Friday, February 5, 2010

These are not negotiations

I'm here to try and help you, people. You may not believe that, but it's true.

I'm not ordering the tests for MY benefit. They are so I can figure out what's wrong with you, and fix it.

Personally, I don't give a crap if you don't have them. That's your business. You came to me for my advice, and I'm giving it.

Don't try to negotiate with me on this. They are entirely for your benefit, not mine.

Therefore, comments like the following WILL NOT get you anywhere in Dr. Grumpy's world:

1. "I'll have the brain MRI, but ONLY if you'll waive my co-pay."

2. "Okay, I'll do the CT scan, but you have to pay whatever my insurance won't cover."

3. "If the labs are that important I'll get them, on the condition that you order some for my husband, too, because he's due and doesn't want to see his internist."

4. "You can do the test, but only if the MRI place agrees not to charge for it."

And my personal favorite:

5. "I'll only let you do the tests if you'll double my monthly Percocet."

40 comments:

Amanda said...

I was telling my PCP about your blog yesterday and a light bulb went on over his head. I laughed asking if he had blog fodder and he just rolled his eyes and declined to comment.

Francine said...

quite demanding patients you have. geez! where do they get the balls to say things like that to you?

Anonymous said...

and what world do you live in?

idiots


mm

Chrysalis Angel said...

Here, have a diet coke on me. (Hands you a cyber diet coke, with sympathy.)

Grumpy, M.D. said...

Thank you, Chrysalis!

Barb said...

Did you tell them about the nice nap they get to take during the MRI? I recently had one on my ankle and the 45 minute nap was heavenly!

Julie said...

**shakes head** (actually that is all i ever seem to do when i read your blog - that and laugh)

John Woolman said...

Sounds as if some of these patients need the funetional MRI test described in the current NEJM:

"These findings suggest that functional MRI can be used to demonstrate evidence of awareness and cognition that cannot be detected by means of clinical assessment"

minimedic said...

Would you like some rum in that diet coke? Might make things easier...

Amanda said...

If I told my doctor any of those lines, I think her brain would explode.

Diet Coke's on sale at Publix if you have any of those up your way. If not, I'm sure other chains have sodas on special due to the upcoming Stupor Bowl. Stock up!!!

Karen W said...

I can not imagine saying that to my doctor. I can see it now - oh, you want to do a yearly physical? Then I'll do it, but you have to do it for free, otherwise forget it.

Riiiiiight.

Grumpy, M.D. said...

Yeah, and no one would walk into a restaurant and say "I'll have the steak, but only if it's free".

But they do that here without a second thought.

CQ, Medical Biller said...

Heh, yeah, and then those same people call ME up and try to pull the same crap! Only they try to tell me the doc's office told them they had a discount. Yeah sorry people, if it ain't on the paperwork, it ain't so. Nice try though. Now will that be Visa or MasterCard today?

The Mother said...

Shrug shoulders.

Send "fire patient" letter.

Banshee said...

wow.

I thought it would be one patient when reading the title...

yet it seems to be prolific! Where do they get these ideas?

kate said...

We had a lady here who had blood work, x-rays and an MRI ordered...she didn't show up to do any of them. When she came back for her follow-up appointment, our docs told her that they couldn't do anything new for her without new information - you know, 'we can't make a treatment plan without knowing what to treat.'

She went and complained to patient affairs that her doctors wanted her to die and refused to treat her.

They're all crazy, I swear.

Anonymous said...

When I first read the title and the
next few lines, I thought it was about
attempted negotiations for a new
treatment protocol for meds, i.e. narcotics. Which I go there every
year with my neurologist. With the
whole point behind it being, make everyone comfortable and not out in the cold. Never in a million years
could I ever imagine there are folks
out there like this! SAD and very
ENTITLED!
My word is ..JUMSILKS
My, this sounds just wrong!

Molly said...

Haha. I always negotiate in opioids.

Susan said...

What Twits! They all need a self entitlement re-adjustment. Big Time. Must be difficult to not shove their test orders up their butts...

Anonymous said...

And this is also one of the reasons your prescription takes so long to fill at the pharmacy, because one or more idiots ahead of you is trying to "strike a deal" with the pharmacist. "I will transfer my prescription because my copay with Aetna is higher than my copay with Cigna 2 years ago. Are you sure you know what you're doing? Here's my card. Run it again. Where's the manager? McDonald never overcharges me!"

Rach said...

Like I like to say "I don't negotiate with terrorists and I don't negotiate with five year olds."

Queen of Crafts, Current Events, and Such. said...

Hmmmmmm...Where will all the good doctors go...when the health care shenanigans get worse...??? Good Luck Grumps. I feel for the future.

