Customer Service (?) at Doctor's Office

Rocquie

It may seem odd that I think of myself as a customer at the doctor's office but I do. The fact is this practice has earned thousands of dollars in revenue off my lymphoma. 

When I became a patient of my hematologist/oncologist, we developed a great rapport. My husband and I both really like him a lot. Not only is he a caring and thorough physician, he has a great sense of humor which we have always appreciated. He has a little son the same age as our granddaughter, so we have always enjoyed sharing children stories. I have always thought, and so does my husband, that he truly cares about us.

In addition, his office ran like a well-oiled machine and I have commented to him about that in the past. Unfortunately that is no longer the case. When I was in active treatment, I was welcomed to the office and treated like an honored guest. All referrals and authorizations were handled promptly and efficiently. 

I'm not sure what has happened. There has suddenly been a routine and regular turnover in staff, which is never a good sign. I hardly know anyone and they don't know me. I feel like just another burdensome cancer patient. 

I had quite an ordeal getting my last CT scan pre-approved with my insurance. Actually that is not altogether true. It had been authorized, it was just that no one bothered to let me know or make an appointment. 

The latest is that when I saw my doctor 5 weeks ago, he made a referral to a pulmologist due to scarring in my lungs and shortness of breath. When I checked out that day, the woman told me she would make the referral and if I didn't hear from the pulmonary office within a few days to let her know. Two weeks later I called her back because I had not heard anything. That was 3 weeks ago and I have still never had a return phone call. 

Finally I called the pulmonary office and made my own appointment which is in 3 days. I called to get my own insurance authorization. 

Another issue is that over the past year, I have requested an appointment with the social worker 4 times. Each time I was told that she would call me. I have given up on that one.

Lastly, back in their days of excellent customer service, if you called their office an actual person answered the phone. Now they have what in my opinion is the worst possible way for a business to answer their phone. . .the recording, You have reached the doctor's office (without even a "hello") "Please listen carefully. . ." Please don't scold me before you even know why I'm calling and please don't talk to me like I am a child.

Thoughts?

Rocquie

 

Max Former Hodgkins Stage 3

Guess

Roc,

Since your doctor is the same person he was a year ago, I have a strong guess:  Radical changes in insurers, or a selling/reorganization of the practice. Mostly the latter, very likely.

Doctors and medical practices are being contorted by legal changes that are causing a large percentage of older doctor to just retire early.

Their world is miserable at the moment.

max

Unknown

I just despise getting a recording anywhere, much less at a Dr. office. My onc office always answers the phone. At my gp office a human never answers till I go thru a gauntlet of number punching and never calls back. Somewhere along the way customers became "consumers". Not real people, just nameless faceless units who consume. I have a relative who is a yound 40 ish Dr. He is quitting to start a plant nursery.  Says he just can't take it any more. He says "I don't even like sick people". My biggest fear relating to cancer is being in the hospital, a place where I nearly died from incompetent staff. We just have to deal with it. I see no other option, and expect much worse if we go single payer. 

Kaniksu

Does "he"care??

Rocquie, since you have such a great relationship with your Dr..and I am sure you want to see him succeed..tell him how you are feeling...I am sure he doesn't want his patients feeling like that..it may be interesting to hear how  he is feeling... He may not even have a clue...I swear I have seen so much turnover in my small rural community I almost don't have the energy to build a rapport with my new Doctors...I totally understand your frustration..but be glad you at least still have the same Doc....Take Care..n

GSP2

Kaniksu said:

Does "he"care??

Rocquie, since you have such a great relationship with your Dr..and I am sure you want to see him succeed..tell him how you are feeling...I am sure he doesn't want his patients feeling like that..it may be interesting to hear how  he is feeling... He may not even have a clue...I swear I have seen so much turnover in my small rural community I almost don't have the energy to build a rapport with my new Doctors...I totally understand your frustration..but be glad you at least still have the same Doc....Take Care..n

Agree with most comments here

If the doctor is part of a group or network then he may not have a choice with regard to

overhead costs. You've seen first hand how important the ancillary staff is in the

patient's overall experience. Turnover is worrisome. Sometimes it means there is a bad

apple and people cannot get along with that person. Staff tend to be loyal as long as they are

treated fairly and the pay scale is "customary". A lot of offices have surveys i.e. Press Ganey.

Before you vent on that I would agree discuss your experience with the doctor. Or if there is an

office manager.

Just some thoughts.

 

Steve.

Max Former Hodgkins Stage 3

Friend

We met a navy anastesiologist at a church party years ago.  I asked him why he chose Navy medicine, and he said "So I can't be sued."

I then asked why he chose his specialty, and he said, "Beause I don't have to listen to patients whine. I walk in, put them to sleep, and when they start to wake up, I walk out and leave them with the post-op nurses."

Doctors come in all varieties of personalities and get into medicine for a variety  of reasons.

