The Turkey Finds a Doc, But…

As promised, this is a follow-up to my previous posts about the arduous process of finding a new doctor. I have found one and I had my first appointment with him. As I expected, there are good things and not-so-good things. The anticipation was running high, because I had waited one full month from the time I scheduled the appointment. Must be a popular doc, I thought.

I arrived on time for my Wednesday appointment. The first thing I noticed was that this was a large practice—several doctors, both family physicians and internists; large, open air waiting rooms, with the “family” waiting room sort of separated from the “internal medicine” (i.e., adult) waiting room; a lab for blood drawing, urinalysis, etc.; and a branch of a local radiological diagnostic operation for x-rays and the like. That was a good sign, in that I was looking for a full-service practice that wouldn’t send me all over town for mundane stuff like blood tests and x-rays.

At the ubiquitous receptionist-under-glass window, there were two queueing stations, one marked “Internal Medicine” and the other marked “Women’s Health.” Being nobody’s fool, I queued up on the Internal Medicine side. When I got to the front, the receptionist was pleasant, and she handed me the usual clipboard full of releases, disclaimers, privacy policies, and a one-page form intended to summarize one’s entire medical history and describe current complaints. One page is usually inadequate for an older person with a few conditions and some surgeries, but I suppose the idea is to get the patient to record the most memorable events and hope that he or she does not forget anything significant. This is just one further indication of the cursory and fleeting nature of recordkeeping in today’s inefficient health care industry, as well as being an omnipresent example of the burden placed on both patient and doctor to rehash a lot of redundant information every time a patient changes doctors. There must be a better way. So, let me digress for a bit.

Until we implement Electronic Medical Records (EMR) that are portable and accessible—if the civil libertarians would just shut their big mouths about privacy long enough to understand the importance of EMR—this is the kind of stuff we have to put up with each time we change doctors. Given the ass-backward way our society looks at things, we might not get there in my lifetime, but in the meanwhile I maintain my own multi-page medical history that goes back to Day One. It includes lots of things that the typical one or two page form one is given in doctors’ offices cannot accommodate due to space limitations and it eliminates errors due to my own poor memory (who can remember dates, dosages, and immunizations?). I also get copies of all records each time I leave a particular practice for another. I package my personal history and copies of prior doctors’ records when I go to a new practice, and give them all that stuff along with their silly little form. Until EMR comes our way, this is the best solution I have found. Most doctors have expressed appreciation, noting that it is difficult to put together a relevant diagnostic picture without a complete patient history. But I digress…

I gave the completed clipboard, along with a file folder full of my history and prior records to the woman-behind-the-glass. At that point, she asked me for my co-pay, which I’ve come to understand is now collected in advance just about everywhere one goes. It was supposed to be $25, but she told me $15. I told her that I was the benefits administrator for my company, and I had changed the plan at the beginning of the year to one with a $25 co-pay, but she said that she just checked on-line and my co-pay was $15. OK, OK, I’m not going to argue, because it wouldn’t get me anywhere. It took my insurer four months to get the billing right after my change, so no doubt they’re still catching up with themselves on the co-pay. So, I paid $15 and sat down to wait.

Five minutes later, I was called in by a nurse to do the usual weigh-in and vitals check. Then she left, and I waited for the doc.

By the time he arrived, it was about a full hour after my appointment time. We discussed my medications, my complaints, and various aspects of my medical history. Dr D was glad that I did the medical history and he asked me to excuse him while he read through it. I appreciated that. He poked and probed a bit and said he would do some blood tests and call me if anything was out of whack. Other than that, he wanted me to come back for a physical exam, which he said might take a couple months to schedule. I figured I could live with that.

During the course of our discussion, Dr. D told me that it was his policy to no longer deal with drug salesmen. I told him that that made him my hero. Those of you who have read some of my other posts know that I cannot stand practices that give these leeches priority over patients.

The good doctor spent about 15 minutes with me, toward the end of which he dictated his notes to a pocket digital recorder and wrote my refill prescriptions. And that was that.

From the examining room, I went to a room behind the reception desk with a long row of women behind computer screens who do the scheduling, recordkeeping, and so forth. First, one of them called the lab to warn the tech that I was coming for some tests, and then I was handed off to the scheduling person to schedule the physical exam. She said that it would have to be sometime in October. October? I am writing this in May. I told her that the doc said “a couple of months.” She said that he probably didn’t know how far backed up they were with physicals. Hmmm…who is running the damn practice, anyway? Seems like the schedulers are running this one. I scheduled my physical for October 12. Columbus Day. How appropriate. In the 500+ years this new world has been operating, we’ve come this far. Five months’ wait for a physical. Harrumph!! Old Chris Columbus could have scheduled a blood letting by his barber in a matter of hours back in 1492.

I proceeded to the lab, where the genial Ms. Dracula deftly located a good vein, took my blood and sent me on my way. That was Wednesday. Today is Saturday and I have as yet heard nothing about the status of the myriad tests (four vials of blood). I am wondering whether I ever will, or whether I’ll have to wait for October, or just precisely when. I have no idea whether not getting a call thus far means I’m OK, or whether it means that they’ll get around to it when they get around to it. Moreover, if I need a follow-up appointment, I am further wondering whether I shall have to wait for a month or more?

Bring on concierge medicine, already! Soon!