The Skiesseu Man said...

"It's not fair! My doctors in Haifa always pay me to take their tests!"

Flavius said...

It's time to start offering free exams. When they show up, put on the glove and ask them to bend over. Now that you've got them, advertise all of your wonderful, painless, exams that only cost slightly more.

Also works with a nice 10 gauge, 2" needle with huge syringe and asking where they want to get stuck. "Don't you have a smaller one?" Yes, but it costs more and you obviously are concerned with your healthcare expenses... bend over!

You gotta give them the shit-eating grin to top it off.

-Flavius

webhill said...

What is wrong with people that they can't just politely say "Gee, doc. I don't know what to do. I understand you can't figure out what's wrong without doing the test, but the copay on that is way more than I can afford right now. What happens if we don't do the test right now?" and see what happens?

Moose said...

Seriously, if you're not regularly reading notalwaysright.com you should be.

Would this face steer you wrong?

Ok, more wrong...

Anonymous said...

What about a patient with a high insurance deductible who will need to pay $1000 cash for your services over the course of the next six months who offers to pay $500 in advance for everything?

Sarah G said...

Ah, Dr. Grumpy, it is strangely satisfying to know that patients act just as crazy at the Dr.'s office as they do at the pharmacy. Gotta love the bargaining techniques we see when we tell them they have to get the abx if they want the pain meds.

Anonymous said...

We get it in the hospital every day. "I'll only get that CAT scan if you give my IV Demerol."

OK - suffer; I have nothing to help you if you won't let me work this up.

Amazing how very sick people somehow are able to tolerate the workup without incident...

ShoShoni Rose said...

#5 is my favorite by far!

as a chronic pain patient, i've been rebuffed occasionally when i ask for a different treatment option or a medication adjustment.

but to just tell the doc that the only way this patient will allow to be tested if their narcotics are doubled!? that's pretty ballsy, i have to admit. incredibly stupid, but ballsy^.^


also, am new to your blog and this is my first comment here. i just wanted you to know how delightful and hilarious your posts are. so yeah...Yay!

student dr. blaze said...

i sense another t-shirt idea coming on.... ;-)

OK, but only if you buy me a Mercedes said...

Sounds like fall-out from the slogan du jour: "YOU can negotiate ANYTHING!"

Think of yourself as performing a public service by informing these dolts that, no, you CAN'T negotiate anything/everything.

Anonymous said...

I think the last one was to use the extra medication as a money making scheme to pay for the test.

quixote said...

Very humbling blog, this one. I think I'm so smart, I know all sorts of stuff other people have no clue about . . . but never in a million years would I have thought to bargain with a doctor about tests. o_O

Anonymous said...

My dad is a colorful kind of guy (intelligence, funny, and yet a little crazy (bipolar). Anyways, he has high blood pressure, diabetes, asthma...etc. He avoids appointments and it takes him a long time to accept increases in meds. Well his doctor refuses to refill his albuterol until he makes an appointment. Very affective

Dr. Woof-Woof said...

I'm a veterinarian - we get this in our profession ALL the time too. Except they throw in the added guilt-trip... "Fine. If ALL you care about is money, then I'll just let my cat DIE. And it will be all YOUR fault. How can you live with yourself?" Uuummmm... lets see... Nope, its still your fault that you didn't bring your cat to me six weeks ago when you first noticed the increased appetite, weight loss, and vomiting. It is NOT my fault that, although I strongly suspect hyperthyroid disease, I will not give your cat the medication without running the appropriate confirmatory blood testing. *sigh*

webhill said...

yo Dr. Woof-Woof - I feel ya. I had one about six weeks ago that is still painful. Mom came in with a 6 yr old kid and million-year-old ADR dog, proceeded to decline EVERYTHING, and then told the kid "This greedy doctor is making us kill your dog. I'm sorry but there's nothing I can do about it. Maybe she'll listen to you if you ask nicely." Then the kid begged me not to kill the dog, and the mom stage-whispered "just do it, he pees in the house" while the kid was begging and wailing. They were not established clients. I referred them back to their original doctor. Maybe that was a cop-out but I couldn't deal with that situation.

Chrysalis Angel said...

Cop away, Webhill. That was an awful situation to be in. Poor kid. At least you won't have played a part in scarring that little one for life.

ERP said...

How bout, "I will only stop seeing you and go over to Dr Prik's office if you give me a double Rx of Percocet".
Probably a good deal if the patient is a royal pain in the ass.

Anonymous said...

I went to medical school because I wanted to work with people, but now I realize that that was before I had really met people.

 
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