors and inefficient management of the health system, problem areas are many.
Have you been to an ER lately? It’s a mess. Have you noticed some doctors can’t live without Googling medication interactions (I’m not talking about complicated things here but is Amoxicillin from the Penicillin family or not…you’d think a doctor would know this).
Of course, there are so many complex issues in the health organization of any country that criticism is easy without knowing details. But at the end of the day, some of the blame for the problems in the medical system is on individuals. We can’t blame everything on larger than life entities.
As patients, we need to be more aware of our choices and make sure we use efficient services and complain about problems. If we keep quiet, the status quo will continue and health professionals will take advantage of us (the majority of the times it is unintentional).
For example, we have to always follow up on test results. Doctors are supposed to call when results are abnormal but you don’t want to fall through the cracks! Other times, we have to be aware of the tests doctors prescribe and question their necessity, side effects and the way things work!
We have to DEMAND a high level of service from practitioners and be prepared to take our business else where when they don’t comply! The medical industry is a service industry. Just as a mechanic or retail sales person works to keep your business, doctors should understand the competition is fierce and their clientele is educated!
When I work with a doctor, I refuse to continue my relationship if he doesn’t go the extra mile. There’s a famous Iranian doctor (I won’t name) in LA. This dude’s roopoosh is DIRTY. He has sweat marks around his neck. Excuse me but if a doctor doesn’t take care of keeping his clothes clean, I don’t want him any where near me. And he always asks “shoma chi fekr mikonid”! What do I look like a doctor??? And who is he the milk man? It’s one thing to ask for opinions and consult with one’s patient. It’s another thing to give the choice of several problems and ask the patient to pick one! Another Iranian doctor in the Valley once looked me straight in the eye’s and told me: “lotfan ziad soal nakonid man mariz ziad daram emrooz”. Excuse me? Are you talking to me? Me? I waited 3 weeks to see you and you have too many patients to answer my questions? Well patientat bokhoran too saret, I’m outta here.
What’s up with doctors who are too cheap to validate parking stubs? Or doctors who keep rude receptionists?
I’ve noticed a new policy going around and it really annoys me. It started with doctors and now even my hair dresser is charging for a missed appointment. Are you kidding me? I am one of those people who misses appointments maybe 5 or 6 times a year (not all at the same facility or for the same reason). I don’t do it on purpose but life happens. I’m sure that sign wouldn’t be up if I was the only one.
I’m busy. My schedule is unpredictable and my financial means are not as unlimited as these doctors’! If I miss an appointment, I expect a call to reschedule. Not a 50$ deduction from my pocket book.
I realize that missing appointments is disrespectful, annoying, and inconvenient. Not to mention it costs the doctor money and it’s bad for patients who could have used my spot. But life is life! Part of a business is to accept that money will leak from time to time. And to stop the leak by financially punishing loyal clients is just bad service. There’s also a human element here, people get stuck in traffic. They have to drive long distances. They get into accidents. They get held up at work. So many last minute things can happen and we just don’t get the time to call and cancel or we just forget.
I missed a hair appointment on Friday and I got a call from a 17 a rude year old chewing bubblegum. She said “next time” I’m at the salon, they’ll charge me an extra 35$ for the missed appointment. I respectfully apologized and called Babak (real name – screw him I’m not guarding his identity). I asked him what’s up with the charge, I only missed one appointment and that was over 6 months ago, I’ve been there many times since then and spend a lot of money (you know what a cut and style costs these days? God forbid you ask for a head massage or for the flat iron, I’m glad I don’t have blond envy because highlights don’t come cheap). He said it was the salon’s policy. Well, do you think I’m going there again? For 35$, they are losing at least 50$ a month from me and that doesn’t count nails! I’ve told every friend of mine and the lovely ladies at work (this salon is a chain). I’m sure it’s a threat and I won’t get charged but I hate the attitude!
