This does not inspire confidence
At my ten-minute biopsy follow-up appointment yesterday -- and I should preface this by saying that I otherwise like this doctor, and this is coming from someone who generally thinks most physicians are incipient sociopaths:
Doc: "...and I'm also giving you a couple handouts about your upcoming surgery. You can schedule with Radiology."
E: "Surgery? So it can't be removed by needle?"
Doc: "Did the doctor who performed the biopsy say that it could be aspirated by needle?"
E (starting to feel like when the cashier at Giant asks me "how much are those bagels?"): "Um. I think she said it'd have to come out either by surgery or needle, and that you and I would discuss the options."
Doc: "Hunh. Oh, what the heck! Let's try it by needle!"
Wait, wait. It gets worse.
So I toodled off to Radiology, and waited. And waited. Eventually, someone came out and said that their system was down, and gave me a phone number to call. I called that afternoon, got voicemail, and left a message.
This morning, there was a nasty voicemail on my phone at work from the hospital's scheduler, timestamped 6:45 PM, berating me for not being there to take her call. "I'm staying late to call everybody back," she whined, "so it really would've been nice if you could at least have answered."
Ok, whatever. I called back today and told the same scheduler what I needed an appointment for -- something called a "mammotone," apparently. (My first thought: does this somehow involve humming?) She informed me that I must be reading the doctor's writing wrong, because she had no idea what a mammotone was. Well, I didn't either, but, then; it wasn't my job to know. ("How much do you think the bagels are, honey?") I told her I would've been happy to actually show her the doctor's order sheet, but their department seemed to be having a little equipment trouble at the time that I came by yesterday. She told me to call my doctor.
Fine. I phoned my doctor's office and explained that the scheduler didn't know what the hell she was doing. The doctor's receptionist was also a little puzzled, and asked me some questions that I, in turn, found a little baffling (and that's once we got past the "data birf?" queries).
Receptionist: "Is it pink?
E: "I beg your pardon?"
Receptionist: "The doctor's order sheet. Is it pink?"
After considerable back-and-forth, I persuaded her to check with the damn doctor, and she finally did, and then told me: "you want a mammotone."
I called back the scheduler. She put me on hold and called the doctor herself. She eventually got back to me and informed me triumphantly, snidely, that what I really wanted was a core biopsy. Look, whatever gets me scheduled, ok? I have work I'm supposed to be avoiding. We began auditioning various days and times. But something was bugging me.
E: "You do realize that I just had one of those, right?"
Scheduler: "What, you mean since you saw Dr. T yesterday?"
E (with amazing restraint): "No-oo, the appointment with Dr. T was to check on the aftermath of the biopsy."
Scheduler: "Says here you had a fine needle aspiration."
E: "They also performed a small aspiration. But, I'm telling you, the main event was a biopsy. They gave me the little "So You're About To Have A Core Biopsy" brochure, and everything.
Scheduler: "I don't see nothing bout that."
E: "I really don't want a duplicate biopsy."
Scheduler: "Lemme call you back."
Eventually, by the end of the day, I emerged with an appointment for June 16th. We both avoided technical terminology on our icy little follow-up call, but I did ensure that they were planning to remove the growth, and not just cut off a piece for testing. At this point, I still have to call another number and wait on hold for fifteen minutes in order to "register with the system," something that has to be done before each and every appointment. You'd think that'd fall under the category of "scheduling," but apparently not. I'm debating whether it's worth doing at all, because I did it for my last appointment, even calling back the day before to confirm that I was registered, only to be chastised on the day of my appointment for failing to register, because, of course, they had no record.
Frankly, at this point, I'll just be pleased if they perform the procedure on the correct breast.
Doc: "...and I'm also giving you a couple handouts about your upcoming surgery. You can schedule with Radiology."
E: "Surgery? So it can't be removed by needle?"
Doc: "Did the doctor who performed the biopsy say that it could be aspirated by needle?"
