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The practice of medicine, like everything else, has changed. That said, not all those changes seem to benefit patient care as much as they do the provider’s bottom line. In the doctors’ defense, they are working harder and longer, even though it sure seems that patients have less access to them. Here are a few of my biggest pet peeves:
Medical Speed-Dating (AKA: One Ailment Per Customer, Please.)
Yes, the doctor will see you now — but probably only for about 15 minutes, so talk fast. While short visits are nothing new, the responsibility of staying on schedule has a new wrinkle: Patients are being told to limit themselves to one chief complaint. In other words, if you are there to have your diabetes monitored, don’t complain about your bunions. If you need more time, you will be encouraged to schedule another appointment — and pay for it.
Studies have shown that 15 minutes is hardly enough time for a doctor to establish a rapport, absorb the patient’s medical history or understand their lifestyle. When the egg timer buzzes, you best be on your way. I half expect to see ejection seats for uncooperative patients.
The RX Game
Increasingly, I have found it cheaper to pay for my prescription drugs out of pocket instead of using my health insurance. I pay premiums for that coverage, but with co-pays and deductibles, it is often still cheaper to pay for the medications myself. This annoys me to no end. In what other circumstance do you buy insurance for something that costs less if you don’t have that insurance?
The drug couponing system only complicates the mission of finding the best price possible. I am a GoodRX loyalist but was recently shocked to find that a very expensive drug I take was actually the cheapest if I used my supermarket’s club card. Yes, I saved 20 cents on my bananas and $400 on my pills.
I would love some explanation as to why drugs aren’t priced the same regardless of where you buy them. And more to the point, why does the United States have the highest prescription drug prices in the world?
My Insurance Company Practices Medicine Without a License
My doctor writes a prescription. My mail-order pharmacy decides to send me something else that costs them less. Who knows what is best for me: my doctor or the mail-order pharmacy’s formulary?
True story: My doctor wants me to take 40 mg of medication daily, but she wants to spread out its coverage by having me take 20 mg in the morning and 20 mg in the evening. My mail-order pharmacy says that the 40 mg pill is cheaper (for them) than dispensing two 20 mg, which are readily available and would allow me to take them as my doctor directed. But the Call Center Dude tells me I should cut the 40 mg in half and be happy. I point out that these are small with no score line, so when I try to cut them in half, they shatter and crumble or the two pieces are uneven — and uneven dosing isn’t the goal here.
Online Messaging Portals Have No Bedside Manner
Like most others, my healthcare provider uses an online portal that keeps track of my medical information and quickly posts my test results, making it easy for me, the patient, to find them.
Too easy. The Washington Post recently reported on instances of patients learning of a devastating health diagnosis from their communications system instead of hearing it from the doctor. A federal requirement insists that patients have immediate access to their test and scan results. Frankly, I believe that part is helpful. Transparency is generally a good thing and speed can be of the essence in health care. What isn’t so great is that doctors — who should be delivering bad news themselves in person or by phone — don’t always get around to it as soon as results are posted. I can only imagine how horrible it would be to learn I have cancer while scrolling through phone messages at lunch.
Before you throw daggers at frontline doctors, know they are just too busy to keep up. A startling statistic from a 2022 study in The Journal of General Internal Medicine found that primary care physicians would need almost 27 hours a day to provide guideline-recommended care for the average patient load of 2,500 adults. Last I looked, the day only has 24 hours.
The Hand-Off to Lesser-Trained Staff
Without question, some trips to see a doctor aren’t necessary. I completely agree that a nurse is high enough on the food chain to remove wax buildup in my ears. But for more serious issues, I’m paying for and want to see a doctor. I visit my gastroenterologist once a year — while I’m asleep on a gurney under general anesthesia as he performs my annual colonoscopy. My results are delivered on a video call with his nurse practitioner a few weeks after the procedure. I honestly couldn’t pick this doctor out of a lineup since I don’t recall ever seeing his face behind his surgical mask.
His nurse practitioner is a super smart young woman with a great bedside manner. But she isn’t in the operating room looking through the tiny camera at my intestines during the colonoscopy. The doctor is. And it feels like a game of telephone in which he tells her what he saw, and she then tells me.
I think we all know how that ends, don’t we?
What's YOUR biggest pet peeve when it comes to health care? Let us know in the comments below.
Follow Article Topics: Health