Are You Challenging Your Healthcare System To Serve You Better?

Electronic Patient Portal and Patient Consent: Now that should not be so hard; right? Well, I perplexed the provider’s electronic record when I refused to accept the clause that allowed fellows to implement any part of my care, at any time now or in the future, for any procedure. When I did not accept this clause, the process came to a screeching halt. Apparently I am the first person to have ever declined this clause in this very busy practice. The receptionist at the well regarded medical group patiently explained that I had to accept the clause in order to complete my paperwork and proceed with my appointment, but I was not to worry because she had been told that their group would only accept fellows from the best medical schools. There are a couple of challenges here. First, this kind of consent clause should have an option not to consent. Secondly, some of the physicians that are the most “book smart,” do not have the best surgical hands, especially before they have not yet had the opportunity to repeat a live or simulated procedure many times. Lastly, as excellent as this group might be at selecting fellows, I cannot be assured that every fellow chosen every time will be prepared to do any surgery. On several occasions, I have enthusiastically allowed students, residents or fellows to participate in my healthcare, but I should be able to make this decision on a case by case basis. My penalty: redoing all my paperwork in writing before I was allowed to proceed with my appointment.

Cost considerations: Prior to scheduling a MRI, I called several places to investigate cost. Two out of three centers gave me a lower price if I paid cash as compared to the price that was negotiated with my very large insurance company. Now of course, I would be responsible for submitting my paperwork to my insurance company so that they would have record of the cost that I had paid toward my large deductible. I was told by the third center that this was illegal. According to them, one has to have all claims processed directly with one’s insurance if one has any kind of insurance, even if it costs the consumer (no, that word is not used) and the insurance company more.

Physician selection: There are more sources of information on physicians than there ever has been, but is it really the kind of information that makes a difference? As I took a look at multiple sources, such as Healthgrades®, I found that there was more information available about the timeliness of appointments and friendliness of staff than surgical outcomes. When I tried to find information about my anesthesiologist, the anesthesia practice did not even have a website, the practice and surgery center did not have a particular anesthesiologist assigned to the case five days pre-procedure and even if they did, they were very hesitant to provide that information. Many of us do not allow a technician to work on our car or house before getting a referral or doing some kind of background check; why would we allow someone to control our vitals while we are unconscious? I was blessed because the lead anesthesiologist returned my calls, answered my questions and then personally administered my anesthesia while providing outstanding information and care.

This particular medical journey ends with a positive clinical outcome thanks to skilled healthcare professionals. Although the system was not ready to serve an engaged consumer, maybe this is because not enough consumers are challenging the system to do so.