E (starting to feel like when the cashier at Giant asks me "how much are those bagels?"): "Um. I think she said it'd have to come out either by surgery or needle, and that you and I would discuss the options."
Doc: "Hunh. Oh, what the heck! Let's try it by needle!"
Wait, wait. It gets worse.
So I toodled off to Radiology, and waited. And waited. Eventually, someone came out and said that their system was down, and gave me a phone number to call. I called that afternoon, got voicemail, and left a message.
This morning, there was a nasty voicemail on my phone at work from the hospital's scheduler, timestamped 6:45 PM, berating me for not being there to take her call. "I'm staying late to call everybody back," she whined, "so it really would've been nice if you could at least have answered."
Ok, whatever. I called back today and told the same scheduler what I needed an appointment for -- something called a "mammotone," apparently. (My first thought: does this somehow involve humming?) She informed me that I must be reading the doctor's writing wrong, because she had no idea what a mammotone was. Well, I didn't either, but, then; it wasn't my job to know. ("How much do you think the bagels are, honey?") I told her I would've been happy to actually show her the doctor's order sheet, but their department seemed to be having a little equipment trouble at the time that I came by yesterday. She told me to call my doctor.
Fine. I phoned my doctor's office and explained that the scheduler didn't know what the hell she was doing. The doctor's receptionist was also a little puzzled, and asked me some questions that I, in turn, found a little baffling (and that's once we got past the "data birf?" queries).
Receptionist: "Is it pink?
E: "I beg your pardon?"
Receptionist: "The doctor's order sheet. Is it pink?"
After considerable back-and-forth, I persuaded her to check with the damn doctor, and she finally did, and then told me: "you want a mammotone."
I called back the scheduler. She put me on hold and called the doctor herself. She eventually got back to me and informed me triumphantly, snidely, that what I really wanted was a core biopsy. Look, whatever gets me scheduled, ok? I have work I'm supposed to be avoiding. We began auditioning various days and times. But something was bugging me.
E: "You do realize that I just had one of those, right?"
Scheduler: "What, you mean since you saw Dr. T yesterday?"
E (with amazing restraint): "No-oo, the appointment with Dr. T was to check on the aftermath of the biopsy."
Scheduler: "Says here you had a fine needle aspiration."
E: "They also performed a small aspiration. But, I'm telling you, the main event was a biopsy. They gave me the little "So You're About To Have A Core Biopsy" brochure, and everything.
Scheduler: "I don't see nothing bout that."
E: "I really don't want a duplicate biopsy."
Scheduler: "Lemme call you back."
Eventually, by the end of the day, I emerged with an appointment for June 16th. We both avoided technical terminology on our icy little follow-up call, but I did ensure that they were planning to remove the growth, and not just cut off a piece for testing. At this point, I still have to call another number and wait on hold for fifteen minutes in order to "register with the system," something that has to be done before each and every appointment. You'd think that'd fall under the category of "scheduling," but apparently not. I'm debating whether it's worth doing at all, because I did it for my last appointment, even calling back the day before to confirm that I was registered, only to be chastised on the day of my appointment for failing to register, because, of course, they had no record.
Frankly, at this point, I'll just be pleased if they perform the procedure on the correct breast.
3 Comments:
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Anonymous said...
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- 10:39 AM
Post a CommentThe shambolic state of the American health care system despite all the money that's thrown at it is one very important, non-Italian-related reason that I don't want to move back there.
Your story is outrageous.
Speaking of Adventures in Medicine--I've got a dope story to add (no worries: This has kind of a happy ending, has nothing to do cancer-- and because it happened to me, there are no boobs whatsoever).
So, for reasons far to long & complicated to go into here, my health insurance has dropped me like a load of hot rocks. My one perscription medication that I take daily, name not important (let's just say it's not a 'male enhancement') is now covered by SucksToBeYou Insurance (out of pocket. My pocket). So, I call the drug store where I had been getting this med. This drugstore is part of a nation-wide chain, with the only real distinction being its open 24 hours. With my malady, being able to pick up medication between two & three AM is a real help, which is why I had been going there.
