Sunday, April 21, 2024

The HMO/PPO Healthcare System Is Not Geared Toward Listening To Patients

I'm not usually the one in my family who runs into that, but this week I was the one in my family who ran into that.

My primary care physician is leaving her practice within the network that provides my care (Tamara's insurance through her work). I had an appointment scheduled for her final day, but had to cancel that appointment due to the sudden travel you've previously been mentioned here.

So, I had to re-schedule with a new doctor.

The earliest available appointment is in late July. OK, no problem, I'm the one who canceled and these things take time.

BUT!

I had a bunch of bloodwork done a few days before the appointment I had to cancel.

So when I scheduled the replacement appointment for three months from now, I suggested in the scheduling web form that new labs be ordered, since the existing ones will be more than three months old.

Initial doctor's reply: We'll schedule labs after the initial appointment.

My response: There are several things on that lab report that my prior doctor wanted to discuss -- and I have reason to believe that the measurements will have changed by the time I see you.

Doctor's assistant's response: Labs will only be scheduled after we "establish care."

So basically I get to make a visit and pony up a co-pay for the entire purpose of having the following conversation:

Doctor: Hello, Mr. Knapp.

Me: Hello, doctor.

Doctor: I care!

Me: So do I!

Doctor: OK, get some lab work done and come back in three months.

Fortunately, I can do something about that. The measurements for worry -- that is, the ones the doctor who is leaving wanted to discuss -- are:

  1. My A1C, which went way up for fully explicable reasons and which I expect to look a lot better three months from now.
  2. Slighly low sodium, slightly low chloride, and slightly high alkaline phosphatase. I strongly suspect the first two have to do with me spending a lot of time out in hot weather doing yard work, drinking lots of water, and not drinking anything with electrolytes in it during the three days before my bloodwork. Not sure about the last one, but unless it is sustained I don't find it too worrisome in the absence of other markers for liver problems (I've also had my liver looked at in the last few years).
They can do an A1C at the doctor's office.

And I can get a Comprehensive Metabolic Panel (which measures the items in #2) done for about $20 at an outside lab and just take the results with me to discuss with the doctor.

So not really a big hairy deal.

But it would have been easier on me, and likely not a big deal for the new doctor, to have just put in an order for new labs. And those doctor-ordered labs, unlike the ones I'll be getting done myself, would have been right there in the "MyChart" for the new doctor to see before I even get there, shortening the appointment time consumed by her looking at old labs and me showing her new labs.

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