Wednesday, February 27, 2013

The jester continues to giggle.....

Well, the laugh's on us, I guess. What else can we attribute such incompetence to, other than we are stuck in a cosmic comedy of some kind, with no visible escape?

Remember the follow up doctor's visit from two days ago? Here's a reminder for those who need it:

The patient called me again THAT evening and said, "Oh, it gets better! I got home and noticed a paper stapled to my checkout form, and called the doctor's office to find out what it was. Remember when you asked the doctor if there was going to be any pre-op lab work that needed to be done between tomorrow and Thursday? He said, NO, just go to the hospital and they'll take care of it that morning, right?"

Yep, that's what the doc said, I recalled.

"Not true, apparently. But after being switched around from phone to phone for about 15 minutes, they said, 'Well, just go ahead to the hospital on Thursday morning, and they'll do it on a STAT basis, and have the results in about two hours."

(And if you believe that, I've got a bridge to sell you, too.)

Guess that problem has been resolved, then. Right?

You'd be wrong, as the jesters shakes his bells and snickers in glee. Yesterday afternoon, when the patient was back at the doctor's office to [finally] get the test that they couldn't find in the file but that is probably there after all, they looked at him like he was crazy when he mentioned the pre-op lab work. "NOOOOOOO!," the nurse screeched. "That has to be done here before Thursday! You need to come in tomorrow and get it done!"

So, that's where he is right now. There are no more shoes that can drop......are there??

I'll keep you posted on the outcome of all of this, and then we'll talk about who consumers report this kind of incompetence to, especially when there are multiple billings going to Medicare for each return visit, even if it's the result of that incompetence. 

And I'm NOT kidding.

Monday, February 25, 2013

The jester won't stop laughing.....

We looked at each other, and burst out laughing. What else could we do?

If you haven't followed this blog before, you might want to catch up before returning here for the fun: that you have the picture: Today was the follow up visit, two weeks having passed since we were sent away--again--from a doctor's office for lack of medical records that they all have within the tips of their fingers, but seem too disorganized to make the effort to obtain.


Scene 1: Patient is ushered into the examining room by a nurse.

She turns and, perplexed, says "So, you are here for a two week follow up, is that right?" She flips through patient's file.

Patient: "Well, we were here two weeks ago and had to come back today because the doctor didn't have my records from my hospital stay in November. He said he needed that before he could decide for sure about [THE PROCEDURE]."

Nurse: "Oh." She keeps flipping pages in the file. "Well, I don't see those records here. Are you sure it wasn't the [NAME OF ANOTHER PROCEDURE] that he needed? I see that one here!"

Patient: "No, it was the records from the hospital he needed."

Nurse: "Oh. Well, I'll just call over there right now, since they're in the same practice we are, and have them faxed over! It should only take a few minutes!" Happy nurse. Irritated patient and friend.

Time passes.

Scene 2: Nurse skips back in. "OK! I called and 'Denise' is going to fax them right over! It should only be about 10 minutes! I'll be back." 

Patient: "Why didn't they ask them to do that two weeks ago when I was here?"

Nurse: "Well, we thought we only needed the results for the [NAME OF ANOTHER PROCEDURE], and they did send that!"  Did she not realize that she didn't answer the question at all? Or is that the ploy?

Twenty minutes pass. The doctor opens the door wide enough for his head, and says, "It should only be a few more minutes!" Gone again.

The examining room gets colder. The hallway outside the closed door is quiet now. Did they all go home?

Ten more minutes pass. Rustling noises outside the door, which means.....something. 

Scene 3: Doctor enters. "The forms just got here!" He stands and silently skims each piece of paper, gets to the end and does it again. Not a good sign. "When was your last [NAME OF YET ANOTHER PROCEDURE]?"

Patient makes his best estimate. Friend is thinking, "Isn't that what the file is for?" Friend can feel her own blood pressure rise, which only reinforces her general attitude about staying away from doctors at all costs.

Doctor: "I'll need to do another one of those [NAME OF ANOTHER PROCEDURE] before I can make this decision. How about tomorrow?" Is he kidding?! It appears not.