Now, the actual dollar cost of this one med at the 24 hour drug store was $544. per month--roughly the cost of my health insurance premium. So, I called another pharmacy (this one part of a formerly locally owned grocery store chain). THEY charged $300. for the monthly dose--same med, same manufacturer, not a generic, all things really ARE equal. In talking to both pharmacists, I specificed that I was paying C-A-S-H cash--not insurance, and both assured me that didn't make no doughnuts: everyone pays the same price at their shop. However, the grocery store pharmacist said 'You might try CrapCo [not it's real name]. They could be cheaper.'
So, I call CrapCo, and and THEY sell the exact same drug, same everything, with a monthly cost of about $240--or $300. a month CHEAPER than the place I had been going to....Not only that, the CrapCo pharmacist tells me that there is a new generic that's not time release (mine's a time release), and that if my doctor thinks it works for me...my monthly cost might drop to about fifty clams--but I'm not to quote him on that. I laugh, and promise him that I won't try to get him fired....Neither of the other pharmists mentioned that. In fact, the 24 drugstore person told me there was no generic.
Of course, this same medication sells for nickels outside of the US. Granted, there's no FDA in many third world countries (not that the FDA is ringing any bells here, what with a certain president handcuffing any federal organization that helps consumers--but we digress). Still, looking at somewhere between a less than a buck (outside the US) and $550. a month.....What's wrong with this picture?
The American health care system is a POS (secret code to get past the niece censor), but for people who HAVE good employer provided insurance, the system works great for them--or good enough....Which is why I think we as a people lack the 'political will' to really do something about health care.
When the first primaries started rolling, I went & looked at the raw numbers of who voted, and what were the percentages of registered voters who actually voted. The numbers (to save you all a long rant) were tiny. What is the consituency who votes? I'm suggesting that the heavy bulk of those voters not only have decent health insurance, but are pretty much happy with the status quo. That number is a small fraction of the population, but consitute a tremendously disproportionate electoral clout--and they know which side their bread is buttered on.
What is the purpose of insurance? To pool risk. How do you minimize the cost of a pooled risk? Throw out everyone who's a bad risk. With single payor universal health care, everyone--especially the bad risks--are covered. For those who have private insurance through United WASP Mutual, being part of a plan that includes all the uninsured & underinsured is going to cost more money. That's bad. Know what's worse? Having some form of a public health insurance that consists of everyone that no private insurance company wants. The total benefits paid out of the public health care program will be much higher (on average) than the private insurer, the pool of insured will (on average) have less resources, so those covered by the public health care will never be able to pay any where near what the actual 'premiums' would have to be for the program to be solvent....So those voters who belong to United WASP are going to get stuck subsidizing the cost of any public health insurance--which is what they should be doing anyway, because what they pay in premiums is artifically low (because the private insurance pool throws out all the sickees who would be a drain).
But that's political poison: paying higher taxes for slackers to get health care, WASPs (and WASP fellow travelers) won't stand for that (why they stand for paying $15 billion USD a month for the war in Iraq, on the other hand, that I can't figure out).
So--if a significant percentage of the population doesn't have access to health care for no good reason (other than perhaps to reduce the average risk of the insurance pool--I'm assuming 'no good reason' here, because the economic argument why there is 'no good reason' would take too long), why did 'Hillary Health Care' in 1992 go down with such a thud? Why isn't health care making the impact at the polls that it should? Only weirdos like Dennis Kucinich (sp) talk about single payor health care, and look how he did.
I'm a leftist (I'm not even one of the 1970s 'new left' people, if you can believe it), so I bristle at anything that smacks of 'blaming the victim.' Still--while it's become a cliche, the numbers of people who 'vote' on American Idol and Dancing with the Has Beens continue to outpoll any kind of political election. There are lots of good (and bad) reasons why that is, but at a certain point it's time to start pointing fingers.
