by Liz O’Brien
A long time ago — when managed care-style employee healthcare benefits were a new thing — we worker bees learned we might have to throw our old family doc under the bus.
We were given a booklet of providers on the network panel, and if the faithful retainer who had served our family for years wasn’t on that list, it was sayonara — unless we wanted to foot the bill for our medical care ourselves.
Alas, for most of us, economics trumped all, and — with regret — we began the search for a new physician.
We thumbed through that booklet, wondering how to choose our new “primary care physician” from among all those names. How could we tell who the good ones were — the docs who were competent, kind, and ready to listen and answer our questions?
We were literally putting our lives into these doctors’ hands — and all we had to go on was how conveniently located the office was.
I changed jobs frequently during this time of my life — jumping haphazardly from one doctor to the next with each new health plan. But finally I found employment at a publishing company where I stayed for the next 17 years.
And — as a bonus — the place had figured out the solution to the “how to pick a doctor” problem.
Kept under lock and key in the Human Resources department, there was a Book. A big, loose-leaf notebook they had been compiling for years.
It was full of anecdotal accounts — written by the employees themselves — of their experiences with local health plan physicians. Glowing testimonials, angry complaints, heartfelt expressions of gratitude for care above and beyond the call of duty. It made fascinating reading. Who had the longest waiting-room times? Who offered same-day appointments? Who had staff that smoked in the parking lot and smelled like it?
It was all here!
You could borrow the Book whenever you needed to check out a physician. Of course, you had to be alert for the odd exaggeration or misunderstanding. But I had the impression that people were telling it pretty much like it was. And, for the most part, they were pointing out who the good guys were.
I mention this only as a tiny footnote to the story of healthcare in America. Whether it was a good idea or a bad one, I’m not sure.
Only once did I consider adding an entry of my own — when my husband returned from a visit to a plan physician to have a cyst removed from his chest.
The doc, after examining the cyst carefully, suggested to Joe that anyone who required anesthesia for the procedure was “chicken sh-t.” Then — without warning — he suddenly lunged at him with a gauze pad and, in one swoop, slammed the cyst and ripped it off Joe’s chest with his bare hands.
I was appalled. This was ridiculous! The people need to be warned. I’m going to write this up in the Book. This couldn’t be standard medical practice but, yet . . .
The cyst was gone. The wound healed nicely. And the patient himself had no complaint. Also, the price was right — just a copay for an office visit.
And the more I thought about it, I suppose that’s how people had removed such cysts from time immemorial. No harm, no foul, I finally decided.
Or, at least, not enough of a problem to scare away business from this poor doc by telling all about the cyst incident in the Book.
I gave him the benefit of the doubt — a decision that may have been stupid, but it seemed like the right thing to do.
Although I used the Book on occasion, I never added to its pages.
Liz O’Brien is production editor at MedPage Today and blogs at In Other Words, the MedPage Today staff blog.
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