Right here waiting

Posted: January 11, 2013 in Health, Personal
Tags: ,

I have been sick a lot lately, more than just the flu that I have had for about three weeks now. Without going into details I wanted to complain about an experience I had the other day. I was at an Urgent Care facility near my job in the middle of the week, mid-morning. The lobby was full and it appeared that about half of the 20 people there had appointments for the internal medicine part of the facility and the other half were walk ins like me.

It took about two hours before I was finally called in to be seen by a nurse and then wait another 15 minutes to half an hour to see a doctor. Why did it take so long? Well part of the problem is that the doctors tend to schedule their appointments 15 minutes apart which is simply not enough time for a doctor to really spend with a patient. The other part of the problem is that the doctors helping those with appointments were also seeing urgent care patients.

The third complication was the real clincher….the part that really gummed up the works–the pharmaceutical representatives. It must have THE day for sales people to stop by because one rep after another wheeled in after another. I say wheeled because they all seem to have wheeled cases full of sample drugs with them. All told while I was sitting there about 6 reps came and went completely disrupting the schedule.

Now here is my first bitch. Why do they let these sales reps have precedence over sick patients? I have known a few pharmaceutical reps in my life and to a one they made an absolute ton of money–at a minimum a six figure salary. I also know that pharmaceutical industry is a multi-trillion dollar profit making industry. And I know that they give doctors free drug samples to encourage the use of those specific drugs and that the odds are the drugs we are given are the ones pushed hardest by the sales reps, not necessarily the ones best suited for your situation.

More importantly, I know that those sales reps can wait. We have a shortage of doctors in the U.S. and there are tons of reps competing for their limited attention. So again, I have to ask why do those sales reps get preferential treatment over sick patients? They shouldn’t and the doctors should have the upper hand in that relationship but for some reason they don’t act like it.

The other thing that pisses me off was how much the facility charges and their policies. This was the fourth time I had been to this Urgent Care for the exact same problem–there aren’t that many urgent care places in my neighborhood. Most doctors don’t charge you for follow up visits related to the same problem….usually because they should have helped you the first time and subsequent visits are usually their fault. Not this place. They charged me all four times as if it was the first time I had walked in the door.

Add to that the fact that I didn’t know that they would take my insurance for the first three visits. So they charged me $115 each time. On the fourth time I finally got them to accept my insurance and you know how much I saved? $15…that’s it. When I asked them why they said, when you were self-pay the $115 was a discount. It’s normally $200 when a person has insurance and my insurance required a $100 co-pay….hence the whopping savings of $15.

One more little gem to share….there was this young man in his twenties with his mom who waited over an hour. They finally called him up to get his co-pay and the receptionist wanted to charge him the co-pay for both his primary and secondary insurance. Does that makes sense? Isn’t secondary insurance supposed to cover what the first insurance doesn’t? Why would anyone ever have secondary insurance if they had to pay twice to see a doctor one time?! The mother and the son stormed out after having waited all that time and I didn’t blame them one whit.

But the U.S. healthcare system is soooooooo awesome and the best in the world!!!! (for the sarcastically impaired this is snark)

  1. mhasegawa says:

    The affordable care act will help eventually with cost of insurance, but something needs to be done about quality of care. I have to say that I lucked out living in Boston and going to the HMO I go to. Yes, there are annoying things about all medical care (do they really know what they are doing?) but they are polite and rarely make one wait too long. I think they schedule 15 minutes for urgent care and at least half an hour for a regular visit. Of course the docs there get paid salary not per patient or procedure. Hey, maybe that’s the answer.

    In any case, I don’t think your situation is that unusual, unforturnately.

    • drangedinaz says:

      Well, I figured that people would be able to relate because it was a common scenario. Right now I only have catastrophic coverage and it just isn’t adequate for my needs. I cannot wait until 2014 when the law that forces insurance company’s to accept adults with pre-existing conditions kicks in. Not that I will necessarily be able to afford it anyway but I can always join one of the high risk pools. Hoping that that will indeed be more affordable. We shall see.

      • mhasegawa says:

        I hope the exchange thing works for you. I’ll be interested to see what happens if you are willing to keep sharing.

        • drangedinaz says:

          Thanks, I will keep sharing because I think it might save others from having to go through the same thing and I hope that my success in using the new “system” will advocate for it to those who currently oppose Obamacare–IF I am successful that is.

  2. alopecia says:

    Another reason you had to wait was because you were triaged as low(ish) priority. My dad fell a couple of years ago ago when he was out on a walk and while he didn’t appear to be seriously hurt, I took him to Urgent Care; an elderly man with a sizable scrape on his forehead gets moved to the exam area pretty much instantly (PROTIP: blood often lets you jump the queue). I’m guessing you got flagged as “weak and dizzy all over” and so had to wait.

    Most practices I’m familiar with are pretty careful not to let drug reps disrupt things too much, usually by having the nurse or receptionist tell them everyone is busy (like it or not, drug reps are the way most docs get their information about new treatments [even as they say extremely rude things behind the reps’ backs], so that doesn’t happen often). Sounds like this particular practice/clinic simply isn’t very well-run. It also sounds like they’re greedy, but that’s a topic worth a few thousand words on its own.

    Urgent Care is a lot of things, but a panacea isn’t one of them. Sorry your experiences were so lousy.

    • drangedinaz says:

      Agree on the triage thing and I understand the necessity. However I’ve had the experience where triage wasn’t being done properly. When my daughter as about 18 months old she had the flu and one night started wheezing and literally started turning blue. We rushed her to the ER, which was packed. They basically ignored us and my baby was getting darker and darker by the moment. I knew that she wasn’t getting enough oxygen and that her situation was dire and there wasn’t anyone else there that had such obviously dangerous symptoms. Finally I went up to the receptionist and basically told them that someone better look at my daughter right f*cking now. They brought her back and sure enough, they went into emergency response mode. But if I hadn’t lost my temper I shudder to think of what might have happened. It ended up being RSV and her bronchial tubes were permanently damaged.

      • alopecia says:

        I hate to say it because I’m going to enrage every doctor and hospital administrator reading this, but the patients who assert themselves—or have someone who will advocate for them—get better care (I’m not telling nurses anything they don’t already know, and every nurse I know prefers a slightly pushy patient or family member).

        I’m sort of hyper-aware of all this because my dad spent four days in hospital this week (he’s fine, or he will be once he gets his strength back) and I automatically went into “pushy pain in the arse” mode as soon as he was admitted to the Emergency Department. I make a point of not being a pest and I’m always nice to the nurses (never piss off the nurses!), but I’m definitely on the high end of the assertiveness scale. (It also helps that I spent a decade or so working around doctors, so I kind of know what’s going on. The staff doesn’t have to dumb things down quite as much as usual, which they seem to appreciate.)

        Comes now the typical male advice-giving (to all reading this): If there’s a real medical emergency, DO NOT DRIVE THEM TO THE ED YOURSELF! CALL 911! That’s what it’s there for. Sad but true, a patient arriving in the back of an ambulance will get higher priority than someone walking in through the front door, especially if the waiting area is crowded.

        And yes, triage failed big time for your daughter. I sincerely hope a lot of people in that ED got yelled at—and not a few got fired—for that.

        • drangedinaz says:

          No one got fired or reprimanded but I didn’t push it after they admitted her. I had my hands full with a sick toddler who wanted nothing whatsoever to do with an IV. But I hear ya on the assertiveness. My family tends to be very passive when dealing with doctors and I’m always on their case to ask questions, get a second opinion, etc. It’s almost as if people need to be educated on how to be a good patient advocate for themselves. Sad but true……

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