So to any doctors out there, believe me, there are as many of you as there are of us! If you want to charge money for missed appointments, boogh bezan boro kenar. Are you seriously expecting me to believe you were bleeding money 10 years ago when these policies weren’t around? Good service starts with respect for your clients’ pocket book. And the first step is to stop taking so much money from us. From health insurance at work, pharmacy expenses, optometrists, dentists and so on…the medical industry has been robbing patients for many decades now. The first step to correct this is for individual doctors to take that fee sign off and replace it with:”
Dear patients,
Missed appointments are costly to the clinic and inconvenient for other patients. Please help us keep our costs down and provide better service to other patients. Please cancel appointments you cannot keep. We appreciate your help and will strive to continue with our high level of service. We value you.
Thank you,
The Staff
How about email reminders? It’s not 1950 anymore, why aren’t doctors using email to remind patients of upcoming appointments? I kid you not, one of my doctor’s calls 3 WEEKS ahead of time to remind me of an upcoming appointment. Not the week before, not the night before, 3 weeks before.
Why don’t doctors have incentives to keep patients in line? Patients who never miss appointments could get free movie tickets! 20 Bucks at the local theatre cannot be more expensive than missed appointments. But of course, that’s never going to happen because now the flood gates have been opened and doctors are cashing in 50 bucks at a time…
One time, I got to an appointment 10 minutes late. There was no one else waiting. The receptionist told me I lost my appointment and would have to reschedule. I moved heaven and earth to get there and all I could do was turn around and look at the empty room and ask her: “who’s seeing the doctor after me, there’s no way to schedule me between these patients?” I guess it was funny because I heard a couple of people giggling in there. You know, back “there”, god knows who hides “there” or what they do “there”. This doctor was new and was accepting new patients; he heard me and motioned me inside. But COME ON. I’m convinced a lot of these receptionists love the power trip.
Now, 99% of the time, I’m on time with a smile on my face and at least one joke to crack. But I so totally cannot stand those few that need to wake up and smell the 21st century. Please people, demand more for the bucks going out of your taxes and pay checks.
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Marge Dear
by Kaveh Nouraee on Wed Feb 25, 2009 10:08 AM PSTOne of the things Mrs voiced (and which I agree with) is that doctors aren't doing that hard work anymore.
I'm sure you've heard of the expression "treat 'em and street 'em". ERs, especially busy ones at public hospitals (the ones who are obligated to treat everyone regardless of the ability to pay) modelled the concept after mobile combat hospitals. It's like an assembly line almost.
Thing is, now it's happenng with internists, and specialists for routine or preventative issues. And if it's an urgent matter, chronic or acute, it's worse! Even for the best doctors, with the highest qualifications and greatest patient care, a patient isn't a person anymore. They're a chart, they're a case, they're a diagnosis, they're a prognosis. They're an insurance claim.
You are right, people go to the doctor over nothing, or worse they go to the ER for nothing. A few years back the District of Columbia used to have a problem with morons calling 911 for an ambulance not for an emergency, but to get them from one part of town to another, if you can believe it. But make no mistake... the system is broken, Marge. One reason why it costs so damn much is because doctors and hospitals are getting reimbursed maybe for 20% of the services they provide.
Also Mrs. if you'd like regal care
by I Have a Crush on Alex Trebek on Tue Feb 24, 2009 06:38 PM PSTSee a plastic surgeon or cosmetic doctor. Doctors who aren't getting a 10 dollar co-pay to stick their fingers in asses and ears. If you want good service, cancel your insurance and pay out of pocket.
Maybe Instead of blaming the "system"
by I Have a Crush on Alex Trebek on Tue Feb 24, 2009 06:20 PM PSTTake a look around you. Look at all the morons who are going to the doctor over nothing. People are insane about over medicating and "doctoring".
This is a capitalist society. People can sue doctors, but they can't sue insurance companies. Therefore, who are you complaining about? the doctors! I don't blame them. If I did all that hard work and then had to take so much shit from people, I'd see the difficulty of calling Madame Mrs. to tell her she does not have some venereal disease or diabetes.