Different story: In ICU for 25 days in 1986, I was put on a ventillator by a young, arrogant pulmonologist. The nurses all hated this punk. It was assumed I would die; I turned pumpkin-colored for a long time due to liver issues.  On a vent, of course, patients cannot speak.

He had not been in my room in about a week, but was seeing another patient in the next cube over. When he walked past, he looked at me and said, "Hey ! Did you liver ever start working?"  He just kept moving, apparantly forgot that people on vents can't speak.  Real bedside manner.

A few years my dad was in ICU also, following a crash.  This same guy was his lung doctor. Dad appeared to be dying. He stopped me, my mom, and brother in the hall and said he needed to ask up something.  Basically he told us he was pouring antibiotics into him but things looked bad. He then asked, "So.  What do you want me to do ?" We asked what he meant, and he said "I can keep pouring on these drugs and try to save him, or turn them down and he'll be gone in a day or so.  Which do you prefer?'

Dad lived another decade or so.

.

max

Unknown

My Mother

Mom went into a coma on Christmas eve 1999. We put her in hospital. A younger Dr. Said "sometimes it just time to die" and wanted to stop nourishment. Basically let her starve to death. I did not say no, I said "hell no". The Dr. asked if I was threatening him and I said no, of course not. Next day we got a new Dr. After 4 months Mom started coming around. After 6 months she was home. She died in 2013 , almost 14 years later. Dr.s can be punks too. Most are not but if you happen upon one who is, be wary. If you confront them, get a different doctor. Its kinda like never arguing with your food server before you get your food. Punks can be dangerous and a sick person is vulnerable. You don't want a Dr. with whom you have a conflict making life and death decisions. Same for staff who tend to you in a hospital. Be nice to them but keep an eye open all the time. Just my experience based on knowing and being related to several physicians. Like the rest of us, they come in all flavors.

lindary

My mom

We had a bad experience with the Dr. my mom had to but he wasn't a young punk. He was older, mostly likely in his 60s. He only took serniors as patients and my mom really liked him. Then when she started having some helath issues I began to question his response to them. He would run a test and then put her on a medication to treat the problem. Usually on a week or two my mom would say it wasn't helping or it was making her sick. My brother & I would tell he to give it some more time. She would then call her Dr and he would tell her to stop taking it. No alternative, seldom a followup appointment.  He just seemed to go anlong with whatever she wanted.  You would think that a Dr who is in the senior age range would be more in tune with his patients and work with them to improve their health situation. I did not feel that he really cared about his patients. 

 

po18guy

Con-descension

"If this is a life threatening emergency, please hang up and dial 9-1-1." Really? But I always call my podiatrist while lying on the floor, clutching my chest! It is not a matter of whether or not they think we're stupid. The question is, how stupid do they think we are? Truthfully, if we were actually that stupid, we would already have received the Darwin award (posthumously, of course). 

Max Former Hodgkins Stage 3

Oddest

Po,

For some reason your post reminded me of one of the odder things I have observed in medical care. I listen to a scanner all night at work, and began noting this years ago; I have confirmed this observation in discussions with my own doctors:  When a patient is visiting a doctor, even a cardiologist, and has a heart attack there, what do they do ?   They call EMS.   In other words, the cardiologist, and his cardiology nurses, hand off patients to EMTs.  My family doctor is housed inside a hospital, and they do the same thing: If you go to the floor, they call EMS, who drives you around the building, to the ER.

I guess to insurance lawyers it constitutes "good medical care."

max

.

GSP2

Max Former Hodgkins Stage 3 said:

Oddest

Po,

For some reason your post reminded me of one of the odder things I have observed in medical care. I listen to a scanner all night at work, and began noting this years ago; I have confirmed this observation in discussions with my own doctors:  When a patient is visiting a doctor, even a cardiologist, and has a heart attack there, what do they do ?   They call EMS.   In other words, the cardiologist, and his cardiology nurses, hand off patients to EMTs.  My family doctor is housed inside a hospital, and they do the same thing: If you go to the floor, they call EMS, who drives you around the building, to the ER.

I guess to insurance lawyers it constitutes "good medical care."

max

.

Evenest

That is a legal issue and is felt to be good care. Because something might happen/go wrong in the short time it takes to get from the office to the

ER or cath lab or wherever is deemed appropriate.

Pretty soon when you dial your local grocery store the recording will say "if this is an emergency, hang up and dial 911"

Rocquie

Max Former Hodgkins Stage 3 said:

Guess

Roc,

Since your doctor is the same person he was a year ago, I have a strong guess:  Radical changes in insurers, or a selling/reorganization of the practice. Mostly the latter, very likely.

Doctors and medical practices are being contorted by legal changes that are causing a large percentage of older doctor to just retire early.

Their world is miserable at the moment.

max

Max

I believe you are correct in your guess that reorganization of the medical practice is the culprit for the poor service. My doctor is young and at the beginning of his career. Sometimes, I fantasize that he will leave the practice and go elsewhere. If he does, I will certainly follow if he stays local.

