Wednesday, February 2, 2011

Annie's desk, February 1, 2011

Annie: "Dr. Grumpy's office, this is Annie."

Mrs. Copay: "Hi, I need Dr. Grumpy to call in some medication for my back. I also need him to order physical therapy and an MRI."

Annie: "Hang on, let me look up your chart... it looks like we haven't seen you since 2008..."

Mrs. Copay: "That's correct."

Annie: "... and at that time you were here for a completely different issue. It looks like Dr. Grumpy has never seen you for back problems."

Mrs. Copay. "Whatever. Let me give you the number for my pharmacy..."

Annie: "Look, he can't give you medications or order anything for a condition he hasn't seen you for before. Especially when it's been 3 years since you were last here at all. You'll need to make an appointment."

Mrs. Copay: "Well, my insurance copay is now $35, and I don't want to spend that just to come see him."

Annie: "We can't do anything without seeing you."

Mrs. Copay: "Why doesn't anyone care about patients anymore? All you people want is my money." (hangs up).

36 comments:

Anonymous said...

Magnificent. This one anecdote summarizes about 80% of the problems with the health care system in our country.

SR said...

Geez,just prescribe pain meds over the phone for some person you haven't seen in 3 years like any reputable doctor would.

Anonymous said...

How come there are more blog entries for Mary's desk than Annie's? It's not fair! :p

Anonymous said...

She needs to shut the hell up, at least she has medical insurance.

Outre said...

I say it’s time a law (federal, state or whatever) goes into act to allow medical offices to charge administrative fees to cover phone/paperwork work load for patients. Extra fees for cases like this. I know some offices do this, but there is no law protecting them from doing that, which surly some asshat will find a way to sue for...

Admin fee will probably make ppl think twice about wasting office staff/doctor’s time over the phone and haul their sorry ass in instead of pay the totally out of pocket admin. fee that is only slightly less than their co-pay.

If any of my doctors, esp my primary care starts charging annual administrative fee, I’ll gladly pay it. I see how much extra bs work they have to do that will never be reimbursed by insurance companies, esp due to people like Mrs. Copay.

Not House said...

Jeez.

As a matter of personal curiosity, what IS your policy on calling in prescriptions? I ask because I've seen a range of family docs/specialists's attitudes towards that, ranging from "sure, here's three more months of Oxy" to "I'm sorry, I need to lay hands on you before I up your prescription of Ibuprofen", and I'm always curious about the rationale for either.

Grumpy, M.D. said...

Varies with the patient. I'm likely a little more tightfisted than most.

Anonymous said...

If she thinks a $35 co-pay is something to complain about, she ought to try not having insurance at all! Whiny bitch.

That said, it's interesting what docs will and won't call in to the pharmacy. I used to have a doc who would make me come in before he'd prescribe antibiotics, but he'd just call pain meds in without question. Of course, I was going through a 30-count supply over the course of six months or more, so I don't think he was worried about addiction or abuse.....

Anonymous said...

Sounds like some of my clients (I'm a vet)...self-diagnosing their pets & demanding meds because "its just like last time" & "I just don't have money to come in for what I KNOW is happening" & "if you don't prescribe this med, YOU are making Fluffy suffer!" Hmm...maybe I should stop complaining about being stuck in my house for 2 days because of the storm! I got a long ass weekend off!

Anonymous said...

I wish I had her co-pay

Moose said...

Cripes, I can't even get my insulin refills from the clinic if I haven't been there in three MONTHS.

Makes for a fun winter, especially when I get snowed in.

terri c said...

I say good riddance--this is not a reasonable person! If she recognizes that you're right and she should come in, I think she needs some nerve conduction tests. Preferably done by an outside source who isn't very good at doing them...

Kat's Kats said...

::shakes head:: Maintenance meds are one thing so long as I have had my annual physical (last month) but for anything else I call for an appointment. Hello? My pediatrician taught me to come in and describe all of my symptoms even if they seemed related or not just in case that one made the differential diagnosis (and yes, that actually happened one time, he pulled out three books to show me, way cool).