Pia. Nice one. But I'm not
by TheMrs on Tue Feb 24, 2009 06:19 PM PSTPia. Nice one. But I'm not demonizing doctors. I know they are frustrated too. But bottom line is I'm a patient and I have to look out for me. And doctors are setting the standard lower and lower. As for the wait time, you are an exception. The majority of PPO HMO ABCs have longer wait times. And when I pay to see a doctor, I don't want a nurse, no matter who is supervizing here. But as for speaking up, I agree 100%. This rant came as a result of an official complaint I send a doctor. I recieve the apology and a reversal of BS charges. But guess what, I'm still not going back and I told him politely why. I figure maybe he can improve his business. Even though I won't be there to witness it. That's why when I see a good doctor with good client services...I stick like glue. In some cases, I STILL consult with my pediatrician...as an adult. Isn't that nuts!?!?!?! But he knows his stuff and is excellent. When I get a good doctor, I reward them every way I can and I take gifts and cards and lots of thank yous.
speak up, don't just leave a doctor
by Pia (not verified) on Tue Feb 24, 2009 04:44 PM PSTI live in Boston, and except for ghetto hospitals, and poor neighborhood clinics, most places are nothing like what you write. The HMO that I go to, has a posted wait time of no more than 15 minutes. I never, ever wait more than 5 minutes, and quite frankly, it is not even that long. I am usually called in, as I am about to sit down. The nurse takes some measurments. I wait for the doctor for about 5 to 10 minutes. For the long visit, which is the annual, or brand new problems, you can be there for about 45 minutes and ask many questions. For the "short visit", which is a follow up, it may take 10-20 minutes. And my HMO is not the only one like this. Most of the clinics and hospitals that me or my family have visited are like this also.
Some people like to demonize doctors, and it is not as simple as that, if you were ever close to one. Doctors can be just as furstrated with rude patients who cancel out on them, and therefore decrease their revenues. This is a business also, and now than any other time, and it should be treated as a two way street.
Someone mentioned that he just saw a nurse, but a doctor sent them a bill. Remember, a nurse only works under a doctor's supervision, and it is because of that supervising responsiblity, that you're being charged. ( and rightfully so) If anything goes wrong, guess who is most liable?
I like most of my doctors. I am usually 5-15 minutes early. If a system is wrong, speak up. People should voice their concerns, and set patient advocay groups, hopefully working alongside the legislature, to bring up the standards, and dignity for the patients.
Ali P.
by Kaveh Nouraee on Tue Feb 24, 2009 03:25 PM PSTI wish it were that easy or practical!!
If you boycott the city bus or subway, you can walk or take a cab. Somehow there's always a way to get from 'A' to 'B'.
If we do that with doctors, it's not like there's really comparable recourse that will still allow us to address our health care needs. Maybe that's why they do this with virtual impunity. They pretty much have patients by the you-know-whats.
Let's all do what Blacks did in Alabama in 1955...
by Ali P. on Tue Feb 24, 2009 02:43 PM PSTthey boycotted the public transit system, causing huge deficits in their profits.
Let's boycott the doctors! :-)
"begard(an) ...taa begardeem..."
unapologetically demanding
by TheMrs on Tue Feb 24, 2009 12:12 PM PSTObama can’t change the problems I’m talking about. It’s an individual thing. Maybe we can’t support 45 minutes per patient anymore but that doesn’t mean doctors can be talabkar either.
You never buy electronics from a store that doesn’t accept refunds. Sears knows refunds are costly but they take things back because ultimately it’s good for business. So doctors might have missed appointments but if they’re good, people will always reschedule!
Does your doctor validate parking? keep you waiting every time and charge you if you miss an appointment once every 2 years? Is he talabkar as if he’s doing you a favor by giving you an appointment? Does he leave a replacement and change his voice mail message when he’s out? Does he talk with his hand on the door knob or sit patiently through all your questions?
But Drmajid’s personality is very typical of many real doctors. It’s like you owe them something! In fact, the doctor is the one who should be asking patients for business not the other way around
Dear Kaveh
by shirazie (not verified) on Tue Feb 24, 2009 11:19 AM PSTYou do not have to pay the additional bill the doctor sends you.
Once they accept your insurance card, they are under contract with insurance company. The insurance company calls it "unnecessary charges".
You may want to get an explanation from your insurance and then use it against the doctors.
Foremost, get an specialist i.e cardiologist. line him up for your emergency room. However make sure he is approved by you insurance company.
I was amazed to find out Blue Shields has actual doctors on staff that review the cases.
