How would you rate your doctor? Have you ever met a doctor who looks well? Do you get pissed off every time you walk into his or her office and they tell you to lose weight, stop smoking, drink less alcohol, stay off red meat, and all the while you are staring at them from across the room thinking. ‘Hey wait a minute you fat bastard, is that nicotine stains on your teeth and are you really 45 years old cause you look 60!” It’s strange, I walked into my doctors office many years ago, and she sat me down and asked me what the matter was, when quite clearly, as we were in the process of our casual greeting, I was coughing my guts up! There was no discussion as to what the matter could possibly be, and she, as an MD could have done a Sherlock Holmes and written the prescription for a cough medicine before my bum had a chance to plonk itself in her uncomfortable guest chair. Instead we had to go through the process. Conversation, word for word.
“What seems to be the matter Mr Zoltie?”
“This cough, it’s killing me!”
Dead pan, straight face response, “It’s not killing you!”, but from the way she looked at me from the other side of her desk, I honestly thought she would be the one to finish me off! She was deadly serious. Her humor, non existent, her attitude, disgraceful. Our meeting ended 2 minutes later with a prescription for cough medicine, and it didn’t take a genius to predict that outcome. My 7 year old son at the time could have diagnosed that one. Several years later, I remember having to go back to that same lady, my final visit, and I’ll tell you why. I was losing weight rapidly. Conversation, no word of a lie.
“Mr. Zoltie, how are you?”
“Well I’m concerned I’m losing weight too quickly, and I don’t know why?” I showed her the wrist watch on my left hand, which was now uncomfortably dangling in her face, only because my wrists had become so thin.
Her next words were,
“You travel to Asia a lot, don’t you Mr. Zoltie’?
“Have you ever been tested for HIV?”
What the fuck!! I went bright red, and was about to get up and walk out in disgust, when suddenly I realized, this doctor was a complete buffoon. With this and with the cough situation some years prior, I was wasting my time. I told her in no uncertain terms that she should practice playing tiddly winks and not medicine, and THEN I walked out the door! I never went back and two days later I had found a new doctor with a much beter sense of how to practice his chosen profession!
When I lived in Scotland, my parents used to take me to see Dr. White. He was a great guy, old and grey, but gentle and caring. You never needed an appointment. You just walked into his surgery, sat down and waited in line. If you felt the line was too big, you could leave and come back the following day, or, you could just sit and wait and listen to BBC Radio 4 which played continuously on a transistor radio sitting on one of the windowsills in that waiting room . It was a system that worked and one that was accepted by all who used it. He would make house visits too, and he knew me, my parents and my grandparents. It was as if we lived in a small town, but really we didn’t and he was just one of many doctors practicing the same way, with patience and with common sense. Oh how things have changed!
Which quietly brings me to my experience of the past three weeks, here in CA.
I’ve been seeing the same doctor here for the past 15 years. I go perhaps once a year, normally to donate blood for analysis, just to be sure that all is well and that nothing sinister is brewing. I’m sure you all do the same, practicing prevention rather than trying to put fires out at the last minute. My doctor is competent, gives me plenty time during our consultations, and is always courteous and careful to prescribe a course of treatment he knows will fit in with my rather eccentric lifestyle, which he also knows and understands! He has a relationship with me, and I’m sure all of his other patients, where mutual respect is of the utmost importance. He knows I don’t like to take drugs unless absolutely necessary, he knows that I am averse to any form of hospitalization, and finally, he understands that whatever it is I come to see him to discuss, that it will be short sweet and to the point! Which brings me to an awkward experience that took place about a month ago.
I was at home, watching TV when the phone rang. Conversation without any fabrication.
“This is Signature MD, and I am doing a survey on behalf of your doctor, Dr.(blank)”
My standard reply to anyone who calls me to ask me to partake in a survey is to ask them for their home phone number and tell them that I will call them while they are eating their own dinner, an action that normally leads to a disconnect, but, in this instance, since the gentleman on the phone had mentioned my doctor by name, I thought I would offer a more courteous ear.
“What can I do for you?”
“Well your doctor would like to know the following”
“Are you happy with his service, the time he gives to you on each visit, his manner, the promptness of his attendance, and his staff”
I answered yes to everything. Then came the catch.
“Well your doctor is contemplating a service that could offer you more time and a balanced plan to enable you to you live your life under a healthier regimen which will be prescribed according to your age and he is prepared to do so with your participation at a cost of $2000 a year to you, and of course this would not reflect on any insurance you already hold or that he would already bill. Would that be something you could be interested in?”
Being quick witted, not all the time, but quite often, I replied
“Would you pay for a service like that if you had answered yes to all your previous questions, had no issues with any of your doctors services for the past 15 years, and knew that every penny you spent was covered already by your insurance company, OR am I missing something here?”
“Would you pay $1800?” came his response.
It was clear that this conversation had now become an auction.
“I wouldn’t pay $15 total! Why would anyone who has just told you what I told you, be stupid enough to pay $2000 to get the same treatment that’s already being offered, OR, and I repeat OR, am I missing something here?” I said again, now quite agitated. It was now 8 30PM and I was missing, not only Deadliest Catch on Discovery, which I love to watch, but more importantly, I was missing my quiet time when the phone isn’t supposed to ring and if it does, it had better be important, or else!
The gentleman on the other end of the phone immediately thanked me for my time, obviously sensing my frustration and disconnected the call.
Fast forward three weeks.
Yesterday, in the mail, I received a gloss brochure, with my doctors face in all it’s glory, plastered with a plastic smile all over the front cover. The brochure, from, yes, you’ve guessed it, Signature MD, took 6 small pages, plus one A4 letter, to explain that on Aug 19th I was invited to a meeting to either convert to this new ‘personalized’ medical program, or to find another doctor. In any event, if I chose not to participate, I would be, and I quote again “no longer able to see me as your personal physician, and arrangements will be made to ensure I receive high quality healthcare from another provider in my office”. What the fuck does that mean? He is a sole practitioner! Does that mean I’m going to see his secretary? His receptionist? Or do I just sit there and self-diagnose on WebMD while his receptionist makes me coffee?
Curious, I called his office. I was told that because I was a patient of such long standing, I would not have to find another doctor and that my doctor would be happy to continue seeing me. Surprise surprise! So, let me ask you, what is this $2000 per year for? I’ll tell you what it’s for. When you go to a doctors office, and you hand over your insurance card, they charge you about $120 for each visit. They claim that the doctor gets about $36 out of this and the insurance company takes the rest. True or not, I don’t have the exact numbers from my provider, but lets say it is correct. That means if the doctor sees 20 people a day, he’s making a minimum of $800 a day, a minimum, not to mention all the other things the doctor does, like hospital visits, consultations, kick backs from drug companies for recommendations etc. Let’s be honest, for all the studying and work required to become a doctor, that’s not really a lot of money to make in a year. So, with 300 patients, and that’s the number the brochure suggested would be his limit, at $2000 a pop, plus the insurance money….
Bingo!! Pension fund in the making!! I am now interested to see who participates and what other MDs in this area think of this scheme and will they also decide to enroll their services with Signature MD and then create many more’pension’ funds, just because they can? Who thought up this scheme and who is stupid enough to participate? Is it legal? Is it ethical? Will there ever be another Dr. White? Is Obama care making this better or worse? So many questions and absolutely NO answers! What a mess. Oh boy, I feel ill after writing this. I think I’ll phone my doctor!