Demand more time?

Some patients don’t see things from the other side:

The panel’s participants were very enthusiastic for this opportunity to tell the seniors about what all is available in our area, and the audience members had a lot of good questions. The fourth speaker, the representative for the area council on aging, recommended a somewhat assertive style of getting the patients’ needs met.
“Don’t let your doctor shoo you out of the room in five minutes,” he said. “You are paying them. They work for you. If you need an hour, demand an hour.” He further recommended badgering the appointment setters and nurses in the office if the patients felt rushed.

Comments

Anonymous
“You are paying them. They work for you. If you need an hour, demand an hour.”
This is simply untrue. When the government allows a Medicare patient to pay you for your time, the patient may have as much time as he desires. Badgering the appointment setters and nurses is a good way to be dismissed from a practice.
Anonymous
1. You are not paying them. You have shrugged that responsibility and the right to represent you onto the government and whatever secondary insurers you have hired. You are entitled to have what they pay for on your behalf, not whatever you want.
2. If you are the sort of person who wants that extra time you feel entitled to, then don’t complain when you get seen later than your appointment time. It may be hard to think of someone besides yourself, but imagine for a moment an entire patient schedule of patients like yourself, all feeling entitled to a little more than what they really have paid for. Bring a book.
3. Enjoy bothering the staff? In my office, you will enjoy that just once. They are hard to replace. I want them to stay and if possible , stay happy. You, the botherer, can be replaced easily. It isn’t rocket science to run that algorithm. Learn to be nice, even if it kills you.
4. Medicare is not the same as you paying for something, like a dinner. Electing to bestow your custom on a practice, your Medicare custom that is, is not an example of free give-and-take. Ever wonder why many practices limit the numbers of new Medicare patients? It isn’t because they’re getting rich seeing them, that is for sure. No Medicare heavy practices are worrying about back injuries while carting all the cash out the back door, that is for sure. No one says you need to grovel, but you should get real about what you are and are not bringing to the table. Oh, and your good word and its value in drawing other seniors to a practice? Everyone likes to be spoken well of, but it isn’t the bonanza you might think it is. Every Medicare-aged patient has the potential to displace a better-insured patient, if you want to think of things that way.
Megan
I can think of two occassions where a doctor actually walked out on me. One was the day I was diagnosed with diabetes. I left both doctor that did that to me. While I certainly don’t demand an hour, walking out precisely at the 5 minute mark is inappropriate, especially after delivering life altering news to someone.
I used to have to wait 3 hours to see my peds GI doctor. That was ok with me though. I brought homework and sat patiently. I was 15 and recognized that he was pretty much the only GI doctor that would see anyone under 18 in a 100 mile radius, and I knew he would spend the time I needed with me once it finally was my turn. Why can’t most adults see this perspective?
KoKo
What should a Senior on Medicare do about that mean old Doc, who insults his/her patients and gives them only 5 min of “professional time”?
Easy!
Don’t bring a book to the next appointment, bring a hidden camera and recorder and tape the whole scene. Then, post it on the internet in the entertainment section.
Human medicine has reached
an all time low when household pets receive better care from their professional tkcomsbVets than does the average US citizen.
Anonymous
KOKO. The reason that pets get better care is that their owners pay cash upfront and pay much more than Medicare and HMO’s.
Anonymous
KoKo, I hope you don’t mind getting sued by the doctor’s other patients after your surreptitious video recording. You might be entertaining yourself and your friends by a YouTube posting, but you will have violated their privacy.
If the guys who were paid in Bumfights had a case, going after you will be like shooting fish in a barrel.
Anonymous
You are free to surreptitiously tape record your own interaction with a doctor–unless your state prohibit such recordings in general. HIPAA protects patients privacy rights against others’ disclosures.
Anonymous
“The reason that pets get better care is that their owners pay cash upfront and pay much more than Medicare and HMO’s.”
No! Pets get better care because Vets care more caring than too many MDs.
Anonymous
“Don’t bring a book to the next appointment, bring a hidden camera and recorder and tape the whole scene. Then, post it on the internet in the entertainment section.”
Hmmm! I don’t see anything here about filming other patients! Why the confusion?
Best for all to READ THE WORDS before starting the ATTACK!
Yes, film your interaction and record your conversation with the MD that supposed to be “caring” for you.
