Your Doctor vs. the Pope – Who’s More Unreachable
(A post in which I go way off the reservation into a rant about crummy healthcare.)
I’ve been fortunate not to have had a terrible complicated migraine in months. When I’m not in pain I’m not thinking of migraines. On Friday morning, I noticed the old, familiar light-flashing aura wash over me. I quickly remembered that I had a prescription for my migraine medication that I had not filled. My thoughtful husband left almost immediately for the pharmacy so he could be there as soon as they opened to get my Rx filled.
When he returned to the pharmacy to pick it up they told him it was expired and with it being for a controlled substance – they couldn’t fill it. Once he told me, I called my doctor’s office. Of course I couldn’t speak to the doctor but I did leave him a detailed message about the severity of my migraines and the serious neurological symptoms which should be in my chart anyway. They never called me back. I called again. They never called me back.
The receptionist remarked, “You haven’t been in this year.” I explained to her that I did visit the doctor specifically to get this very prescription at the end of 2008. I didn’t know the Rx had a magic expiration date on it. It didn’t say so on the paper copy. How was I to know this? If anyone would have given me a heads up to fill it right away – I would have. I still have the darn expired Rx so I can show them that I did not already refill it and come back “drug seeking”. Did they listen? no. Did they care a wit? I guess not. So it would have probably been to much to ask them to join me in a hug because, “Hooray, I haven’t needed the pain meds in the last 7 months”.
I tried to phone again after hours wondering if maybe I could at least leave another message with the answering service or machine. If I was super lucky my doctor might have been on call and I would have been able to speak with him. Or so I dared hope. Instead there was no answer. I guess this is their solution now to patient care - just don’t answer their calls. If it’s bad enough over the weekend they’ll go to the emergency room or the doc in a box and it won’t be our problem. Am I the only one feeling nauseous here?
If this was the first or second time I have experienced this lack of concern I would not be writing about it. This is after many times of being treated as a “difficult” patient just because I want them to give me a prescription that the doctor has already said was okay. Good luck getting to the doctor.
These days doctors are more well-guarded than most governors. You can NOT talk with them. Unless, I guess, you are wanting to pay a $35+ co-pay for an audience. For which I receive a lot of polite nodding and agreeing that “Yes, the system stinks. It’s not fair. I know you’re not drug seeking, and here’s your prescription”. My doctor apologizes profusely in person for the way I’ve been given the run around by the staff and never called back. He goes even further in his sympathies because he has a wife who also suffers from migraines. He knows how hard it is. He empathizes. He tells me he will get me an appointment with her fabulous neurologist.
Oh, I bought into it several times. The most caring doctor when you’re in the room with him. But once you leave that office, Sayanara to the concern. During my last visit I was supposed to get a referral to a neurologist according to the Doc. Never got one. Obviously I never got the pain medication either.
Now I realize that following up on these things is MY responsibility. And I dropped the ball. I goofed. Once the headaches got better and stayed better for months I forgot about it. I went on with my life, got busy meeting my many responsibilities, and forgot about the “what if” of another bad headache.
So here I am Friday. In pain, with the possibility of this pain progressing into agonizing, debilitating pain. The people at the pharmacy showed compassion but their hands were tied. It would have taken any number of people at my doctor’s office a matter of minutes to call in my prescription and save me from pain. Even calling in a dose or two until I could come in next week would have been preferable to being completely ignored.
I have worked in a hospital and other medical settings when I was a psychologist. I know what it is like to have a mountain of messages to go through at the end of the day to see what can possibly wait til the next day. Some things can wait. But how does a man whose wife suffers from migraines and “understands” and cares for his patients so well….how does this man abandon the patient who has been suffering from a migraine all day without as much as a call back? A call from him, or any human on his staff would have been sufficient.
Or is he unaware of who even calls because the gargoyles at the gate make those decisions as to what’s important enough to tell the Grand Poo bah?
We live in a smallish town with around 12,000 people, where we don’t have a lot of choices for family physicians. We switched several years ago when we couldn’t get return calls for a family member after he was discharged from the hospital where he spent almost a week suffering from encephalitis. What is going on with doctors who don’t seem to care about people’s severe pain? Are they devoid of empathy?
I debated over whether or not I should post on this topic. This tweet from @Zenasurialpacas helped me decide to go ahead with it. “I say blog away. What’s the doctor going to do? Refuse to call and leave you without pain meds?”
With the internet, we have a voice. The patients out there can be heard. This is a broad issue that affects millions of Americans each day. We need our doctors and we can’t talk to them. They truly don’t get paid enough anymore to spend more time with patients. I know that there are only a few hours in a day. But if the doctors can’t be in touch then they need to find a way to do better. Perhaps hire better nurses. We generally expect nurses to be helpful and caring but in my experience the “gatekeeper nurse” is often less concerned than the doctor OR the receptionist.
