Medical Rant

January 25, 2007

I sit here this morning in utter and complete frustration. I feel like a ship at sea in the midst of waves so high they’re splashing over the bow and making it hard for me to hold the rudder. It’s like I can almost control this ship in this particular weather, but I can tell you now that one wave hitting wrong will capsize the whole thing…

I’m talking about making medical diagnoses. Without going into extravagant detail in an effort to protect the privacy of the people involved, I am trying to discover a diagnosis. But the thing is? Why am I the one, the only one it seems, to be trying to solve the various conundrums here? When I suggested a possible diagnosis, the doctor was all like, “Wow, I think you may be right.” This, after I called the office last week, requesting an appointment with her, and was somewhat brushed off.

So yesterday the doctor gave me some names of occupational therapists and told me to call Children’s Hospital because the waiting list can be as long as six months. Well, the woman at Children’s acted like I had some kind of social disease and informed me that the blinkin’ doctor’s office has to send a prescription for occupational therapy, that I, as the parent (and did I mention, the only one who seems to have any idea what the hell is going on here), cannot make the appointment, because I need a diagnosis from the doctor’s office.

Irony, anyone?

And no one is on our insurance plan; in fact, some of these professionals don’t even deal with insurance and operate on a fee-only basis. I might as well continue this rant and state, for the record (or at least the blog), that the insurance-medical professional tug-of-war always always always screws the patient in the end. The money is, as Tim always says, just a thing, and really the least important thing here. But still.

I’ve been dealing with voice mails and people not calling back. I’m generally running blind, hoping and praying that I’m pursuing the right avenues here. And I’m a really really good medical advocate and diagnostician. Despite my lack of any formal medical training, I have an intuitive grasp of what goes wrong in our bodies and minds and how to move toward healing. Good thing, I guess, ’cause it sure seems that such a gift is needed right now.

And I know: God is in control. He’s been guiding our steps. But is it too much to ask for a medical professional to come alongside here and help?

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6 Responses to “Medical Rant”

  1. AndyWhitman said

    It’s very frustrating, and I sympathize. And I hate the whole doctor/insurance dance, in which nobody wants to take the ball, and it inevitably ends up back in my (the patient’s) hands.

    I have sleep apnea. I have what’s caled a CPAP machine, which blows air into my nose all night. I look like the Elephant Man when I wear the mask. Very romantic. At any rate, my machine is old, and I need a new machine. To get a new machine, I have to be evaluated at a sleep/wake study clinic. To be evaluated at a sleep/wake study clinic, I need to be referred to said clinic by an MSLT-certifified physician. So I visited said physician, who was listed as a member of our insurance plan. I know because I checked to make sure before scheduling an appointment. So I talked to the guy, who spent all of three minutes with me before writing the referral, and I went on my merry way. Now I get a bill from the insurance company asking me to pay the full $200 charge for my office visit because Dr. MSLT Certification isn’t covered under our insurance plan. I have two quesions: 1) Why does my medical benefits website list him as part of the plan? and 2) Where can I get a job that pays $4,000/hr.?

    It’s maddening, I tell you. I feel your pain.

  2. Oh, man. Talk to Kori about all of this.

  3. Beth Koruna said

    Because great minds clearly think alike, your lovely wife has already e-mailed me her sympathy! The scary thing is, though, how very universal such stories are. Why oh why is medical care so difficult to manage?

  4. Tim said

    “Why oh why is medical care so difficult to manage?”

    – Bone-headed regulation As an adult in America, you cannot buy pain medication more potent than, say, Advil, without getting a doctor involved. I can buy gallons of booze, though, with no legal hoops to jump through. Does this make sense? If I leave my employer and go out on my own, the tax treatment for my medical insurance changes, making it a huge disadvantage to leave one’s employer. Does that make sense? I can buy the exact same pharmaceutical in “non-prescription strength”. Does that make sense? The regulatory environment is just nuts.

    – The litigation lotto. This leads to justifiably paranoid practicioners, and a minority of patients who treat litigating as a lottery, rather than a last resort. Those patients contribute to drivng up insurance costs, which can lead to doctors leaving certain fields altogether. Google “OB GYN shortages” for this sort of thing.

    – Third-party payors insulate the medical industry from market forces. One such market force is an irate patient taking business elsewhere. Hard to go elsewhere, though, when your particular HMO or PPO restricts your choices, adding incremental additional costs when you want to consult with someone ‘out of network’.

    – HMOs and the like add yet another layer of bureaucracy to the practice of medicine. Now your doctor doesn’t just have to worry about getting sued by you, they’ve also got to toe the line with the various HMO/PPOs with whom they deal. Oh, and you get to pay for those bureaucrats, too. TANSTAAFL.

    So, we’ve got a market where the suppliers are scared to death of a minority of the customers. The customers, in turn, have very little clout in defining the terms of their professional relationship with their suppliers. Intermediaries that ostensibly exist to hold costs in line (costs inflated by the regulatory environment) just add another layer of cost into the system. The net effect of all this is that reasonable, responsible adults must incur a variety of costs, in time and coin, to do things that they already believe are the right thing to do for themselves. This leads to Kafkaesque situations such as Andy’s hassle described in his post above. The Constitution enumerates your rights to free speech, to bear arms, to worship freely, and a host of others. Truth is, though, you’ve got other God-given rights that aren’t so enumerated. The right to do what you will with your own medical care, for example.

    GK Chesterton said, “The free man owns himself. He can damage himself with either eating or drinking; he can ruin himself with gambling. If he does he is certainly a damn fool, and he might possibly be a damned soul; but if he may not, he is not a free man any more than a dog.”

    We have freedoms, but in many key areas of our lives, we’re not quite free. Medical care is one of those areas.

  5. kjames said

    oh man, beth. this totally sucks. i’m sorry!

  6. Beth Koruna said

    Thanks Karen! And Andy, I, too, would like a job where I make $4,000 an hour. Heck, I’ll settle for making $2,000 an hour. I’m not hard to please.

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