OTOH I could taste my strep throat which I got three to four times a year so he would go ahead and call in my antibiotic but I still went in for the throat swab. Geez Louise!

Anonymous said...

Has this world really come to the point that we are supposed to be on bended knee and beyond thankful simply because we have health insurance - that we likely pay many, many hundreds of dollars a month for? We are to shut up and be thankful for this "privilege?" Is that where we have come? I'm just curious.

miss kitten said...

dear anonymous,

in the past 3 years i've had a full scan MRI (3K out of pocket with insurance), two CT scans (500 each with insurance), a liver biopsy (another 600 with insurance), an endoscopy (700 with insurance) and two liver ultrasounds (400 each with insurance). that's $6,100 out of pocket for us, on top of the $400 a month insurance and the $20 copay for office visits. and i'm not including the eye doctor visits in there.

so yes, after going most of my life uninsured and not able to treat things like, oh, diabetes and cirrhosis of the liver, that were both undiagnosed? i'm thankful to have insurance.

and we arent even going to go into how much my meds cost. cause that's another arseload of money each month.

Kat's Kats said...

I have to second miss kitten. We have insurance. Last year we had copays rather than percentages like we do this year. We still spent $200-300 a month (more for tests & surgeries). This year we have to pay percentages and I already have to have a cervical MRI & a colonoscopy this month.

With a diabetic/ADD/heart/high bp/high cholesterol; fibromyalgia/chronic myofascial pain/bipolar/PTSD/migraines (think at least 3 a month/IBS/edema/high cholesterol; bipolar/ADD/anxiety disorder (about to see a GI to rule out Chron's & see if it's just IBS) and another with bipolar/ADD/Asperger's in the house. We not only have pcp/specialist visits at least once a month (copay is now $25/40) but also medications that cost quite a bit. We're also living on one salary since I can't work. I do well to do housework some days.

And those medical bills? That doesn't include how much insurance costs each month. My two children have insurance via my husband and their father but not all offices will bill both. I have to pay everything up front and be reimbursed by their father who pays 75% of the bill... two+ weeks later.

I have a friend who finally managed to get on indigent care. By the time she did she had breast cancer, heart issues, weight issues, knee & hip problems, her diabetes II required insulin and there is a mass on her liver which is in a place that can't be biopsied and looks malignant on the tests they've preformed. I've known her for 22 years and I don't think I'll see 23 come around. Sorry this is so long.

Packer said...

My back hurts too --What can you do for me , over the internet ?

Can I at least get a note that tells my wife I am not to vacuum or shovel snow for a week, if the drugs aren't available.

She does sound like a pain med addict making the rounds, she will score somewhere.

Kim said...

Hey, can you call in my Synthroid refill for me? Please? I know that's not your area of specialty, but my doctor only calls in the prescriptions for a year at a time and then expects me to come in for blood work. It'd be so much easier if you'd just call in a 6 year supply for me so I wouldn't have to bother. And the Vitamin D script I started a few weeks ago? I only got one refill on that and then I'm supposed to go in for a blood test...can you call that in for me as well so I don't have to get stuck with a needle again? Thanks! ;)

Anonymous said...

I always love when they say "you care more for money than me!!" Oh yes, I love your monthly capition of $30 that comes to us regardless of how much you're seen or services provided!!

emmy said...

Are any of your patients sane?

Diana said...

My family doc has a sign posted: no prescription for antibiotics or pain meds without consultation. I've been using the same doctor and dentist since they started practice. It's safe to say I can get pain meds if needed to hold me over until my office visit, which I make an appt. for BEFORE asking for the relief. I have never failed to follow up - don't want to lose their trust and confidence in me. There are so many different antibiotics now I wouldn't want to be prescribed any without being seen. Under some conditions less is more!

Katherine said...

Are you sure you aren't talking about the patients at my office? And I get it from the specialist as well requesting authorizations for surgery for a patient we haven't seen in over 2 years!

Anonymous said...