There's an old adage that people pretty much wind up with the government that they deserve. Is that the problem with American democracy? The old 'lead a horse to water' phenomena? How long must a group of people engage in behavior that can be considered 'dumb ass,' before you can say 'Wow. Those people really are dumb asses.' I am saying (in a gross oversimplification) that Americans who are either underserved or uninsured who did not vote for Dennis Kuncinich or Ralph Nader are dumb asses.
On the other side of the coin, my parents have United WASP health insurance, and are violently opposed to national health care (I'm not completely clear how they reconcile that belief with their extreme conservative form of christianity, but we pointedly do not discusss it. Come on--we're WASPs). The closest I get to discussing it is when I mention the alarming growth of strains of drug resistant TB, and how MAYBE that's something their own insurance wouldn't be able to help them with....but that goes no where: they refuse to see a connection between their economic interests and seeing lazy ass deadbeat dope heads getting the right medication for TB. So, should I expect the average American Idol voter (discounting all the 'under 18 year olds' who vote for Idol) to pay attention enough to be able to vote their socioeconomic interests?
I guess I do. At some point, that percentage of the population who will pay money to vote for American Idol (but not vote in elections, which with the abolition of poll taxes are 'free') needs to pull their head out of their rear end.
And don't hand me that crap about how 'there's not any difference between candidates.' First, virtually everyone who says that doesn't know squat about the candidates anyway--but if that's your problem, then vote for Bob Barr or Ralph Nader. Don't tell me there's no one out there who reflects your values.
I need to make one more rant on elections, again as an 'old left' ie 'idiot.' For a long time, the US left either avoided electoral politics altogether (because that's 'social fascism'--and I am not making that up), or engaged in campaigns that were sick jokes (like Gus Hall). But back in February 1917, when the Tsar's government collapsed, Lenin was in Switzerland. There's lots of reasons why Lenin was organizing there (e.g. a Marxist view of the evolution of economic systems, where socialism follows capitalism--1917 Russia being largely agarian, the 'socialist revoltion' can't happen there....), but the point is, Lenin was trying to build his revolution in a nation and a forum that he thought was the most productive.
What would be the most 'productive' strategy to organize real political change, not just in the US, but in the world? I would suggest getting a truly representative number of Americans to actually vote their pockbooks.
Just how to do that, though, I have no idea. But I am open to suggestions.
I remain:
Bill Abendroth
So, the good news is that you don't actually know the name of the various procedures. Once you've started recognizing the names of the procedures and how to do them, it's a whole other ballgame. Though, it is handy to know the tricks to get the correct procedure scheduled.
Next time, have the doctor's office call to schedule the appointment while you wait. Then, the back and forth medical babble can be handled by experts. The doctor's office doesn't like to do this but if you plead and say you've had problems in the past, they should do this little thing for you. It takes longer at the doctor's office but saves much more time in the long run and should prevent unnecessary procedures.
For a while, I always have several more mammogram "views" than the regular victim. Unfortunately, I would get the first mammogram and then have to schedule more as they had to determine what that smudge was. I finally figured out that I needed to have the mammogram done at a certain location X so they could use the better machine to check things out ON THE SAME DAY. However, I, as a mere mortal, could not schedule at location X. The irony was the because the better machine would always confirm that I did not have a problem, I couldn't schedule my appointment at location X which was only for problem mammograms. Once I convinced my doctor's office to make the appointment for me, I could get out of mammogram world in under 2 hours.
At my mammogram mart, they have customer surveys. Did your technician greet you warmly? Did she tell your her name? Was her technician certificate on the wall? I have found the technicians to be lovely. The radiologists to be ok and the schedulers and the system register people to be clueless. Good luck and if you ever move to New England, I can walk you through the procedures in my local village.
V
P.S. What is the favorite plant of all radiologists?
A: The hedge.
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