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22 03 2010continued
According to the Center of Medicare and Medicaid Services in Washington, D.C., healthcare is a $1.5 trillion industry, 13.2 percent of U.S. economy. Because everybody is in this for the money, it is important for doctors to cram as many patients into their day as possible. Physicians blame managed care for making them rush through their appointments. The reason being, when you have an HMO, doctors get paid a flat rate per person, whether you come in or not. Obviously, the more people you see, the more money you get. No matter that the person did not get what they are entitled to from the visit. The fewer tests they order, the lower the cost for the HMO and the bigger the physicians financial incentive from the HMO for keeping cost down.
What are you getting for your buck? “Don’t let your HMO kill you” by Dr. Jason Theodosakis and Dr. David T. Feinberg gives us this example. Let’s say your premium is $100. As stated previously, your doctor’s practice will still get paid every month whether you show up or not. The money you save the HMO for not showing up will go in their pocket or go towards another patients care. About 15 percent goes to profit, roughly $37 is saved unless you’re hospitalized and the rest is put into a pool with the rest of the patients payments to pay the doctors. Some of the doctors are in specialty clinics such as OB/GYN and they might only see about $3 of the original $100 premium. They are going to see as many patients as they can to cover their cost. They have someone breathing down their necks to keep cost down and if things run according to plan, this person gets a bonus. This person is also rewarded if they keep referral down and probably is not interested in new treatment or test.
Despite recent reports that doctors are actually spending more time with their patients than they used to, I’m not seeing this and the emails I receive aren’t saying this either. Now, maybe the situation was the doctor was getting ready to go out of town and he was in a hurry to get the surly duty of sick patients out of the way. This was not the first time that I felt my visit was a monumental waste of time, energy and patience. I smirk when I see a commercial or advertisement with a smiling, great looking physician surrounded by smiling, healthy, great looking patients. I rarely see any of my physicians smiling.
I am not the only person that is unhappy with this. Approximately 60 percent of Americans with insurance are unhappy with it. Even with what I know, I am still shocked when I see a doctor and I am hurried along or there is no real interest in new symptoms or concern when another has worsened. You don’t expect to encounter rudeness, neglect and impatience when visiting a doctor. There is a certain amount of compassion and understanding that should be demonstrated. After all, doctors are supposed to be in the business of diagnosing and fixing what ails you and I would hope that part of the lure of being a physician was because you feel compelled to help other people. Perhaps doctors have become desensitized from seeing nothing but the sickest of the population day in and day out. I am not a normal, healthy person. I sometimes average an appointment a week. You would think they would want to prevent any future problems but the reality is if they can put off a test or two in exchange for prizes, why not?
And what are we going to do? Treat ourselves? Resort to alternative care? Tempting, but we just don’t have the resources or access to the things we need; prescriptions, test, knowledge, we are stuck. You can always switch doctors but how many times can you do that before you are profiled as a difficult patient? Will the next doctor know my history? Will they be rude? Will they listen to what I have to say instead of blowing me off? What is a premium, paying patient to do?
Well, the best thing appears to be to stick it out unless your doctor is a complete incompetent or is not treating you like a human being. Instead of complaining to your friends and family or seething silently, talk to your doctor and let him/her know what your needs are. Be persistent. Know yourself and your condition because doctors pay attention to patients who are interested in their healthcare. I liken it to the good student and the bad student. If you show up to class on time and turn in your homework, then the teacher pays a lot more attention to you. If you show up when you get ready and halfway do your work, if at all, then the teacher barely acknowledges your existence and doesn’t pay attention to you. Be a star patient. It challenges your doctor and it educates your as well, which is a win-win situation.