Here in a country with the dreaded Socialized Medicine (New Zealand), I pay $30 to see the doctor and $3.00 for a prescription.

Anonymous said...

Am I alone in wondering who diagnosed her new condition and told her she needed meds, PT and an MRI, but did not order any of them for her?

vw: farlialse - what she suffers from....

Grumpy, M.D. said...

In my experience, it's usually Dr. Google.

a.generic doc said...

Seems to me that if Dr. Google can tell people what they need, he ought to prescribe for them, too.

And he doesn't collect any insurance co-pays.

Anonymous said...

That heux should have my office co-pay which is NONE. Just gave my neurologist $200 for an office visit. He's that good, and my other choice is a neurologist that shouldn't even treat a cat. Less expensive, but a total dolt.

I want to punch every idiot who bitches about how their RX co-pay goes up from $2 to $4, and how a $50 office co-pay for a specialist is unreasonable. I don't live in the hood, and these aren't hood rats complaining. They have more money on their back than I have on my wallet, and I usually get trapped hearing about a upcoming vacation/trip out of country or lastest $$$ purchase.

SkullCandy

ERP said...

Dude, you should TOTALLY treat him for free.

MostlyHarmless said...

Unfortunately, practicing good medicine is not what's going to make you loved by everyone(just look at Dr. Oz – he tells people what they want to hear and wears scrubs on TV = America’s favorite doctor, never mind that he’s mostly full of sh*t).
Once I got my cardiologist to prescribe me Retin-A over the phone… I was in med school at the time with no insurance. He really didn’t have to do it, but it helped me out a great deal.

txpharmguy said...

We get a bunch of grief on the pharmacy side, too. We generally will loan on maintenance meds (if compliant) until refill auth'd. Never on antibiotics or any controlled substances. Once refill denied, we're off the hook. "But I need my medication." "Well, you need a prescription from your doctor!" "If anything happens to me, you'll be talking to my lawyer!" (Oh, those that barely have $10 to pay the copay for Norco can have an attorney on waiver, puh-leeeeze). In fact, we get a lot of grief because we don't notify pts if there rx is denied (Too busy > 500 rxs/day). I tell people they're grownups and need to follow up on their own medication and part of that would be keeping appointments. Being the pharmacy manager, I get the short end of the stick because my employee was "rude" because she told me I can't get my medication.

Anonymous said...

Living with the dreaded 'Socialised Medicine' in the UK, I pay nothing for visits to doctors, specialists, or hospital. I pay £7.20 (under $12) for each medication (except free contraception. My dad pays nothing for medicine as he's diabetic & also gets free eye tests & glasses. Because he's diabetic I will also get free eye tests & glasses when I'm over 40.

Anonymous said...

would you expect your lawyer or accountant to provide a portion of their services to you for free? why do we expect our doctors to?

Anonymous said...

That evil Dr. Google...the bane of many an MD & DVM...

Outre said...

Either Dr. Google or the local back cracker.

Oooh you have a (made up chiro disease or age related degeneration that I saw on my crappy xray that gives out higher dose of radiation than ones at a full-fledged radiology office) You need an MRI and PT. See if your doctor can prescribe those oh, advil doesn’t work? Ask your doctor for pain meds too.

Mostly harmless, I too think Oz is is full of sh*t. I got all sorts of twitchy when a coworker bought one of the YOU something something whatever books and was gushing about how great it was. She thought my department (the only dept. with medical knowledge/education) would enjoy it. Had to fight back from stating my true feelings about Oz to not hurt her feelings. (They are sensitive my coworkers...)

lovinmyjob said...

What the heck did she think the copay was going to be on that MRI? And we all know that PT is never a one time thing, so did she think that was going to be free also? Hey, here's an idea; see your doc and maybe, just maybe, you don't really need any of that stuff that will cost you way more than the doc visit!!

The Mother said...

I am just starting to deal with this stuff. Had a guy call to explain that he couldn't pay his bill from last March because he hadn't set up bill pay for his computer yet.

 
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