Doctor No

Scanning the health blog universe I wandered across a post on Kevin MD about a council on aging member urging the elderly to demand more than five minutes of a doctor's time if it was needed. What follows is an anonymous comment that appears to heve been made by one such doctor.

1. You are not paying them. You have shrugged that responsibility and the right to represent you onto the government and whatever secondary insurers you have hired. You are entitled to have what they pay for on your behalf, not whatever you want.

2. If you are the sort of person who wants that extra time you feel entitled to, then don't complain when you get seen later than your appointment time. It may be hard to think of someone besides yourself, but imagine for a moment an entire patient schedule of patients like yourself, all feeling entitled to a little more than what they really have paid for. Bring a book.

3. Enjoy bothering the staff? In my office, you will enjoy that just once. They are hard to replace. I want them to stay and if possible , stay happy. You, the botherer, can be replaced easily. It isn't rocket science to run that algorithm. Learn to be nice, even if it kills you.

4. Medicare is not the same as you paying for something, like a dinner. Electing to bestow your custom on a practice, your Medicare custom that is, is not an example of free give-and-take. Ever wonder why many practices limit the numbers of new Medicare patients? It isn't because they're getting rich seeing them, that is for sure. No Medicare heavy practices are worrying about back injuries while carting all the cash out the back door, that is for sure. No one says you need to grovel, but you should get real about what you are and are not bringing to the table. Oh, and your good word and its value in drawing other seniors to a practice? Everyone likes to be spoken well of, but it isn't the bonanza you might think it is. Every Medicare-aged patient has the potential to displace a better-insured patient, if you want to think of things that way.
# posted by Anonymous : 10:46 PM

There's so much that's wrong with that comment, but I'll address the one thing that stings:

Medicare is not the same as you paying for something, like a dinner. Electing to bestow your custom on a practice, your Medicare custom that is, is not an example of free give-and-take.

Utter nonsense. Keeping consumers tied to this belief is propping up a fetid market. Airlines, restaurants, car rental agencies, IRAs, supermarkets, all compete for dollars that you don't have in your hand. They seem to understand that the decision maker, not the payer, is the customer. That's what we're missing in health care. Consumer empowerment begins with us understanding our purchasing power.

To the doc who wrote the above, I challenge you to send your feelings above to each and every one of your bread-and-butter Medicare patients with a list of other doctors, and willingly lose a large percentage of them. Posting anonymously on the Internet may have made your feelings a little better, but I feel sorry for your patients who are unable to evade the system and remain on Medicare and feel they are being adequately cared for by you.

What happened to the word "care" anyway? This doc obviously doesn't "care", yet we call it health "care", "care" givers, it's baloney. Avis cares. Hilton cares. Jetblue cares. My mechanic cares.

Bring back care to health care, and we'll cut back on the apparently-untenable bothering of you and your staff.
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