Tuesday, July 21, 2009

What I Did For Health Care...Or How Much I Love My Doctor
Recently, I made my annual trek to my endocrinologist, whose only regional office that takes my health insurance (BCBS Federal, not an obscure, esoteric plan) is roughly 22 Mapquest miles from my home in Alexandria, VA, with an estimated travel time of approximately 30 minutes. I hit the road at 9:20AM, confident I would easily make my 10:15AM appointment. Rush hour was over. Two accidents and one disabled in the middle lane vehicle later, I arrived, 15 minutes late. This particular medical group charges for tardiness and has a posted policy of refusing to see patients if they show up more than 10 minutes past the appointed time, a thought that raced through my mind as I sped up Route 50 toward the Fair Oaks medical complex at 10:15AM...but not fast enough to get myself in an accident, although I did run a few lights while disobeying the speed limit. It was July 15th (not the 13th), a Wednesday not a Friday, and apparently my lucky day - the doctor saw me and I only had to shell out my copay. So much for making rhymes... But then I apologized profusely, groveled - please, please, don't send me back to Alexandria without being seen after all I've been through already today - and gushed my thanks to every member of the staff I encountered. Nothing for a lawyer like kneeling prostrate at the alter of the medical establishment.
At the conclusion of the visit, which lasted one-third the time it took to get to it, I was informed that the on site lab was not operational, so I would have to go to another facility to have my blood drawn to check my thyroid function. I was given two pamphlets with a list of 49 Metro DC facilities, including 9 in Loudoun, Spotsylvania and Stafford Counties. As if. From the addresses, I recognized one as being close by to my home and affiliated with the same group that normally processes my bloodwork, so from experience I knew it was a preferred provider with my health insurance. Yeah! So after getting back from the doctor's office at noon, one-quarter of a tank of gas lighter, hitting the gym for a half hour to work out, and work off some of the morning's frustrations, and having lunch, I headed out to find the lab. Dialing the listed phone numbers for directions only got me a machine. No live person; no directional message. Google Maps wasn't all that helpful. So I parked at one of my regular haunts which I knew by its address was close, Beatley Central Library, and started to walk along the very busy thoroughfare, on a sultry, hot afternoon. Although the facility had a Duke Street address, it was set back, way back, from the road, and had two buildings in front of it obscuring a direct view.
When I checked in - electronically - the system did not recognize my name as a repeat customer on the first try, but rather tried to matriculate me by tacking on a second surname to mine. Nice to know there is someone else with my maiden name in the DC Metro area, but scary, since had I not caught it, a reporting error could have easily been made with my test results. Door to door, another hour of my time.
This little musing on my everyday life is illustrative of some of what is wrong with our current health care system. Why in the world should I have to drive so many miles to see a doctor whose group has an office much more convenient to me because of insurance? DC isn't the boondocks. Are doctors so undercompensated that late charges and no show fees are needed? What in the world are they going to do when reimbursements are cut further as is currently under debate? And how about all the times a doctor keeps you waiting? What was that rule in college, if a professor didn't show up after a certain period of time, class was canceled? And the bloodwork...why not leave directions to a facility location on the phone message if the staff is so barebones no one can pick up? It might be good for business! That would make sense, common sense. Apparently there's not much room for that in our present medical system. As we reform it, there should be. And while I agree with CBO Chief Douglas Elmendorf that the current plans set forth by the Obama Administration and under consideration by the Congress do not "bend the long term cost curve" downward and instead significantly expand the federal responsibility for and spending on health care costs, it's early in the discourse and nothing is set in stone. And what's that old adage, you have to spend money to make money? Pay now, save later. What is imperative is that the system have a few less twists and turns for the consumer, because waste of patient time is a cost as well, and while it does not show up as debt, it does show up as lost productivity, and the stress of dealing with such a convoluted setup can be counterproductive and impact health as well. No one seems to be talking about that. I needlessly frittered away almost a day...how about you?

Karen Ann DeLuca

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