I guess we are seeing a crack in that Hippocrates Oath of theirs
I am anxiously awaiting obama's speech about health care tonight. My brother in law had to go back to England to have back surgery because the doctors jack him around in California
Now I'm getting angry
by Kaveh Nouraee on Tue Feb 24, 2009 10:54 AM PSTDr. Majid, when one goes to the doctor nowadays to be tested or screened, you're not being tested or screened by the doctor. Rather, you're being attended by some equipment operator, or someone with the title of technician. If you have a question, the person who is attending to you is either unequipped to answer or isn't allowed to answer because the question should only be answered by the doctor. OK, so, where's the doctor? He/she isn't there. He/she is attending to one of the four or five other patients booked at the exact same time slot as you. And what happens at the end?
Follow-up instructions no longer consists of the doctor explaining prescribed treatments or options, if there are any. Follow-up is an 8.5"x11" sheet of paper that's a copy of a copy of a copy of a copy of generalized instructions, with portions crossed out in black magic marker.
The patient is still billed at the full rate, plus the lab costs, x-ray costs, MRI, etc.
In other words, the patient was just subcontracted and outsourced, and still was charged for the doctor's time as though you had their full attention, which you didn't.
Also, can you explain why, with all of the state of the art technology that exists today, it takes longer to obtain test results than it did just a few years ago?
Health care costs have never been higher than they are now, while the quantity and quality of actual doctor-patient interaction has never been lower. Frankly, it sucks.
It used to be that you go to the doctor for a physical, you get called into an exam room within 5 minutes of the actual appointment time, a nurse would weigh and measure you, note the chart and by that time the doctor would come in and start the show. Blood pressure, eyes, ears, nose, mouth, listen to your lungs and heart front and back, apologize for the stethoscope being cold, check your reflexes, look for abnormalities in the spine and extremities, the skin, tell you to turn your head and cough, so you look at a framed print on the wall while he's checking you down below and you ask, "Doctor, is that a Claude MoNAAAYYYY!!!!" The doctor would ask questions throughout each part of the exam, regarding any pain, discomfort, any abnormalities or changes in appetite, weight, breathing, sleeping, urination, excretion, and so on. Any questions you have would be answered. The nurse would then draw a sample of blood for a CBC and get a urine specimen and that would be about the end, where the doctor would go over with you what he/she found during the exam, and compare it to your overall medical history. If any additional tests would be needed, the whats, wheres, whys, hows and whens would be explained.
45 minutes. One on one. On the way out, the first thing the recpetionist asks is, "your next appointment is in 6 or 12 months, do you want morning or afternoon?" Not a word about the bill. Why? Because they billed the insurance company and then sent you an invoice for the balance in the mail.
Show me a doctor who does any of that now.
Yes
by programmer craig on Mon Feb 23, 2009 11:49 PM PSTHave you noticed doctors are not what they used to be? I have.
I agree with you. It's a pet peeve of mine. Pay more, get less. Not sure what's going on but it seems to be some kind of systematic failure that's gotten pregressively worse for at *least* the last 20 years.
Tell me Obama can fix it! That's what I want to hear :)
Dear Lord!
by Anonymousbabe (not verified) on Mon Feb 23, 2009 11:37 PM PSTYou are a shining example of Iranian community, always late, not caring for other people's time.
agree 100%
by shirazie (not verified) on Mon Feb 23, 2009 09:36 PM PSTunfortunately I and wife have a long list of bad doctors in LA.
Dr's diploma gives them licenses to steal. I have 1/2 dozen physicians in my family, I know..
The LA doctors are all about $$$, they are known as Dr. Bazzarie by the rest of the Drs in country.
Bring on Nationalized medicine please... whole lot of these Drs will drop out and become junk bond dealers (or used needle sales man).
I spent some time in emergency room, a Philippineo Male nurse saved my life. Weaselly Iranian Dr. showed up, looked at my chart, then send me a bill. I promptly send the bill back and ask him to explain what he did for me?
All LA Drs are sleazy and thieves
I must disagree with you about Insurance company assessment. In two occasions they have steered us away from unnecessary operations. I have been encouraging our company insurance to begin ranking Drs based on customer / patient feed back.
