Health Care and drama... :)

So - I found out this past week how frustrating health care in this country can really be. I want to preface this whole thing by saying my insurance company has been absolutely FABULOUS in working with me. The rules though can make things difficult.

I have... an HMO - that's right - the whole primary care thing with referrals and everything else required. Well I didn't like my old doctors (we'll call them OD) b/c it was insane to get an appointment. If I had a cold or sinus infection I would get "sorry, but Dr. J doens't have any appointments until 2 weeks from now. I can fit you in with the Nurse Practitioner." Now - I have no objection to NP's. They do a wonderful job usually. Problem was this place a) overbooked her terribly and b) it sucked to wait 2 hours for a 3 minute cold impersonal visit with this particular NP. So i switched. The issue though: I have 2 specialists right now (Physical therapy and the orthopedist.) So to switch, i needed to see the new PCP on the first of the month and get all new referrals before I could see my specialists that month because the new referrals would cancel out the old, and you can't have 2 PCP's in one month. (or at least you can't visit 2 in one month.)

So I went to the dr my friend recommended. This is A. Small practice, willing to fit you in when you are sick etc. I figured great. Well small means that office manager is her husband and he does EVERYTHING - including taking you back to the rooms, answering the phones, filing etc. SO i go in to see her on 4/2. She agrees to the referrals, it's all good. Thursday 4/5 I call the PT office to see if the referral arrived. (he said it would probably be there the next day.) They said, nope no referral. So i call A. They aren't there until 1030am. So I leave an urgent message with the answering service. 11am and still no referral. The appt is at 1130. So I call back, and get a woman who says she just got there and doesn't know what's going on etc. She says the dr has been seeing patients since 8am, they just don't turn their phones on for a few hours. I argue with her a bit and tell her this is poor patient care etc, and she says "i'll try to write this up now and fax it over, what's their number?" and i'm like - umm.. I don't have it... don't you?? you were supposed to send it over 2 days ago. So she says she'll try to find it and send it over. I leave for PT. I get there, No referral. I call again and the office manager answers. he says "well you'll just have to reschedule the appointment because there isn't enough time to get a referral." At this point i'm VERY upset. the people at PT can't believe what's happening. I argue with him some more and finally say "well i guess i'm going to have to find a new doctor too because you are too much of an idiot to handle simple paperwork." - now... at this point in the regular customer service world the person should say "ma'am i really do not have to take that kind of abuse. If you calm down we can figure out this situation." it's basically a first warning to defuse the situation. is that what he did? no... he said: "well, no you've hurt my feelings. I guess you will have to find a new doctor," and then he hung up on me. One of the girls at PT said she knows this dr (goes there) and while the dr is nice, getting refills and referrals can be difficult. well - in my mind if you can't handle simple paperwork such as a referral, i don't care how good the dr is i'm not going to go there. At this point i'm crying and I leave PT b/c I can't have my appointment without the referral.

I call the insurance company and they are more than happy to get me an exception for my appt on friday so i wouldn't need the referral, and said they would back date a new primary care to beginning of the month. This means i'd have to pay A's office visit fee but i could still switch docs. So i call another dr a friend recommended. (B) They say, shouldn't be a problem call tomorrow for a fit in appointment and we'll get me squared away. So i officially switch and wait til the next day. (friday) I call friday morning and after much arguing, person checking with the doctor and the doctor refusing to help and finally the office manager coming on and saying "we can't fit you in as a new patient. You'll have to wait until mid may for a new patient visit, and oh yeah - it takes at least 7 days for a referral. 7 DAYS!!!!! they claim that they get *SO* many referrals they have to do (only 2 docs in the practice) that it takes at least a week for them to go through unless it's an emergency, and my situation didn't qualify.

There is a happy ending though after all of this stress. I call the insurance company again and explain the situation. I randomly pick a doc off their website. (C) They are in the same building as my PT. I've had good luck with the hospital centers so far (PT has been great) and so what the hell right? I call, explain the situation to the operator. She checks with each unit to see who is taking new patients. They tell me Dr. J is and switch me to that "unit." See - they have a LOT of doctors in the practice, but they are divided into units of only 2 or 3 so there's full staff for every 2 or 3 dr's. So they answer... and this is Good Friday mind you. And not only could they take me as a new patient, but they could fit me in THAT day! at 3pm. wow! So i took the appointment, made the switch and went later that day.

Night and day let me tell you. I got there early to do paperwork. I hadn't even sat back down after finishing the papers before they called me back at 3pm on the dot. The MA (medical assistant) did her own work up and went over my papers an history and then the doc came in about 10 minutes later. She did a very thorough history and exam and then they wrote up the referrals, and handed them to me to take with me as I left. See - not that hard!! :) when i talked to her office staff they were boggled. "7 days for a referral?? that's ridiculous, we ask for 3 days as a courtesy, but 7? And they *CAN'T* have more referrals to do than we do!"

I guess there's a big difference between competent office staff and an office that actually cares about their patients and their health as well as customer service and isn't just in it for the business.

In other news - ALIT progresses with the usual idiocy. Turns out that auntie em is actually cosigning on sukastar's house. Big surprise. They are going to end up SUCKING her dry and in the process cousin P gets attacked and left by the wayside. It gets more and more complicated the longer it goes on - too many details to go into. But one amusing bit...

My KAR(krazy aunt R if you don't remember) has a number of paintings by a very famous dead contemporary artist whom she represented when she was a lawyer. We'll call these Art. :) Suka has the GALL/Chutzpa/cajones to ask KAR, "would you mind terribly if I took one of your Art's to hang in the new house?? it would look so lovely and add so much color and cheer to the new house." Kar may be nuts but she ain't stupid. If Suka 'borrows' art, art will never be returned and she's just scammed a VERY valuable piece. Kar thankfully said no and then complained about it to Cousin P, but i mean - really! The GALL! :)

oh well - I think this post has been long enough. For your pitying cutesy feelings of the day. :) My poor puppy Z hurt her paw. She ripped the nail shell off her nail leaving the quick entirely exposed. So i took her to the emergency vet yesterday. (thankfully only $40 worth since the vet tech did the work and she didn't need to actually see the vet.) and they got her all wrapped up. I was worried about her chewing off the bandage so - the cone was brought out. Poor puppy - walked into walls and couldn't figure out how to fix it! :)