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Waning Faith in the Healthcare System


A physician gets a firsthand account of the struggle many patients go through to schedule an appointment in the American healthcare system.

Today I got a taste of what my hapless patients go through. One of my children is having chronic headaches. Despite a number of treatments, she was not getting better. So, we got a referral to a tertiary care hospital specializing in pediatric headaches. Here are some of the steps I had to take in order to get my daughter seen.

Step 1: Call my daughter's PCP office to get a referral. Because it is a colleague, I get to skip the step in which I have to come in for an office visit to get the referral.

Step 2: Wait for the insurance to approve the referral.

Step 3: Call the main number at the children's hospital to schedule an appointment. Hit "1," then hit "1" again, then "6" after listening to an exhaustive recitation of every clinic in which I could schedule an appointment, speak to a real, live person and give all information except my shoe size. Then it's off to wait to be transferred so that I can schedule an appointment. Only to be told that I need to speak to a nurse before the appointment can be scheduled.

Step 4: Wait for the nurse to call me back for two days.

Step 5: Call the hospital back, hit "1," then "1," and listen to the list again before I can hit "6" again and wait to speak to a person so I can give all the info again. Next I am informed that the nurse needs to call me to schedule the appointment. I politely inquire as to when this call may occur and am informed it may take two business days. I reply that it has been two business days, and I'm told to call back the next day.

Step 6: Be patient, wait two more days. I call back, hit the aforementioned numbers, and give my information to the person who answers. Told that the nurse needs to call me before I can schedule the appointment. Explain that I have been waiting and would like to schedule the appointment now. Transferred to the nurse's line.

Step 7: Nurse's line not answered so transferred back to another scheduling person. Give all the information again. Informed that I will need to be transferred to the nurse's line. Inform not-so-helpful person that I was already transferred to the nurse's line. Instructed that I should leave a message for the nurse. Ask the not-so-helpful person whether she could see the irony in leaving a message for a nurse to call me when I was calling to find out why the nurse hadn't called me.

Step 8: Transferred to the scheduling desk at the specialty clinic. All staff are at lunch. Apparently, they close the clinic at lunch. I am not familiar with this concept.

Step 9: Leave a message.

Those nine steps took nine days to complete. Shortly after, I tried to schedule an appointment for acupuncture, and the process started over from the beginning. The end results were much different however.  

Step 1: Email the clinic requesting information about their experience with pediatric headaches.

Step 2: Receive a response from the acupuncturist outlining her experience and best estimate of the plan of care and cost of the treatment.

Step 3: Email her back to request an appointment.

Step 4: Receive an email back with an appointment time.

These four steps took just four hours. I have an appointment in two days, a plan of care, and know how much it will cost.

With these latest experiences, I am not confident that the modern American healthcare system is going to survive or even if it should.

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