Now,
by Aboli (not verified) on Mon Feb 23, 2009 06:51 PM PSTI don't know what your experience in Canada is, but we have wonderful mental health facilities here in the US.
I'll be glad to give you some names.
Dr X,It's precisely that
by TheMrs on Mon Feb 23, 2009 06:51 PM PSTDr X,
It's precisely that sense of entitlement and ownership that I cannot stand! What makes you think anyone has bought anyone else's time? Need I remind you patients all over the world spend hours in waiting rooms waiting, waiting and waiting. For doctors who book too many patients to catch up to their schedule. For doctors who are late to work. For doctors who get caught with a patient that needs more time than expected etc. Do you see patients charging doctors for their time? Their missed hours at work? Their children's late pick ups and so on? No. It's because the way this business works is that people understand they ahve to wait for each other! As soon as one party starts demanding money for their time, the other is entitled to do the same! Or take their business else where.
I am not bi ahamiayt with anyone's time. But when life happens, I don't appreciate being penalized by the same doctors who've made me wait numerous times (with free magazines and not even bothered to order some good entertainment in waiting areas) as if MY time is not worth a penny!
The only way out of this is to see the medical BUSINESS as a service industry. Doctors are there to serve the patient who is always right. They have to provide medical expertise, which is their basic job description. And to provide good service and to pamper their guests. In return, they get loyal customers who come back to them and will be more than glad to put up with rude receptionists and long wait times. In return, they get paid good money and command respect and prestige in the community. In return, their patients become dependent on them, sometimes for survival. Moreover, the loyal customers will recommend good doctors to other people! Ever heard the expression: doctor joon ghorboonet beram be dadam beres? That doctor sure as hell isn't going around accusing people of being bi ahamiyat. He is a part of the community life. Heck, he probably misses a few appointments too.
I think a good doctor understands the service side of his business with all the hassles that come with it. You may disagree.
Khanum jan,
by Dr.XXXXXX (not verified) on Mon Feb 23, 2009 05:59 PM PSTShoma jouri darid az in mohem harf mizanid ke ingaar kar va dar^aamade shoma mohemtar az har kase digast!!!!!!vase kare mardoum hamoon^ghaadar arzesh ghael bashed ke vasah kare khodetoon ghael hastid.
Ingar ke shoma yaad nagerefitd ke; vaghti-ke vaghat migirid, yani oun vaghat ro kharedid. Man ham tou kare medical hastam, bi^meh ham ghaboul namikonam. Agaar hame mesle shoma ba vaghate mardoum bi^ahamiyet bashand maha bayed dareh officemon rou bebandim. Lotfan yaad bagirid ke mani^e vaghat gereftan yani chii? Va agah bahash mosh^gal darid, barid ba ja^ee ke masle clinic walking ghaboul mikonand.
Next time you get sick,
by DrMajid (not verified) on Mon Feb 23, 2009 05:16 PM PSTNext time you get sick, don't go to a doctor. And don't get bothered getting screened or tested for cancers and other diseases. You seem to know everything already.
And That Goes For All Professions
by ms (not verified) on Mon Feb 23, 2009 04:06 PM PSTGreat timing.I just got off the phone with my attorney. Firstly, let me explain that I'm an attorney myself (but I work for Corp America and do not represent individuals). I can clearly see why attorneys have a bad name. The attorney misses on key legal issues which I point out and he wants to charge me to clean up his own sloppy work. I give him an ear full and what is his response: "I can't represent you because you are too demanding. So take your business elsewhere." I'm certainly doing that. He tells me to take him to fee arbitration if I have issue with his bill. My time is worth more. So, frankly I will only tell my friends about my experience with the idiot and let see if they will take their business or recommend him to others. He seems not to have a good business sense either. SO Mrs. I agree with you, you need to demand a lot of your doctors, lawyers, hairdressers and the like. I do go out of my way to represent my client (all at no additional charge).
...
by Red Wine on Mon Feb 23, 2009 03:22 PM PSTAll of doctors are dangerous ...
Great Post Mrs!!
by Kaveh Nouraee on Mon Feb 23, 2009 03:11 PM PSTI have seen the same drop in the quality of service from the medical profession too. Not only is it scary, it's safe to say that it's killing us.