Patient, trying to be agreeable instead of violent, a state the friend is quickly reaching: "Fine. Can I come by after I get off work, around 1:30?"

Doctor: "Sure. Just come by and we can do it then. I should have the results in plenty of time that way, and we can schedule the procedure for Thursday." Spends 3-4 minutes entering the information into his phone. Hands the patient his check-out form and ushers us out.

Scene 3: Patient and friend go to the front desk to turn in form (this would be the BILLING and scheduling form.) How many bills WILL Medicare get for this situation, I wonder?

Receptionist: "Who is your primary doctor?" Oh, you mean the one that referred the patient here, the same one your office had to contact for records--twice--and the one that is supposedly in the same practice?? The one whose name you asked the patient for twice already, just since he's been here today, not to mention the two times (at least) you asked at the previous visit? Is this information never retained ANYWHERE?? 

Patient sighs. Patient answers. Again. 

Receptionist:  "Can you be here tomorrow morning at 8 AM for the [THE MISSING PROCEDURE]?" She smiles sweetly.

Patient: "No, the doctor said I could stop by after 1:30 tomorrow, since I have to work!"

Receptionist laughs at that answer. "Who told you that? The doctor?! We don't do it that way!" She's getting a real chuckle out of us right now.

Patient: "Yes, he said to stop in, but go ahead and schedule it for 8AM and I'll be here!" Friend walks away in order to prevent "an eruption of violence in a doctor's office," probably some kind of felony.

Receptionist: "OK. Then the [REAL PROCEDURE] will be done on Wednesday."

Patient: "But the doctor said it would be Thursday, so he could get the results back from the OTHER procedure in time...."

Receptionist: "No, he has Wednesday's date here."

Patient: "He definitely said Thursday."

Receptionist: "Well, have a seat in the lobby. He's in with another patient, and I'll ask him when he comes out."  Patient sits--again--while friend leaves to work out at the gym or die from frustration, thus putting herself in the "care" of these people. She would rather keel over from over-exertion on the treadmill or some other instrument of torture.

Scene 4:  Friend is driving away when her cell phone rings. Patient says it's all set for 8AM tomorrow, with the [REAL PROCEDURE] scheduled for Thursday. Receptionist apparently seemed surprised that the patient was right after all!

Patient and friend hang up, since they are both driving, being good citizens and all.

Friend's cell phone rings again. Patient is laughing so hard he can hardly talk, "You won't believe it!" They just called me and asked if I could come tomorrow at 3:30 for the [MISSING PROCEDURE] after all!"


“Taking crazy things seriously is a serious waste of time.”
Haruki Murakami

Sunday, February 17, 2013

The jester has left the building......

After the third time, I wanted to strangle a doctor. Whichever one said it again. With my bare hands.

I do try to see the humor in just about any situation that crosses my path, but occasionally the jester just doesn't juggle that day. Plus, the issue is one that appears in the news periodically, with much lamenting and commission-forming, all to no avail apparently. Memories are short (I can't even joke about that one right now), and we are all busy folks, tending to our lives without worrying about things so overwhelming.

But here it was.....again....within the span of about four weeks. I'm not in a laughing mood.

The man in my life was ill in November. Ill enough that he ended up in the hospital for a week, and you know what that meant. Every test known to man (and woman) was performed on him, some of them multiple times. Finally he was released with strict orders to see his own doctors for follow ups to determine a course of action, if action was deemed necessary. So, the first appointment was made with the appropriate doctor, two weeks in the future.

We sat in the examining room after the nurse did nurse-type things, and left us sitting there. Without too much of a wait, the doctor came in and proceeded to ask questions that indicated to me that he had no idea why we were even there. But, hey, I AM a wiser woman than I used to be, so I stayed quiet. (Stop laughing. I really did!) When the purpose of the visit was made clear, he said, "Oh, well, I can't do anything until I get the records from the hospital. Make another appointment at the front desk for two weeks, and we should have the files by then." And he left.

