Wednesday, December 21, 2016

I Just Fired my Primary Care Doctor. Before the Appointment Even Happened.



I sighed and slumped into a chair. The office was straight out of the 90’s: clunky desktop computer, paper forms attached to a clipboard. 15 minutes after my appointment should have started, a cagey Latino gentleman ambled behind the desk and asked for my ID and insurance card. I handed them over and watched as he proceeded to fire up a printer in an attached room, print off the registration and history forms I’d sent through ZocDoc, and make copies of my information.  I craned halfheartedly to count the number of shelves before I stopped caring. I felt uncomfortable all of a sudden. The dinginess of the cramped office seemed to amplify a sense of entropy, an oppressive, disheveled dysfunctionality. The stacked tower of dusty magazines. Two dying plants, leaves dried yellow and curling. A slightly off-center, sun-faded print: Monet. Reams of manilla folders so ancient that they literally had holes in them. Literally. I don’t want this anachronistic nightmare of a place to become the bottleneck to my ability to access my own health information (or is it even really mine?) Especially not if or inevitably when I become medically vulnerable. Consumer Me can protect Patient Me by being impatient.
Patients now expect physicians to be experts in technology and business acumen.  It is o longer acceptable to be  dependent upon fax machines, when electronic health records and secure digital documents are more efficient and cost effective.
The waiting room and shenanigans in this vignette do not breed comfort or a sense of competence for a patient. Perhaps calling a patient a consumer (anathema to we physicians) can be a good thing. It gives the patient consumer power. ie follow the money. Sad as I am losing the old 'cottage medicine flavor' I see the benefits of the decade  of revolution.
Many physicians embraced the changes adapting EHR, some  aspects of health reform, while most resisted and bridled at changing their ways.
Medical Front Office of the 90s


Reception Area of 2016
I walked with my feet  to another doctor's office:

This morning’s experience combined some of the best consumer-grade tools (Shout out to Zocdoc: Crushing it! Quick, accurate search with no log-in/account required → confirmation code sent via SMS → second text to my phone with a secured link that prompted my phone’s camera to pop up, so I could snap a picture of my insurance card, front and back, for ease of all future transactions. Magic! Love it.), with some of the worst (see above.)
I voted with my feet today. I left behind an unseen doctor whose clinical adeptness was rendered useless by his business ineptness,   




I Just Fired my Primary Care Doctor. Before the Appointment Even Happened.

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