bad doctors, they need to take parated2k's philosophy on doing their jobs, yep yep yep

souds bad, but when you look on the bright side at least you can get the care you need to keep your child healthy. That is how I tend to look at it when I go to the doctor which is often because I have high bloog pressure and my current job gives my body alot of abuse.

I once went to a doc with an appointment, to change bandage on an abcess. After 45 minutes waiting, I walked out.

Seems that Docs think their time is more important than your time.

Not! Lets see what happens when a virus infects their computer and I tell them I will be around in a week! (it actually happened, just not the week part).

Sorry Jill. That is unexcuseable!

Danny, I'll have to look at ParaTed's philosophy I guess.

Joe, you sound like a kind hearted person. I only pray that my son does indeed get the care he needs. We learned nothing from this doctor and are merely left hoping to find out more from a specialist.

Dr. Guy, if it would have been for me, I would have walked. Good for you on not putting up with it! You got my point. No other professional providing a service would get away with behavior like that. I like how they will charge you if you don't show for an appt but they seem to think keeping you waiting for hours is just fine.

Hey Jill, the philosophy Danny is talking about is my attitude that everyone should hold themselves (and every other worker) to the standard we would hold our parachute riggers and paramedics. Link

Also, if you care to take some advice from one who has spent a lifetime with "growing pains". Look into the possibility of your son experiencing "restless leg syndrome". I'm not saying that is what he has (I have far too little information for that), but some of the words you use are common for kids and adults. Here's a link to a great website that could save you both future visits to "eventual care".

Restlesslegs.com Link

I hope you get better care in the future than some doctor taking up your whole day, just to tell you that you need to "see a doctor".

I have spent much of my life in Dr.'s offices.  It's now to the point that I get completely shocked if I *don't* wait at least 1/2 hour past my appointment time or at least 2 hours at "urgent" care.  I went to emergency once because I wasn't sure that I wasn't having a stroke...you would think that I would get in fast, right?  Nope.  I waited 45 minutes to see anyone- even a nurse.

I could write a blog about my thoughts on the Dr.s that I have seen...but I won't

Make sure you get him tested for RA while you're at it.  Might as well cover all your bases.  When you are younger, joint pain doesn't always feel like it is in the joint (doesn't always when you are an adult, either).  RA in kids is hard to diagnose since most kids don't feel the pain in their joint.  So, it's best just to test for it and rule it out versus ruling out everything else, first.

Hope they find out what is wrong with him quickly.  Otherwise, you'll become very familiar with waiting in Dr.'s offices. 

Hi, Jill -

As both a patient and a physician, I am often just as frustrated by the irrationality of our so-called "system" of health care. 20 years ago or so, you would have probably been seen by your pediatrician that day, and maybe even by an orthopedist that afternoon following a call from your pediatrician asking him to see your son.

As patients, we are led to expect prompt, thorough, competent and compassionate care (nothing wrong with that ideal). And you did the right thing seeking advice about your son's discomfort. But I can attest that we have also developed an expectation that any & all medical problems, once we've decided we have one, no matter how minor, will be resolved "today" - on no notice. If we can't be seen now, we want wildass-guess treatment by phone - just do something and do it now... whatever you do, don't ever make us go the ER, even if it's real emergency. None of us have time for the inconvenience of an illness, because we've got a wedding to go to, or a vacation starting tomorrow, or a dinner out tonight, or an important meeting in Dallas on Monday, or a son's soccer tournament on Saturday... you get the point.

As physicians, we are expected to operate as a "business," getting paid (when & if we get paid) progressively less and less over time, forcing us to squeeze more & more patients into already busy schedules and function wtih the help of fewer and fewer staff (our largest expense, after all), simply because we'll go out of business if we don't. And we're expected to make zero errors in judgement and have no bad outcomes.

Insurance companies operate on the principal that physicians are criminals by definition and the companies aren't going to part with a nickel until & unless we prove we are innocent. No matter that a service was rendered to an individual in need in good faith, if there's a typo in the claim form or there is some fine print in a contract that can enable them to avoid paying, they're all over it. In the eyes of many patients, if an insurance company denies a claim, or determines it is the patient's responsibility, then the doctor did something wrong or didn't file the claim properly and doesn't deserve to get paid. I practice a primary care specialty in which revenue is earned from lots of small-dollar-amount services. If an insurance company decides, for whatever reason, justified or not, to not pay a $38 bill, I'm better off not even arguing about it because it will cost me $50 in staff time and resources to contest it - I'll "only " lose $12 if I "succeed" and $88 if I fail. We are truly in a no-win situation when that happens, and it happens more often than I care to think about. And there's the problem of the crazy medical liability lottery and its consequence, defensive medicine (a large part of the reason you were advised to see a specialist), which further contributes to the sense of frenzied harrassment physicians live with day in & day out.

Even with all that, I'm proud to say that in our practice it is rare for anyone to wait more than 10 minutes, if that, past their appointment time to be seen, and not by a physician extender, but by the physician. We can't fully anticipate everyone's needs so the schedule inevitably bends to meet them on the fly, but I spend as much time waiting for patients late to their appointments as they do waiting for me. I see 18-25 patients in a full day, while the physicians in the practice downstairs see 50-60 or more, many of whom wait an hour or more to be seen. However, providing that kind of service means I earn about 40% of what I took home in 1981 (in 1981 dollars). In actual dollars, I take home almost exactly what I took home in 1981, but the dollar's purchasing power is only about 40% of what it was then. If I were to tell you in advance that the pay for the job you were about to start would lose 60% of its value if you stayed with it for 25 years, you would probably look elsewhere for a job.

