Bending Over Backwards for Patients

July 18, 2011

Most of our patients are very happy with the care they get from the physicians and from the attention they get from my staff. But I’ll give you a couple of examples of people who I feel just ask for too much. Feel free to tell me I’m wrong.

How far do you go to make life easier for your patients? I think my practice tries very hard to accommodate patients, and yet there are so many people who still voice dissatisfaction, and I can’t help but wonder how far they expect us to go and is it as unreasonable as I feel it is.

Don’t misunderstand me, most of our patients are very happy with the care they get from the physicians and from the attention they get from my staff. But I’ll give you a couple of examples of people who I feel just ask for too much. Feel free to tell me I’m wrong.

There is one patient who needs a radiology test done. Two or three days before her scheduled test, the facility calls and says she needs prior authorization. My staff works on it, and is told by her insurance company that they will not cover the test if it is done in a hospital; it must be done in a free standing radiology center. So my staff informs the patient and tries to help her find one.

Well, it turns out there aren’t many that do this test. Actually, it turns out only one does. So she schedules it at that center, only to find out the day before the test, they don’t take her insurance. It somehow gets scheduled at another hospital, and my staff gets the call that she needs prior authorization. Several phone calls later by my staff to her insurance and to her and to the hospital, and by the ordering physician also to the patient, the insurance and the hospital, it was finally approved and scheduled and hopefully it is getting done as we speak. Phew!

Different patient - same insurance -needs a radioactive iodine treatment. It is scheduled at the local hospital and my staff gets the call a couple of days before (even though it had been scheduled for weeks) that she needs prior authorization. Now we had never ever had to obtain prior authorization for this kind of treatment before, so it threw us off. Nonetheless, my staff started working on it. While one of my staff was waiting for a reply, she got a very angry, nasty phone call from the patient’s husband, during which it is not clear if he swore at her or if he just swore at the world. She tried to explain that she just got the call that the prior authorization was needed so any anger should not be directed to her.

We got the approval, but I then got a phone call the afternoon of the patient’s scheduled treatment that she didn’t show up and that she wouldn’t return phone calls from the radiologist. So I called her. She refused to take my call, but I did speak to her husband, who was just as friendly with me as he was with my staff. “Nobody cares”, he said. I said, “If I didn’t care I wouldn’t be calling. She needs this treatment.” Well, apparently, they went ahead and scheduled it elsewhere, and thankfully, have decided to follow-up elsewhere, too.

And yesterday, I saw a patient, who I’ve known for years, but who I only really see once a year. She had called last week and wanted to be seen right away and she wanted me to do her ultrasound.

My secretary told her that for an ultrasound she needs extra time and therefore “right away” wouldn’t be for a few weeks, but she could get the ultrasound done in radiology and then come in to discuss the results with me, and for that kind of visit, she could get squeezed in sooner. She huffed and puffed, but really had no other recourse, so she did it. When she came for her visit (10 minutes late I may add and had the gall to ask if I was running late), I told her that based on her ultrasound she needed a biopsy. She wanted to know if I could do it right then, and of course, I said no. I went in to see my next patient as she went to the desk to set up the appointment for the biopsy, and apparently I missed the excitement.

She gave my staff a hard time about when it would be and how it would be “negligent” to wait that long, and “is this how this place is going to be run”, etc., etc. She wanted to wait to speak to me and my staff told her I would be with my patient for at least half an hour (she was a new patient), to which she said, “What? 30 minutes with one patient?” She left and my staff told me the story. I told them to tell her to have the biopsy done in radiology where they could probably get her in sooner. She didn’t want to, she wanted my associate to do it. I said absolutely not. I may not have minded if she were in the least bit pleasant about it all, but I can’t have an unhappy person go under the knife (or needle as it were) in my office, cause you just know she would be that one person in a million to which something horrible would happen, and we’d all be screwed.

Like I said in the beginning, we try really hard to squeeze people in where we can, to spend extra time, to talk to the family, to make the necessary phone calls, but sometimes I feel like the demands just exceed our capacity. Both physically and psychologically.

Learn more about Melissa Young and our other contributing bloggers here.