for release June 1, 2001
by Melodie Davis
An Open Letter To The Medical Community
Something is wrong when a family of five with two full-time wage earners, two partially paid company medical plans, and slightly more than the median family income, still cannot afford basic medical care.
When I look at our spending patterns for the last six months, other than paying normal household bills, we have not really splurged on any big purchases. We haven't even bought any clothes for me or my husband. Yet we have been having a terrible time paying our bills and the main difference I see is an increase in medical needs. And we aren't talking about any major catastrophic illness or accident here. We're talking your routine orthodontist, dental check ups, eyeglasses, dermatology, a sleep apnea problem and a suspicious lump that turned out to be okay.
That medical care today is expensive is not news. There are many reasons, not the least of which is high expectations from ordinary patients. Patients demand or expect the latest drugs or tests. We expect to live longer. We want straighter teeth. We desire that all our problems-including health ones-be solved.
But there are some things we do not demand and would be happy to see less of: we do not need or want huge new expensive doctor offices in stylish neighborhoods behind the newest mall. Many of us would prefer you stay in your old digs and keep the prices down.
Now of course we want offices that are somewhat modern, clean and sanitary. I went to one office where the office and procedures made me feel squeamish. And I suppose some people who live in $300,000-and-up-homes expect their doctor's office to reflect a certain level of affluence. But for the vast majority of us, if there were a choice, I think we would prefer plainer offices and lower prices.
I remember when our family practice office moved to the up-and-coming mall area, many years before there were any other medical practices there. They built a very simple metal-siding office. I wasn't happy about the increased distance I had to go, but now, looking at the spectacular offices that surround them, I am thankful they have seen their way clear to keep it plain and simple. I hope they do not give in to the urge or unspoken pressure to match the offices of their fellow doctors.
We also do not need three or four different technologists consulting with us (all on the same visit), each doing one little procedure or item of record keeping before we finally see the doctor. This has reached an amazing level of workers standing around idle in some offices. For instance, many times you have three or four technologists or record keepers who each do a little something to the patient or the records. If each staff person takes two minutes with the patient before you see the main doctor (who spends maybe 10 minutes with each patient), the basic patient load is still determined by how many 10-minute appointments the doctor can squeeze into the day. So it only stands to reason that each of those specialists or technologists, who only spend two minutes with each patient, end up with a lot of idle time on their hands. I don't know why the specialists couldn't be cross-trained to do all of the prep-work. It looks like a lot of extra dollars piling up on my bill.
I don't object to your adding staff when you are short, but take a look at the efficiency of the workers you already have. Could someone standing around for eight minutes of each patient's time be trained to do another job?
I don't know if you hear from people when prices go up: if you don't, mostly we have given up, are too embarrassed or resigned. I do know that in any business, if people don't complain about prices, those in charge say, well, no one is complaining, so it won't hurt to bump prices up a little.
I'm sure there are many issues that contribute to rising costs: the costs of billing insurance companies and handling all that dreaded paperwork, patients' uncollectable bills, the rising costs of medical malpractice. Patients are also at fault in this out-of-control health care crisis. Doctors have so much responsibility. I've always said I'm glad I work in a job where my mistakes don't mean the difference between life and death. Many doctors I'm sure try to hold a tight line on expenses and pass those savings on to patients. You have our sincere appreciation. We appreciate the free sample drugs you pass on to us; you are also a lifeline for many a green new parent at 3 a.m. For the most part, you are still held in the highest esteem in the community.
As with many other jobs, some things are out of your control: insurance, the increasing demands for technology. But I urge you to at least consider two areas that are under your control: keeping the doctor's office reasonable and simple, and making better use of the good people on your staff.
What do you think? Send stories or comments to: Melodie Davis, Another Way c/o Name\Address of YOUR newspaper; or e-mail: Melodie@mennomedia.org.
You can also visit Another Way on the Web at www.thirdway.com.
Melodie Davis is the author of seven books and has written her column since 1987. She taught feature writing and has won awards from a number of organizations including the National Federation of Press Women, Virginia Press Women and the American Advertising Association. She and her husband have three growing daughters.
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