The post it on the Internet under Entertainment…
Anonymous
Are there any MDs not interested in the almighty dollar?
Anonymous
“You are paying them. They work for you. If you need an hour, demand an hour.”
If they don’t like their jobs tell them to quit! They won’t be missed!
Anonymous
“Enjoy bothering the staff? In my office, you will enjoy that just once.”
Booooooooo! Does your staff arm themselves with baseball bats, or is it only you?
Anonymous
Wow! The doctor bashing, my word!
My office is my office. I pay the rent. If you want to yell, scream, carry on, or harrass the staff, you can leave. Neither I, nor my staff, is obliged to tolerate indecent, uncivilized behavior.
If you want more time, we can discuss arranging for additional time when it will not incovenience other patients who may be waiting. Similarly, I run on schedule. If you intend to show up at 11:00, dont make a 10:00 appointment. I won’t see you, it’s unfair to those who like to be punctual. For those likely to respond that they “always” wait “hours” to see the doctor, they never waited for me. Don’t take your frustrations with other doctors out on me. I similarly will not make treatment decisions for you based on some other patient’s complaints or behavior.
[Off topic rant]
Furthermore – I use my revenue to pay bills and buy food, just like the butcher, baker, auto mechanic, and grocer. I don’t care what your PI lawyer says about your auto insurance, you are still obligated to pay your bill. It’s not my insurance, it’s yours.
[/Off topic rant]
In short, if you are respectful of the staff and the other patients, you can pretty much get as much time as you need.
Anonymous
If people want to control how much time they get, then they need to pay their bill and not leave it to the taxpayer. In the final analysis, he who pays the piper calls the tune–always. The paymaster is only buying short jingles. You were warned 40 years ago that this would happen–it was wishful thinking to believe congress’s lies that it would not.
I am sick of docs herding people through like cattle–but then I don’t take Medicare. Those who do have to push or they lose money.
I agree with the doc about the office staff. After losing some valuable office staff, I learned to make it explicit to those who like arguments to confine their arguments to me. I’ll go toe to toe with them if that is what makes them happy, but they have to treat the staff civily or it’s out the door. Zero-tolerance.
Happyman
USA today had an article on eldercare managers today. I have met one (once) in a nursing home who was “overseeing” the care i was providing to an elderly demented woman admitted s/p hip fracture & ORIF.
He was about 25 yrs old (probably freshly earning a CSW or RN), clueless, and apparently makes between $80 and $200/hr! I had to explain to him the coverage rules regarding medicaid / medicare/ homecare etc.
He sounded just like the uninformed tool (i love that word) in this post.
http://www.usatoday.com/money/perfi/eldercare/2007-06-24-elder-care-costs_N.htm
Anonymous
Tool?
When MDs speak of others as “tools” and “cash-paying” customers ( not patients ), you know we’re on the downward slope to big Doo-Doo land.
No compassion and only the big $$ is important to so many MDs. Why did they ever enter the profession (?) of medicine, in the first place?
Anonymous
Gee you’ve got me. My guess is if you go to medical school and enter practice it will be much easier to understand. In fact, you may feel like a “tool”, if not a fool. You will wonder how insurance companies, attorneys, your landlord, your employees, and Uncle Sam can have so little compassion, not to mention how difficult it is to get many of your patients to pay their bills. Why, all they seem to think about is the $$!
Anonymous
Not too long ago, I had a patient come in with five (-5-) pages, both sides, with a list of various somatic aches and pains.
And the person had a problem with me, when I suggested we break it up, take the problems one at a time. That could take a lot of visits, but then again, there were a lot of complaints.
I’ll second the first comment. Anyone who continues to give my staff a hard time is gone. Hey, anybody can have a bad day, people can be irritated because of underlying disease and all that.
But continuous harassment of my staff, I have no hesitation to dismiss the person from the practice.
I am not a public utility, and I am sure as hell not a doormat.
People who act like that are also lawsuit risks. You can’t please them. Anything really goes wrong, you’re in court.
In my state, we tried to get tort reform passed. The voters rejected the reforms. The people have spoken. They place more value on the ability to SUE doctors than HAVING doctors.
Now they wonder why they find it so hard to find a doctor.
Anonymous
When MDs speak of others as “tools” and “cash-paying” customers ( not patients ), you know we’re on the downward slope to big Doo-Doo land.
