Patch Voice: Scary Story

By Colleen Walsh Fong

It’s almost Halloween, the time of year when we try to do spooky things and tell scary stories. Here’s mine.

Lately I’ve been dealing with some unresolved mystery medical issues. The two doctors I’ve consulted during six visits don’t seem overly concerned. I’m taking my lead from them and staying calm through my discomfort. But I really hope this thing gets figured out soon because it’s inconvenient and it’s getting expensive. And the treatment seems to be by trial and error with a lot of, “Hmms” and “I don’t knows” for responses to my questions.

I guess what bothers me the most is the way I have to prompt the doctors and their assistants to take actions that they used to take automatically. And when I try to make the follow up appointments the doctor has told me to make on the exact days he has told me to make them I’m told he is on vacation. It feels like getting ditched in middle school by a kid who suddenly gets too cool to be seen with me. But it’s probably more likely that the doctor didn’t think to check his schedule before giving me my follow-up instructions. So I had to insist upon getting an appointment with one of the practice’s other doctors. And I learned that the schedulers really don’t like it when a patient gets firm and won’t back down.

I’m sure things will all be figured out, but this experience got me to thinking about why I’m having so much trouble getting basic medical care. Every thread I follow leads back to something I learned in Economics class a long time ago. Medical practices and most things medical are inelastic.

My simple lay person’s explanation of the use of inelastic demand in this context is that the price of a product or service can be stretched to any length without sales dropping off because a certain base of consumers will pay any amount to have it. Like insulin. Diabetics must have it so they pay what they must to get it. Or cigarettes. My first pack cost 35 cents from a vending machine somewhere back in the 70’s. 25% of the U.S. population still pays between $5.00-14.50 per pack--not carton--depending upon which state they are in when they purchase their smokes. Why would they pay so much? Because they have to. Cigarettes are addicting. It’s either pay the sin taxes or go through the ugly withdrawals necessary to quit. I’m not a smoker and never acquired the habit, but having watched others struggle with kicking it I can understand why they choose to find the money for their tobacco products.

And so it is with medical practices. When we are sick we need medical care. We don’t usually have time to shop around for a doctor. So when I learned that my practitioner’s practices have changed to the point where he no longer returns phone calls I accepted that I would have to deal with his assistant. It turns out she doesn’t really return phone calls too often either. And when she does she lacks the medical knowledge or the permission to answer my questions. So she tells me to make an appointment to see the doctor. Again. Hence the six visits in 10 days to try to get an answer to my problem.

I can’t help feeling it’s all about the fees. Especially because I had to insist upon being given a gown so the doctor would have to actually look at the problem. They used to make me change into a gown no matter what I was there for. But changing clothes takes time and could burn up 3-5 minutes during which another fee could be earned, never mind the cost of the lovely paper gowns. And I had to ask that blood work be done on my 6th visit. Shouldn’t the doctor have reached that conclusion on his own by that point?

Let’s face it. Medical practices are businesses and that’s okay. Doctors deserve to earn a good living. But not at the expense of the customer. I say customer because that’s what I am to them. A sale. A fee. A contribution to the bottom line whether I get better or not.

A few years ago one of my family members spent two years making the rounds to specialists trying to find an answer to a perplexingly odd condition. The specialists never conferred with one another. Each one just laid on another layer of medications and sent us out the door. On our third trip back to primary care the doctor admitted that he and the others simply did not know what the problem was or what to do about it. I like a doctor who can admit that. Not all doctors can. He made a referral for us to the Mayo Clinic.

It’s not easy to get in to Mayo. People come from all over the world to that facility because it is good. Patients are treated with loving care. One M.D. is appointed as case manager upon intake and sends the patient to various specialists within the complex. When all testing is completed the case manager and all of the specialists confer with one another and jointly formulate a care plan for the patient.

Mayo doesn’t accept every referral. They are flooded with requests and don’t have enough resources to take them all. So when we got accepted we were elated. But we had to act quickly to reserve our spot. Mayo required that our referring physician’s practice call its intake office to verify the referral. When I called our doctor’s office I was told by his assistant that they don’t make calls and that “the clinic” would have to call them. That should have clued me in to the level of knowledge the assistant possessed. But I was pretty overwhelmed at that time, so I called Mayo and explained our doctor’s position. The Mayo people told me that our doctor would have to call them or we would lose the spot. I found myself pleading with this heartless, and dare I say, fairly ignorant person to please make the call. “Not going to happen,” she said and refused to put my call through to the doctor. That’s when I learned he has a “no return call policy.”

The thing is, I don’t really think it’s his policy. I think it’s his assistant’s policy because I emailed the doctor to explain what had transpired. I had a return call from his assistant soon after hitting the “send” button. And she didn’t have her “sorry” voice on. Instead she scolded me, exclaiming, “Do you know this clinic is all the way in Minnesota? Why would you go to Minnesota for a clinic?” She had never heard of the Mayo Clinic. A trained medical professional.

That’s whom we’re dealing with now. Those are the hands our health lies in. And that is really scary.

Colleen is a freelance writer specializing in producing custom content for businesses and entrepreneurs.

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