Five Docs in Three Years?

The Turkey has once again changed doctors. Back in September, in a post called The Turkey Finds a Real Doc, I had reason to believe that my search for a new primary care physician had ended successfully. I was wrong. This time, I didn’t fire the doc—instead, the doc fired me! Just how did I get “fired” and wind up engaging my fifth new doctor in three years? Read on.

Although I was opimistic about Dr. M based on my impressions formed during my initial visit, a number of screw-ups by his people soured me toward the practice. I won’t go into excruciating detail here, but suffice to say that I was inconvenienced at least three times in as many months because of errors made ordering the wrong blood tests and rescheduling them. The third time was a charm for me. I was stern and grumpy with the staff at that appointment, which was exacerbated by their calling me by my first name without my invitation to do so, a faux pas guaranteed to inflame my ass.

That same afternoon, I received a message from the doctor’s office. My physical exam, which priginally had been scheduled two days thereafter, was cancelled. No explanation. I called back and left a message for the person who called me. Having received no response by the next morning, I called again and left another message, then left for a hike with my friend Jenny. While on the trail, I got a call on my cell phone from the office manager at Dr. M’s practice. She informed me that because of my “abusive behavior,” I was being “discharged” by the practice. I would be receiving a letter from Dr. M to that effect.

Needless to say, I was taken aback. I’ve never been “fired” by a professional practice before, but there’s always a first time. I continued the conversation with the office manager, whose demeanor was everything I despise about the way many health care practices treat patients these days. My characterization of this attitude is: a) the insurance companies are perceived as the real customer, and b) patients are essentially portable containers for insurance cards, and are no more than necessary evils. The perceived customer, the insurance companies and Medicare, encumber the staff enough. Any additional encumbrance by the patient, perceived as incidental to the staff’s purpose, is to be dealt with as a nuisance. So, in practices like this one, we’re expected to take whatever crap is heaped on us, to be inconvenienced willy-nilly without comment, and to pay our bills and keep our mouths shut.

But I digress. Back to Brunhilde the Office Manager. I asked her whether this unilateral action was final and whether I would be given an opportunity to present my side of the story. She told me that the decision was final. So, as a parting word, I let her know that the person I with whom I had been grumpy, whom I had never before met, addressed me by my first name without having been invited to do so and never used the words “please” and “thank you” with me during the entire encounter. (I’ll repeat my oft-stated objections to the first-name thing. First, I’m twice her age. Second, in no other professional situation would I ever receive such patronizing and discourteous treatment—staffs of my dentist, my lawyer, my CPA, and my car dealer address me by courtesy title and last name until I direct them to do otherwise. That’s regarded as polite business behavior—common courtesy—everywhere but certain doctors’ offices. Why? Because patients in their minds aren’t really the customers.) In any case, Brunhilde scoffed at my suggestion that the staff treat patients with common courtesy, arrogantly stating that their patients preferred to be called by first names. There was no sense taking this further with the witch, as I was no longer their patient, so I signed off.

I did eventually receive the letter from the doc, with a genuine signature, so I’m certain that he was involved in the decision. I understand his loyalty to his staff, which is fine, but by not giving me an opportunity to present my side of the story Dr. M tacitly confirmed that the inmates were in charge of the asylum in his practice. I’m indeed guilty of being grouchy but with provocation—in my opinion, anyway. I fired off a letter explaining my position, which was never answered. Par for the course. Dr. M did me a favor by “firing” me, as I was destined to dump him eventually, anyhow. A practice in which the patients are not treated like customers is not for me.

A further, weird indication that Dr. M’s practice is out of control occurred several weeks later. I received a voice mail from Dr. M himself, telling me that his assistant had received a message from me and didn’t know why I was calling. It sounded as if he was trying to sound tough, which was kind of comical. “OK, have a happy holiday, see?” A regular Edward G. Robinson. The really funny part is that I hadn’t left any messages there for anyone for a few weeks—my original messages asking why the physical exam appointment was cancelled. This served to put the capstone on the whole thing. If I hadn’t been glad to get out of that looney bin before, I sure was after this weird-ass phone message.

So, another year, another doctor. Enter Dr. F. At my initial appointment I was impressed by the amount of time he gave me, and by the level of communication he employed. Moreover, the staff was respectful. I didn’t get any first name crap from them. The good doc has a “preferred patient” plan, which for $300 a year gives priority in scheduling, provides blood collection in the office, diagnostic appointment scheduling, and a bunch of other little things that make life easier for the patient. I don’t mind paying it, knowing how primary care physicians’ pay has been squeezed by Medicare and insurance companies. These guys deserve a break, too, and if I derive a few benefits, so much the better.

At my second appointment, a minor surgery to remove a sebaceous cyst, a staff screw-up gave me an opportunity to see how preferred a patient I was. My appointment had apparently slipped through the cracks, because there was no record of it when I arrived at the appointed time. Even though it was at the end of the day, the staff honored the appointment, apologizing profusely. I did not have to wait, either. I was given an exam room immediately and the doc appeared within 10 minutes. Throughout, I received respectful treatment and I left with a good feeling about the practice.

Will the honeymoon last? Stay tuned…