The system is broken down. We all know that. But what doctors need to know is that their patients do have a voice. With the internet, there are repercussions for letting patients fall through the cracks. Not only can people leave and go to another doctor, but they can also tell others how they feel about the care they receive over the internet. There are numerous places where people can go and rate their doctors and leave comments about the care they’ve received. Yahoo has a place to rate doctors, so does Angies List, and many more.
The internet has turned our world into one in which Consumers hold more power. Patients have access to more information than ever before. Hopefully this will result in an improvement in doctor patient relationships. Trust and positive regard must be the basis for any successful business relationship, medical or otherwise.
What do you think? Have you ever not been able to get in touch with your doctor when it was important? Do you think the internet will change how people relate with their doctors? Please leave your thoughts and comments.
July 11th, 2009 at 4:29 pm
When we moved to a small town of about 8,000 in 1989, there were 4 doctors. I could call in the AFTERNOON and take my baby in the same afternoon. By the time the next one came along three years later, they had a mix master answering machine. I had to wait for months for a PRENATAL visit and there were 10 doctors. The population had only increased to 10,000. I couldn’t get a call back if the kids were sick. I don’t think it has anything to do with population or the lack of doctors at all. I think that they have just sequestered themselves so they don’t have to deal with people.
You want another rant? Why does it cost mega bucks to be treated by a doctor, but the exact same treatment for an animal (surgeries, broken bones, infections) with the same meds costs miniscule amounts of money. I don’t think it has anything to do with population and lack of doctors.
July 11th, 2009 at 4:29 pm
First, I am so sorry you have migraines. As someone who’s suffered through many of them, if your doctor won’t join you in a hug to celebrate 7 months without a headache – I WILL! Awesome.
Second, for years, I’ve been shouting this into the wind: The healthcare debate in this country is so focused on who has insurance and who doesn’t, and I maintain that this misses the point entirely. The discussion *should* be: How do we make sure that everyone has access to good healthcare when they need it? Because, as your story illustrates, having insurance does not guarantee healthcare when you need it.
Third, I wish more doctors would try new approaches to improve patient care. I think it’s appalling that doctors have to have 2-3 full-time staffers JUST to file insurance paperwork. Unacceptable!! Waste of doctor resources. I loved this story of a doctor who no longer accepts insurance and his stress levels are down, patient care is better, and he’s making more money: http://thestory.org/archive/the_story_209_Cash_Doctor.mp3/view
This blog really struck a nerve with me. I hope you don’t ever need the meds again, ever. But thank you for sharing your story (and allowing my mini-rant of a comment.)
July 11th, 2009 at 6:18 pm
Oh, I feel your pain. My father had a double lung transplant six years ago and we are fighting his meds everytime he comes home from the hospital. He is supposed to get an at-home IV treatment for three weeks to battle the infections that put him in and they always mess up the shipment to get him.
Your right, communication has shut down and the system needs to be overhauled. Too many people are without.
Yikes, I hope your migraine calms and your head can be at peace.
July 11th, 2009 at 7:32 pm
You are right on here. Many doctors and/or their staff just aren’t there for you.
I have CRPS (complex regional pain syndrome)and get stellate ganglion blocks for pain. When I need them, I need them yesterday, but I have had staff who didn’t understand (in the early years) tell me I couldn’t get an appointment with the doctor for a month. I finally discovered that the correct response is, “Oh, I’ll be dead by then,” not one of my nicer responses, but it worked.
I’m getting the appointments and medications I need when I need them now and am almost off of medications altogether although I keep them at hand just in case. Immediate response to pain means I now take one non-narcotic pill a day instead of 26 (which included several narcotics and multiple prescriptions). My son, who was 8 when this started will be 20 next month and still has a mom, I raise alpacas and life is good thanks to several doctors who listened.
The CRPS has reached a point where it manifests itself visibly and physically. BP shoots up 50 points or so, my left arm becomes about 10 degrees colder than the rest of my body and changes color. But for about three years I was treated like a drug-seeking nut case as I went from doctor to doctor looking for help. I was lucky enough to be properly diagnosed by a good pain specialist and now have a thick medical file that states to any medical personnel that what I am saying is true, not made up and not in my head.
Please doctors (and legislators), realize that not everyone is a junkie or a wannabe junkie. You would treat a diabetic or someone with epilepsy immediately and would monitor their progress or you would help them find a doctor who would, knowing you could be charged with malpractice if you didn’t. Don’t dismiss people in pain or just throw drugs at them. There is really something wrong and they need proper treatment.