OK, I'm confused. They knew when the appointment was made that this was a follow up from a hospital stay. I know they did. So, now more time will pass before any action will be taken, plus two visits will be charged to Medicare, with more co-pays for the patient, too. Why weren't the records requested in the two weeks between the appointment being made and the actual visit?

Oh, well. What can you do? So, in two weeks, he returned to the doctor's office, an appointment was made with a specialist based on the files obtained from the hospital (finally), and another two weeks goes by. In between, more doctor's visits with other providers, all of whom have to....surprise!....request the records from the hospital! (Can you say "coordination of care" very loudly, please?) More delays, more billing to Medicare, more co-pays and deductibles for the patient.

Finally, we show up at the specialist's office, thinking we are there to schedule a life-saving procedure, and guess what? He needs the records from the hospital, even though the referring doctor has them and could have provided them himself. Or, what a concept, maybe someone in a doctor's office could be tasked with checking a few days before patients show up to see if such a thing might be needed, and take care of that BEFORE the patient shows up. One visit instead of two. Seems logical to me, but what do I know?

I try hard not to get sucked into conspiracy theory-type thinking, but maybe that's the point of all this waste. We often hear of patients committing fraud of one kind or the other, but how about doctors and other health providers? I'm only the one paying for all of these superfluous visits. And so are you.

I know the arguments about reimbursement for services, but I also know what we tell our children about following a bad course just because someone else is doing it. When does it stop? How will it stop? Will my daughter's generation have anything left for them?

Does anybody think this is funny?

We are on the top of a national trend that is causing a hemorrhage of tax dollars ... 
It's a tsunami of fraud..  
Orlando Sentinel 2013-02-17

Tuesday, February 5, 2013

You can't get there from here.....

I’ve learned that categorizing people tends to come back to bite you in the butt. Over the course of my life, I have tried really hard to refrain from doing it. I don’t like it myself when I hear sweeping generalizations:

Women drivers……

Those teachers……


And it’s not simply that I happen to fit into two of those groups, either. 


But once in a while, events and the subsequent temptation overwhelm me and I succumb. I fall right into the jaws of that trap faster than my “teacher” look can be activated in a classroom full of 13-year olds.

Men and directions.

What’s up with this, anyway? We have dashboard-mounted or handheld GPS tools, computer sites that will find our way for us before we even leave the house, complete with visuals AND text, PLUS the old standby, books of maps under the front seat. (For those under the age of about 30, that’s called an ATLAS.)

Let's take a hypothetical situation, told as if it's true:

I had occasion to ride with a male of my species (I think they’re the same species, although  sometimes I’m not certain) a week or so ago, and we got lost. I had gently asked early on if the driver knew how to get to this particular destination, and was assured with lots of male surety that it was so. I am a wiser woman than I was before aging has perfected me, so I kept quiet. He had printed out a map, just in case, so I thought this would be a piece of cake. Right?

Oops. There was only a map, with no text, so when the map took us to somewhere unrecognizable, we had no backup. There was a nice looking young man in a yard, but he didn’t know that street, either. We started driving in circles, so I retrieved the GPS from the glove box and programmed it as the car started circling the area yet again. Soon, the voice stuck in that box was telling us what to do. Whew! Saved.....

Not so fast. The driver decided he didn’t want to follow the voice. Was going to ignore it. Plus it was talking too loud, so turn the darn thing off, how about it?!

As a teacher, I learned the fine art of playing deaf, mainly to keep myself sane enough to move among the rest of the population at the end of each school day. Came in handy here, I can tell you. The GPS kept talking and I started gently pointing and speaking very softly, hoping that we would get back on track. And there it was, just as if we had never lost it to begin with.Turns out we COULD get there from here.

Technology is wonderful if you use it, isn’t it?

I guess the difference between men and women in this regard is that I always assume I don’t know where I’m going while men always assume they’ve got it under control. Therefore, I’m prepared for all alternatives.

Need I finish that sentence? Hypothetically, of course.....

History teaches us that men and nations behave wisely once
they have exhausted all other alternatives." ~ Abba Eban