More and more of the hard-earned money you spend on insurance premiums is being skimmed off the top by opportunists (insurance companies and lawyers) who contribute absolutely nothing to your health or well-being. And it is showing up in the "wasted another day at the Dr." problem that prompted your article. I wish there was a quick and painless solution to the problem, but I'm not optimistic one will be found before my career is finished, or before your son has children of his own, I'm afraid. I just want you to know that physicians are not any happier about it than you are and that the barriers to providing the kind of care you expect and deserve have been growing taller and taller as third parties have aggressively and progressively invaded the physician-patient relationship.

Cheers,
Daiwa

have him tested for leukemia as well.

Make sure you get him tested for RA while you're at it

I plan to get a lot of blood work done on him.  At least the Dr did ask about thyroid disease in the family.

Look into the possibility of your son experiencing "restless leg syndrome".

We ruled that out since it only hurts when he moves.

everyone should hold themselves (and every other worker) to the standard we would hold our parachute riggers and paramedics. Link

Excellent standard! 

Anyone ever try to keep an 8yr old off his feet for any amount of time?  It's close to impossible!  I think the crutches just made him want to walk around more.  He woke up limping again today but said it doesn't hurt like it did yesterday.  This mommy is going to be pretty stressed until we find out what is going on.  I am just praying it is something that is easily treatable.

Daiwa, I am very understanding of what people in the medical field go through.  My husband's cousin is a doctor who works in the same group as our family doctor.  Truth be told, if the doctor had come in and simply apologized for the wait, I probably wouldn't have felt so pissed off.

You sound like you have an appreciation of all sides.  The fact of the matter is though, you are a minority.  Those who know me know that I tend to see the good in people.  I always try to make the best of situations.  One thing that will blow it with me is disregard for the value of my time and insulting my intelligence.

This clinic had half a dozen nurses standing around literally twiddling there thumbs and only had one doctor on staff from 9-2 the Fri before Memorial Weekend.  I simply expect people in the medical field to have more brains and be more prepared than that!  Heck, the local Denny's knows better than that.

Thank you for lending a balance to this conversation!

This is one of the reasons why people are so likely to sue doctors.  It's been my experience that doctors (as a broad generalization) simply stop thinking of their patients as customers - as human beings.  So any good-will that the patient may have has long since been eroded by the callous treatment many receive by health care professionals.

Daiwa - one can't blame insurance companies for health care professionals not behaving with basic courtesy.

Jill & Drag -

You are both quite right, and I didn't intend to excuse the particular physician's behavior or lack of courtesy. I always, always, always thank my patients for their patience with me, even if I'm only 5 minutes late, and I never tell them "we don't have time for that today." Physicians who think of themselves only and don't extend common courtesy out of respect for their patients deserve your scorn. It's just like the tag line from the MasterCard commercials - courtesy is "priceless."

I do want you to have a sense for how the system is broken for the physician as much as it is the patient, how physicians pay a price to provide the kind of customer service we all want, and that physicians can't be taken for granted - we are human just like you and the pressures coercing physicians are strong. Bucking the trend isn't rewarded, rather just the opposite. There are no business incentives to efficiency in medical care, only incentives to churn volume. And the trend can't be sustained indefinitely - I worry about the quality and availability of medical care for myself 15-20 years from now, should I be fortunate enough to still be here. The insurance system is so complicated now and so frought with little "gotcha" land mines that I don't blame patients for being confused and upset. The problem is, the interface between the "system" and the patient, where the rubber meets the road, happens to be the doctor and, rightly or wrongly, the "blame" for all those land mines routinely gets laid at our feet.

Cheers,
Daiwa

It's very sad to see this sort of thing.. makes me wonder about how healthcare will be when I get older and begin to rely on it.

This clinic had half a dozen nurses standing around literally twiddling there thumbs and only had one doctor on staff from 9-2 the Fri before Memorial Weekend. I simply expect people in the medical field to have more brains and be more prepared than that! Heck, the local Denny's knows better than that.

Jill -

If we got paid the way Denny's does - cash at the time of service - you might have been greeted by the doctor on arrival. If Denny's were managed by "healthcare administration professionals," there would be two managers and fourteen waitresses to every cook, your meal would arrive cold in 4 hours (after prior authorization for consumption had been obtained), you'd storm out without paying the bill, you'd get statements for 4 months demanding payment, then your account would get turned over to a collection agency.

If we worked directly for you, you wouldn't exactly call the tune, but you'd at least own the orchestra. The corrosive reality of today's healthcare is that doctor's don't "work" for you in the traditional sense, and our paymasters care only about their bottom line, not your welfare or how courteously you are treated. Oh, if you complain, they'll fluff their feathers & protest their concern & all that, but that's it. I don't intend to defend all physicians here, BTW - I am in a position to know too many whose only concern, IMO, is with milking the system or taking advantage of people, something I am ashamed to acknowledge about our profession, but doing something about it would be the subject of a whole different article.

Cheers,
Daiwa