The Worst Patients

[persipone]

Well, I went to the doctor today for the first time since I started medical school. It was weird seeing things from the other side- the rooms in Ghent Family Practice are almost exactly the same as the ones we use with Standardized Patients. And I discovered another thing-- I really don't much like doctors, when I'm the patient

Comments

My $0.02

[glenmarshall]

First rule: Pain Is Not Normal -- One would have thought the GP would refer you to an orthopod. There are any number of Bad Things that could be going on in your knee and a number of Not So Good Things. At best the advice would be "If it hurts when you do that, then stop doing that for a while." Think of the poor inarticulate elderly people who sees the same doctor as you; they are truly damned.

Second Rule: The Patient Is Never An Informed Consumer -- You are unusual in asking what things cost. From a healthcare provider's point of view they all have standard fees for doing a procedure and for interpreting it. For a US test it amounts to use of the diagnostic equipment and technician (one fee) and then a radioligist report for interpreting the study (second fee). Often the diagnostic imaging department and the radiologist are only affiliated with the hospital or clinic, and their fees are not known to scheduling people you talk with on the phone. Worse, each provider negatiates with several insurance plans, each with different discounts and co-pays. The provisions of plans change frequently, and it takes an "insurance proation" computer program to figure it all out. You, the consumer, are left clueless.

Re: My $0.02

[persipone]

I definitely agree! But, well, re: If it hurts when you do that, then stop doing that for a while. . . that's actually a lot harder than it sounds, when what you're supposed to stop doing is something totally normal that you do every time you sit down.

I'd modify your second rule by saying that "The Patient is not Permitted to Be An Informed Consumer." The information just isn't avaialable. I really think this has *got* to be fixed. People might choose not to have more expensive studies for less serious problems, which is not a bad thing. But it would also make people more conscious of the amount of money that is moving in this system, which might drive in to them how important insurance really is. It's rediculous that with a moderate amount of effort you can't get someone to tell you either the price you'll pay, or the actual cost of the service.

And-- shit, I forgot that I'm going to have to pay for a radiologist. There goes my deductible!