My veterinarian answers my phone calls. The other day I called her office to ask for a renewal of the pain medication for my little dog Jack. He has been blind and deaf for over a year, but now his rear end is going and he is falling a lot and having a hard time getting up. When I asked for the medication, I did so with a certain queasiness that perhaps refilling the prescription was my way of putting off the inevitable. Suddenly I wanted to talk to the vet. I told the receptionist that it was not an emergency, but could she please call me back by the end of the day. She called me back within the hour.
Today I sat with a patient who has recently been through a battery of tests to determine whether his cancer has spread. He told me how frustrating it has been for him to call his doctors’ offices for the test results, and not receive any calls in return. This man belongs to an HMO where he can go on line and look at his results himself. I asked him why he did not do that and he said, “Because I am scared to read the results when I don’t know if I will understand them and there will be no one to talk to.”
Six months ago I received a letter in the mail, from the University that employs me. The letter said that because I am faculty, I am eligible to have a “concierge doctor” at a sharply discounted price. For a mere $5,000 a year more than the exorbitant rate I already pay for my Blue Cross PPO, I (and my spouse) will be entitled to a doctor who will see me within 48 hours if I get sick, who will help me “navigate” the system if I get cancer, who will return my phone calls within 24 hours, and who will make sure that if he is on vacation, a covering physician will see me. My Jewish grandmother rolled over in her grave, sat up and said, “This, I should pay EXTRA for?”
Growing up in a medical family is both a blessing and a curse. My husband and I are third generation practitioners, if you count my grandfather who was a dentist, and his grandfather who was a veterinarian. As a consequence, we remember the days when physicians were expected to return patients’ phone calls themselves in a timely manner, guide their patients through difficult decisions and life crises, and see their patients urgently when necessary. Merriam-Webster defines “concierge” as a person in an apartment building, usually in France, who serves as doorkeeper, landlord’s representative and janitor. Is this what I want from my doctor? Is this what I want to be?
My husband and I had the same reaction when we read our proffered “concierge letter.” We want a doctor who will see us if we are sick, advise us when we have a crisis, and return our phone calls without being paid extra, because it is the right thing to do. This is what we expect. This is what I provide for my own patients. This is what all patients deserve. If my veterinarians can behave like doctors, so can we.
Miranda Fielding is a radiation oncologist who blogs at The Crab Diaries.
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