Friday, May 07, 2010

Used Car Salesmen

The two worst things about a broken foot are 1. that I can't do whatever the hell I please and 2. doctors and our health care system.
I broke the foot on a Thursday. Because of my deep and longstanding indoctrination into insurance panic, I forgot that I'm paying $400 a month (plus $50 copays and all kinds of other extras) to have the privilege not to need a referral from my primary care doctor to see a specialist. So instead of going directly to an orthopedist, I went to her. She looked at it and said: you need an orthopedist. Well, good luck trying to find a practicing bone doctor on a Friday. Either they are playing golf or they are operating on patients. Next available appointment: 10 days from then.
I didn't want to spend the weekend either at the ER or with the foot getting worse by the minute, so I went to a bone doctor that my insurance does not cover. I figured, I work my ass off so that I can have money for shit like this. I'm not going to start nickel and diming my own health.
Fine. He tells me it should be fine in 2 or 3 months, sells me one single brace boot for the price of a fancy pair of shoes and tells me he wants to see me next week. No dude, next week I'm seeing a doctor that my insurance covers, thank you very much.
So second appointment, third round of x-rays, my insurance covered doctor walks into the room and he starts trying to sell me pretty hard on the idea of surgery. He thinks I'm Margot Fonteyn and my career as a prima ballerina will be over. I quickly disabuse him of the notion. I like the stupid ballet but if you tell me I can't do it, I'll do something else.
So then he changes his tune and says what he should have said at the beginning. This may or may not heal correctly. You can wait to find out or I can cut you open and fix you tomorrow. Your choice.  I find it appalling that the main concern seems to be to ratchet up the invoice, rather than the best and most sensible course of action.
I had been to him once before and he solved a shoulder problem quickly and efficiently, so I don't think he is a bad doctor.  But my feeling is that the system encourages these specialists to behave like merchants in a Turkish bazaar.
Worse than this is that every time you go to a doctor's appointment or diagnostic place, you are treated like a potential criminal, not like a patient.  Where's your insurance card, do you still live where you live, who sent you here?
It's not very nice.

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