Thursday, December 5, 2013
Visiting the Doctor is a Waiting Game -- Be Prepared
This week I had to see the doctor when I didn't see a need.
I'm sure as I get older I may have to accept more of this. A prescription that needs a refill and the doctor says he has to see you for a "follow up" visit. I could understand if the prescription was new, but it's a medication I've been taking for about two decades, has few side effects, and if it weren't working I would know it. Still, he's the man who currently holds the prescription pad, since I've sent my previous two physicians into retirement.
At the same time, it seems less about making sure I'm OK than an easy way to bill my insurance for a doctor visit and a bunch of lab work I don't really need. Shall we talk about the high cost of health care and how it got that way?
Perhaps it's even drumming up business, because you're required to get to the doctor's office early so you can deal with the receptionist, handle insurance, pay your copay (thank God my new insurance actually has a copay instead of a bill) and wait.
They will not wait for you. In fact, many offices tell you if you're 15 minutes late you will not be seen and if you repeat that horrible offense they will not see you as a patient. They make it seem as though at the appointed hour, the doctor is standing there waiting on you and your failure to appear wastes his/her time and keeps them from seeing other people. We all know that is far from the truth.
If you're late, unless you have the first appointment of the day, there are actually lots of other people waiting to see the doctor, most of whom had appointment times before you and have been waiting for some time. In the world of the doctor's office, only the doctor's time is worth anything and it is worth a lot.
After all, I spent over an hour at the doctor's office (my appointment was early or it would have been longer as we all know the delay multiplies over the course of the day) and probably less than 10 minutes with the doctor. At least part of that time he was repeating the questions the nurse had already asked for my chart, as though perhaps they could trip me up in a lie about when I last had a mammogram. But I guess asking me again was more time efficient than reading what was on the computer screen. At least it increases face time, which I guess is supposed to make me feel better about the visit.
Despite that brief interaction with the doctor, I'm sure my bill for seeing him will be close to $200, and that's not including the lab work. I'm more aware of this because until my husband found a job with insurance earlier this year, that $200 was coming out of my pocket. I had insurance with a ridiculously high deductible and no copay, although it did have a reduction in fees for "network" providers.
But after touring the office between waiting room, patient room and lab, I see why the cost is so high. I'm not just supporting him and a nurse/receptionist like my childhood doctor had. There's a whole office swarming with people doing paperwork, which I'm guessing is billing insurance and other payment providers. No wonder the whole health care game is out of hand because I'm betting every piece of paperwork has to be handled differently according to who is doing the paying. Can we say single payer option and tremendous savings? No, better not go there.
Back to the waiting. First, you wait in the lobby, where you spend a lot of time breathing the same air as people who came in because they were sick. That's right, if business is slow, all a doctor has to do is call you in for a "follow up" visit and chances are good that not only will they get to charge you for that visit, but maybe you'll pick something else up in the waiting room. Adult offices should be like the pediatrician where the girls go -- separate entrances for healthy and well patients. Even though the rest of the office is shared, there is so much time spent in the waiting room that it could cut down on shared germs.
Then you wait in the patient room. If you've watched TV in the lobby to pass the time, now you're screwed. Nothing but medical tracts and maybe an old Prevention magazine. After that, you may get to wait for lab work. Once again close quarters with potentially sick people. Be prepared to wait.
The key is in how you wait. Don't go expecting that just because you have an 8:45 a.m. appointment you will be seeing the doctor at that time, or even in a patient room. Go prepared to wait. It's how you approach that waiting that makes the difference in the experience.
For me, as long as I get out in time to make whatever appointment comes next (generally being home for the girls and my Ma duties), waiting isn't a bad thing. First of all, I have a lot of experience in waiting from my journalism days: waiting in courtrooms for the case I'm following to be called or the lawyers to hash out some legal terminology, waiting outside a closed door for a closed session of some board in which someone may be getting fired, waiting with police officers for everything to be in place for a drug raid, waiting for the reporter who had the late meeting to file a story so I can edit it and finish the paper.
I've learned how to wait without a lot of advance preparation, but I don't generally do that. Lately waiting is a period of enforced inactivity that I can appreciate, no matter what else I could be doing. With days so crammed full of things I need to do that I cannot sit and read, a visit to the doctor, or next month the dentist, means reading time and although I may not have any distance viewing when I'm done, I don't mind the wait. No longer required to tote along a book or magazine, or worry about finishing whatever I'm reading, I take my Kindle and I'm prepared for whatever the visit throws at me. Waiting means reading time.
I know not everyone is a reader, but most people at least have something they've been meaning to read -- perhaps a gift or a book someone has suggested. Save it for those times you know you'll be waiting. Just can't do it, well if you know you're going to spend a lot of time waiting, go ahead and invest in a handheld game. No, you're not too old. There are games designed to help keep your brain in shape, or you can just got with solitaire. At least you're occupied and not going crazy looking at your watch. Heck, even a smart phone can entertain you for a long time if you can get past the small viewing area.
If you're prepared to wait, (and realistically, you should be) the second key to a successful "follow up" visit is avoiding contact with people who may be sick. Sit far away from everyone else. Carry hand sanitizer. If it's a bad cold/flu season, get a mask. I'm not above any and all of those things. Keep your germs away from me. All I want is my prescription.
And if you really feel like you need the visit, be prepared with notes. Seriously, in the round of dealing with their questions it is easy to forget your own. You're paying for his time, so if you want to ask about diet and exercise, or side effects of your medication, or why you can't sleep or want to weep hysterically at random moments, during that visit is a prime time to do so. Odds are good, however, that you'll forget if you don't go prepared for the actual time with the doctor as well as the time spent waiting. You'll do the blood pressure, temperature, breathe deep, and find yourself in the parking lot going, "Darn it, I forgot...."
Luckily, the Kindle was charged, I was out in time for a little shopping before Ma time, and the doctor didn't have anything to frown about. My insurance will be footing the bill, so I don't have too much to complain about. If I can just remember to pencil him in again in six months.