Cheers,

Rocquie

 

Rocquie

unknown said:

I just despise getting a recording anywhere, much less at a Dr. office. My onc office always answers the phone. At my gp office a human never answers till I go thru a gauntlet of number punching and never calls back. Somewhere along the way customers became "consumers". Not real people, just nameless faceless units who consume. I have a relative who is a yound 40 ish Dr. He is quitting to start a plant nursery.  Says he just can't take it any more. He says "I don't even like sick people". My biggest fear relating to cancer is being in the hospital, a place where I nearly died from incompetent staff. We just have to deal with it. I see no other option, and expect much worse if we go single payer. 

GKH

I don't mind recordings per se, it just depends on what they say and how efficiently the system works. Currently, at my oncology clinic, the recording begins with a scold, "please listen carefully", followed by a lie, "the menu options have changed". Do they think I'm going to call and not listen? And I have been calling that office for 4 years and the menu options have never changed. To reach scheduling, press 5, which has another recording and includes the scolding, "if you leave more that one message, your call will be delayed". 

Worst of all, they don't return my calls! $#@&

Good luck to us,

Rocquie

 

Rocquie

Kaniksu said:

Does "he"care??

Rocquie, since you have such a great relationship with your Dr..and I am sure you want to see him succeed..tell him how you are feeling...I am sure he doesn't want his patients feeling like that..it may be interesting to hear how  he is feeling... He may not even have a clue...I swear I have seen so much turnover in my small rural community I almost don't have the energy to build a rapport with my new Doctors...I totally understand your frustration..but be glad you at least still have the same Doc....Take Care..n

Nancy

I will be talking to my doctor about my frustrations when I see him again in a few months. I suspect he doesn't have any idea of how bad things have become with his office staff. Meanwhile, I'll just not depend on that office.

Hugs,

Rocquie

 

Rocquie

po18guy said:

Con-descension

"If this is a life threatening emergency, please hang up and dial 9-1-1." Really? But I always call my podiatrist while lying on the floor, clutching my chest! It is not a matter of whether or not they think we're stupid. The question is, how stupid do they think we are? Truthfully, if we were actually that stupid, we would already have received the Darwin award (posthumously, of course). 

po18guy

Yes, that is another favorite. Duh!

Rocquie

 

Rocquie

GSP2 said:

Agree with most comments here

If the doctor is part of a group or network then he may not have a choice with regard to

overhead costs. You've seen first hand how important the ancillary staff is in the

patient's overall experience. Turnover is worrisome. Sometimes it means there is a bad

apple and people cannot get along with that person. Staff tend to be loyal as long as they are

treated fairly and the pay scale is "customary". A lot of offices have surveys i.e. Press Ganey.

Before you vent on that I would agree discuss your experience with the doctor. Or if there is an

office manager.

Just some thoughts.

 

Steve.

GSP2

I agree with you. And surprise, there is a new office manager.

Rocquie

 

GSP2

Rocquie said:

Nancy

I will be talking to my doctor about my frustrations when I see him again in a few months. I suspect he doesn't have any idea of how bad things have become with his office staff. Meanwhile, I'll just not depend on that office.

Hugs,

Rocquie

 

Things might be better

Hi Rocquie.

I suspect he does know.  The change in office manager may mean the new one can deal better with the personalities up front.

Hoping your experience is better next time. I would say don't trouble him months down the road.  If you like, write a letter to him now expressing your

concerns but also mention what you  appreciated about him, his care and prior visits. Trust me, it will get read.

 

Steve

Unknown

Also a money thing.

Same way they call fire department for a burglar alarm going off or a minor traffic accident. They get to bill the insurance or homeowner which gives them revenue they need. When I had my first R infusion I had a reaction (not unusual on the first infusion). I passed out in the infusion chair. I went blank. When I woke up, EMS and a cardiologist were there with a stretcher pounding my chest. My b/p was too low to maintain consciousness. They got me going , added drugs to the mixture, reduced infusion the rate and we continued. My first infusion  took over 10 hours. After that it was smooth sailing, normally 4 hours or less. No more problems during the infusion process.

Max Former Hodgkins Stage 3

Yea

GK,

At my infusion center one day I asked what a device on wheels next to the nurse's station was, and my RN said "The crash cart."

My abvd-r always began with the Rituxan. I recall that my first-ever they started very slowly after an IV dose of Benedryl, and sped it up as it bacame clear I wasn't having reactions, except that I recall every infusion feeling chilled, very cold.  The center had pre-heated blankets.

I guess my Ritux bag averaged about 3 or 4 hours, similiar to your's.  I recall my RN saying one day that I took Rituxan "fast," or "wide open."  With everything toogether, infusion day was consistently right at 8 hours -- 8:00 AM till 3:45 pm or thereabout. Then, home to sleep for a day or so, except runs to the bathroom, and then sleeping again most of the next day.  "No Prednisone with R-ABVD."

max