Mundane Medical Care in our Modern World

As someone who has experience as a patient and a healthcare worker, the expectations we hold for medical providers needs to be set at a higher standard. What most of us receive much of the time is subpar care and poor customer service. Without patients, providers have no revenue and large expenses. We need to move towards becoming a well-informed population that advocates for and participates in their wellness.

There are different circumstances that come with each unique patient set – age, chronic conditions, acute conditions, the noncompliant and so on. I expect to wait at a pediatrician or obstetrics appointment. That is a standard. Children are difficult most often because they can’t communicate, or they are scared. Obstetrics is difficult because you are caring for two people, but one is housed inside another. With primary care, the older population is fragile. They are usually on many different medications with little understanding for each medicine and condition. Our aging subset often ignores new symptoms and that puts them at risk for serious and sometimes fatal complications. Chronic conditions requiring specialty care are at the mercy of longer than acceptable wait times to establish care with a provider. Acute issues also face barriers to care with inadequate wait times. People who experience respiratory symptoms, urinary symptoms, or even abdominal pain today, do not need an appointment four days later.

Let me give you some personal examples I am sure most can relate to. When I was relocating, I started experiencing some vision changes in my right eye. Serious changes. I had a black circle in the center of my field of vision and could not see well out of that eye. I looked up participating providers in my insurance knowing that this was out of the scope for a general ophthalmologist and went directly to specialized care. I called numerous practitioners and they want to know who is referring me. Well, me and here is my story. None of the providers would schedule me an appointment and told me I needed to see an optometrist/ophthalmologist and be referred. Against my better judgement I called a few general practices and was offered an appointment 5-6 months out to establish care. Even with pleading that this is a new onset condition, and I cannot see, I was denied. One of the receptionists did feel for my situation, keep in mind I have now called more than six independent medical practices, and gave me the name and information for another specialty practice that I hadn’t yet tried. I made it a point to thank her for her compassion to my situation and called this practice after confirming they were participating in my insurance. I pleaded my case, went through all the I don’t have a referring physician and I cannot get an appointment with someone to refer me, and I am concerned that in 7 months from now I will be blind. The scheduler put me on hold and asked the physician, something no one else had done. She came back on the line and not only did the physician request I have an appointment, I was given an appointment for the following Monday. This call was made on a Friday. The physician was friendly, knowledgeable, honest and the right person for my condition. I am grateful that he agreed to see me and has since successfully treated my condition and saved my vision.

On the other end of the spectrum, I waited almost seven months to establish care with an endocrinologist for a condition I was diagnosed with over twenty years ago and treated by a few different providers. To get this consult appointment, I had to wade through the depths of hades to get my previous labs, chart notes and radiology imaging from an out of state practice accompanied by a referral from my current primary care provider. For over six months this physician had my medical records. During my appointment, he focused on my thyroid (not my current issue) and my recent weight gain (not my issue) told me that he cannot help me since I trialed and failed the one treatment he utilizes. He also told me he can refer me to a bariatric surgeon. Yikes. I would have to gain 70 pounds to meet criteria to meet with a bariatric surgeon. I advised him of the reasons for my appointment and showed him my previous testing on the papers I had with me of my previous health examinations, something he had no idea that was sent forth. After I advocated for myself and my health, he agreed to do some testing, which all resulted as I told him they would because they were early morning fasting with a steroid. We are now back to square one where if I want treatment, I must take the medication I already trialed and failed. I guess it didn’t happen if he didn’t treat it himself. I’m also sure he is going to come out with an equally incorrect conclusion. We’ll play along until I can find another specialty provider to establish care with, as endocrinology is not a specialty with a large pool of providers.

As a health care provider, I work very hard to empower my daily patients with knowledge to be an active participant in their own care. I do a lot of educating on blood pressure medications and the consequences of stopping them without medical oversight or against recommendations. That seems to be one area where people think that they don’t need it anymore or don’t want to take it. I verbalized each patients’ vital signs to them and answer any accompanying questions they have such as “what do those numbers mean?”. The current specialty clinic I work in does not run behind schedule outside of a one off or emergency. Urgent situations happen because oftentimes people write off their symptoms as nothing, but they are likely something that can very easily end with an unfavorable outcome (new onset rapid A Fib?). That is why being knowledgeable about your health and wellness is so important.

As a society with infinite knowledge at our fingertips, we need to set a higher standard for ourselves and as patients, to be treated as something more than a paycheck. This is not a call to go into every appointment and riot. Sometimes stuff happens. Just an overall, this has got to change. We have the power to be well informed advocates of our health and we are letting any Schmo with some letters behind their name treat us as less than. One important thing to remember, even the lowest graduating GPA has an MD behind their name. Choose your healthcare relationship wisely and stop accepting substandard care from first phone call to office visit. If you can’t get a routine visit you won’t get a sick visit. If you can’t get a human on the phone, you won’t get a medication refill. I’ll step down off my soapbox now. Be well.