Comments like these amaze me.
1. The physician has the same right to comment on the activities of other people as you do about the physician. If he/she thinks the consultant is a tool, fine. If you do not think it is fine, than look in the mirror. Why do you believe that the physician does not have the same right comment on others as you have to comment about him/her?
2. Contrary to popular belief, running a medical practice costs money. Lots of it. We don’t get special breaks on rent, payroll, insurance, electricity, water, office supplies, equipment that other business do not get. It all has to be paid for. It would be irresponsible to conitnue to engage in business practices that threaten the economic viability of the practice (business). Talking about money is NOT taboo.
If seeing a certain sub-population (especially without limit) is going to cause the business to ultimately fail, the business owner has the responsibility to limit access to that population (notwithstanding a certain amount of charity care, etc).
If you don’t like reading physicians discussing the business of medical practice with other physicians on a physician oriented medical blog, don’t read it.
Of course, you can put you head back in the sand comfortable in the knowlege that doctors will continue to practice in spite of declining revenues, that you don;t have any responsibility for your bill, and that eventually the government will fix everything, and then you will get exactly what you wanted. Good luck.
LisaMarie
The points about third-party payment are valid. But realistically- I’m cared for by a specialist who currently has NO appointment slots between now and October. She’s that busy. If I walk into the clinic and offer to meet whatever price the doctor asks, in cash, up front, will I really get an appointment that’s as long as I want? Can any doctor actually make the time to do that, unless their practice is made entirely of cash-up-front patients?
Happyman
anon 12:00am-
are you the “tool” police? I can use whatever words I like to describe somebody whose opinion I feel is asinine. You must, at least subconsciously, know how ridiculous you sound, as you maintain anonymity.
I am a board-certified internist working solo (except for my wife, whose training as a board-certified pediatrician makes her LESS valuable than an office assistant). I pay a fortune in business costs, and the declining insurance reimbursements limit my ability to hire a practice manager. Therefore I am acutely aware of ALL the costs of running my practice.
So I know pretty much within a couple of weeks after seeing a patient whether they
1-paid their copay
2-HAD valid insurance the day I saw them
3-have crappy insurance
4-had a deductible that hadn’t been met
5-gave me the wrong contact information so I couldn’t try to collect from them
6-their insurance reimbursed me below cost for a vaccine.
why do you feel that being conscious of running your business AND having compassion for patients (I do, for those who are suffering) are mutually exclusive???
Go to your compassionate naturopath, faith healer, or chiropractor, and see if they’ll fix you for free!
Anonymous
Get a copy of their driver’s licenses to get around that address issue. I always insist on photo ID at at least the first visit, a copy of which goes in the patient record.
If the insurance card isn’t absolutely clear and verifiable, get a deposit as well. “Worn out” and undecipherable insurance cards don’t fly. If the insurer does not verify eligibility, the visit has to be paid for by deposit unless the insurer clears the claim.
Anonymous
@ LisaMarie : 1:42 PM
>>If I walk into the clinic and offer to meet whatever price the doctor asks, in cash, up front, will I really get an appointment that’s as long as I want? Can any doctor actually make the time to do that, unless their practice is made entirely of cash-up-front patients?
If you entered a taxicab in San Francisco and offered enough money, I suspect you could get a ride to Boston.
If you want your own private physician, pay the average annual salary of that physician, and I would imagine you could have your own private physician with all the time in the world to devote to your medical problems and no one else.
The upper-upper-level VIP’s of the world. The types who would generate a media frenzy just sitting in a waiting room. I suspect they can get the physicians to come to them. And they pay accordingly.
I trained at one of those medical centers that gets internationally famous VIP’s. They had to clear out 10-bed ICU’s for one patient. Security.
When the doctor has to clear out the entire afternoon schedule for one patient and ten bodyguards, or a 10-bed ICU for patient and Secret Service, I suspect they paid accordingly. Not that I would know, I was just the grunt.
The docs I met at that place, those who went back to the UK and Europe, they described working in their country’s socialized system, and if they could rise high enough in the pecking order, they got to see patients privately as well.
So, if willing to pay enough, can you get unlimited amounts of the physician’s time? It’s true in the rest of the world, I daresay it would be true in the USA as well.