I thank a dear friend who found me a pain specialist and my dear husband, who believed me and wouldn’t take no for an answer when he demanded an immediate appointment, for my life. The CRPS can strike at any time, but we know what we are fighting and we will deal with it.
July 12th, 2009 at 11:30 am
Ooooooh! That is SO frustrating! It’s situations like yours that explain why I am on my third internist. The first had a wall of staff, identical to what you described. They either did not give my physician my messages or mixed them up. Their fax machine was like a black hole (other doctors would send reports but the paperwork would never be seen again). The big laugh was at office visits (after waiting at least an hour) when the doctor would tell me “Just call me if you need me.” HA! The coup de grace was when the doctor went out of town for a week and my 90 year old father needed some paperwork from his file to take to a referral- and the medical records people had LOST HIS FILE. So there was no one at the office who knew anything about my dad and no papertrail. ARGGGH!
The second internist was just an ass. Nuf said.
The third is wonderful. She works out of our local university clinic which is also a training facility for medical students. It’s obvious that the mission is to give good care while also showing the students how it should be done- which tells me that the medical community knows what it is doing wrong, knows how to fix it, but for the most part just doesn’t care. Sad.
Good luck with the migraines. I’ve had success with daily Inderal, but everybody is different.
July 12th, 2009 at 7:25 pm
Just wait until you have nationalized health care. I am afraid the responses of today’s health care professionals will look super good.
When I was growing up we had no insurance. Doctors and nurses responded to patients like good caring neighbors.
Then I joined the US Navy and got an inside look into government run health care. Some people liked it, but I had a totally different and less than satisfactory experience every time I went to “sick call”.
I worked for IBM when they had self administered health insurance for employees. They paid the charges quickly and with no discussion. Then IBM went to using BC/BS to “administer” the claims and service from the “professionals” began to change ever so slightly as the insurance company questioned charges, set limits on charges and paid slower.
Then I reached the magic age and qualified for government run/administered medicare. Might as well get used to your experience of this week if our illustrious congress passes Obamacare. Old people like me will be like the old feeble indians, put out of the tribe to die alone and unattended.
July 12th, 2009 at 8:26 pm
Katy – The internet is the great equalizer. We all now have a voice. Some voices are clearly louder than others, and you have quite a following.
The healthcare industry needs a complete overhaul, but we can’t just complain about it. We have to find another way.
In another industry I was a business process developer. That means I looked at the needs and wants of our customers, then developed business processes from the customer’s point of view. The idea is to deliver your goods and services quickly and effeciently to your customers while also becoming easy to do business with.
Healthcare is talking about process, but they don’t understand it. It’s like old Detroit implementing robots because Toyota did it. They didn’t understand so instead of realizing the same ROI, they got more expensive and slower.
I’m happy to hear you are feeling better and I hope that you continue to try to impress upon yor doctor this failure in his business practice.
You have me thinking about starting a consulting firm.
Kathryn (@Alpacamundo)
July 15th, 2009 at 1:06 pm
I’m glad you touched on this subject. I actually found my doctor through internet website Angie’s List.com (as you mentioned in your post). I signed up for the site after coming across a web show where they offered 25% off the service ( http://offers.mevio.com/angies-list-promotional-code.html ) . I can’t thank them enough…
~S
July 19th, 2009 at 6:57 pm
Been there and done this. I moved to another town a little over a year ago and my doctor wonders why I haven’t found somebody else. It is beacuse they aren’t HER. She always calls me back,knows everything about me and my kids,doesn’t want me to go to Urgent Care on nights and weekends, she actually WANTS me to drag her to the office at 2 am if we are sick!! I can’t find that somewhere else so I happily drive an hour to see her. I shudder at the thought of trading her in for someone who forgets who I am the minute I leave the office.
I hope you can find your own doc like mine.Don’t give up. Mine is a D.O. as opposed to a MD.
July 19th, 2009 at 9:44 pm
Yep. I was coughing blood due to a severe infection in my throat. Fever of 102-103. While the receptionist was sipping coffee, she suggested I go to Urgent Care, because they couldn’t possibly see me until next week (of course this was a Friday). I went to Urgent Care. They did NOTHING. They said I had a virus. I knew better. I suffered all weekend, getting worse and worse. I called the doctor Monday morning. Begged. Begged. They got me in. My doctor said, oh yes I’ve seen so many patients sounding just like you (I couldn’t talk at that point), it’s a virus. I said I am coughing blood, this is NOT a virus. Through some kind of miracle, she gave me antibiotics. And ordered a chest xray, which I didn’t bother with, because I knew it wasn’t in my chest, it was in my throat. The antibiotics worked.
Next time, I’m just driving to Mexico, where you can get prescription drugs without a prescription at any pharmacy. Hmm. I need to get a passport first (new law).
SIGH