I’ve been on a quest for about the last 3 months to find a new doctor. I’ve had HMO health insurance for the majority of my life and continued to see my HMO doctor even after switching to a PPO health plan. My job provides me with great insurance benefits so I am no longer limited to the practices of an HMO where I sat in the waiting room for an hour, spent 20 minutes in the office waiting, and then have the doctor come in for 15 minutes for a chat, diagnosis and prescription drug.
I’m lucky to never have had any very serious illnesses - but to be honest with the experience I’ve had with doctors it’s not as if I would know. The last time I went to the doctor, I went because I wanted to make sure my heart was healthy. My dad is thin, never smoked, doesn’t drink and had to have emergency sextuplet bypass heart surgery when he was in his early 50’s.
The doctors had no idea that all six of his arteries were blocked and that he was on the verge of a fatal heart attack. He went in with chest pains and my mom had to be very persistent to finally get the doctor to check him into the hospital for heart trouble. When my dad was in surgery, a nurse met with my brother and I to discuss what this meant for the two of us. She looked at us - both at a good weight, non smoking - and basically told us, "you’re screwed."
Genetics were the primary contributing factor to my dad’s heart disease and she told us that most likely we would both have the same sort of troubles.
Nice. In any case, I went to the doctor a few years after that and explained my family’s medical history and that I just wanted to be sure that I was ok. Here’s a rough transcription of how my appointment went after that point:
Doctor: You’re young, you’re thin, you don’t smoke and you don’t drink regularly. Plus you’re a woman so your estrogen keeps you at lower risk for heart disease. Have you had any symptoms that you feel concerned about?
Me: No not really, but I just want to be sure before it’s too late.
Doctor: Ok, well I wouldn’t worry about it too much. (as she checks my vitals.) You could probably exercise more but everyone should.
Me: Well, can I get a blood test?
Doctor: Sure (she scribbles on a notepad)
Me: I don’t’ know anything about what to ask for, but can you make sure it has all that comprehensive stuff, you know cholesterol and everything?
Doctor: Yes - just take this to the 4th floor and they’ll take care of you. If anything abnormal shows up then we can go from there.
Me: Uh, ok. Thanks.
Doctor: Anything else?
Me: No. I guess not.
Total time with the doctor - 15 minutes. Total time in the building, waiting for the appointment and waiting to get my blood drawn? 2 hours. Results came back, mostly normal except I was 1 point away from having "high cholesterol" at 24 weighing 127 lbs. I recieved the results in the mail and interpreted them myself based on the notes scribbled on there from the testing clinic. I called the doctors office, waited to talk to a nurse who got on the phone with me and said, "everything is fine, watch your cholesterol" and hung up.
My experience with my old HMO doctor prior to this one was worse. My mom asked him to run some tests for something she thought I might be having issues with. He looked at me and said how are you feeling. I responded "fine." (I was feeling fine.) He looked at my mom and said "if it’s not broken, don’t fix it." Sure, at the time I didn’t want to be poked and prodded so I welcomed his response, but now that I’m older, I can understand how frustrating this must have been for my mom.
Anyway, I had had enough and I begun trying to find information for a new doctor with my fancy non-HMO insurance. The most I used my PPO for was to go to the walk-in clinic near my home for treatment any time I had a minor issue and was basically experiencing the same treatment without having to drive to Orange to see my primary care physician. 20 minutes in the office waiting, 15 minute chat with the doc, diagnosis and prescription drug. Wham bam, thank you ma’am.
I basically have 4 criteria for my new doctor - listed in order of importance:
1) Female, MD
2) None of this 15-minute-per-patient rush
3) Supports preventative treatment and minimal use of pharmaceuticals
4) Takes my insurance.
I was convinced that a PPO would give me limitless choices in the world of medicine. I had already enjoyed the benefits of a PPO for dental work and I could never turn back (as I have a totally insane phobia of dentists and their sharp metal torture devices and now I can get laser work instead!) I assumed finding a new and awesome doctor would be as easy as 1-800-Doctor.
No. This is not the case with Doctors. I can get 80 user reviews on a Pizza Hut pizza, but I can’t get any feedback on a single doctor from my "In-Network" list of care providers anywhere on the web.
All I have is a name, an address and a couple hundred online offers to send me a report of any malpractice lawsuits against my doctor for a "nominal" fee.
None of the doctors on my In-Network list in Orange County are board certified and worse than that, half the time I can’t tell if Chao-Ming, Dana, Arfa, Jo and Kea are male or female first names.
I don’t think the "Institute of Progressive Medicine" takes our insurance. It’s a place that I found that meets all of my criteria except for number 4. There’s a female MD on staff. These doctors say they spend between 1 and 2 hours with the patient on their first appointment to test and assess. They specialize in prevention and avoid overuse of antibiotics and other loosely prescribed pharma (although they clearly state that there is a need for those medications when used and prescribed correctly.)This is exactly what I had been looking for! And in order to get it, I’d have to pay out of pocket.
I found an article in the Register talking about how a lot of higher end doctors are pissed off about watching necessary treatments for their patients be denied by insurance, or not getting paid for services by insurance companies so they’ve begun to drop private insurance companies and only accept cash payments. They provide billing information to the patient so that the patient can go through the hassle of collecting reimbursement funds from their insurance for applicable out of network costs, but they no longer have to go after the funds themselves and loose out on money they’re owed. Anyway, one of the owners of the Institute of Progressive Medicine was quoted as having dropped their last PPO in September of 2007 because of billing and collecting issues.
It sucks for us as patients and it sucks for the doctors. I guess that’s the whole problem with these stupid insurance companies anyway. You can’t live with them and you can’t live without them (as of right now.)
Anyway - perhaps some of you know a fantastic doctor that happens to meet all my criteria and works out of the Orange County area. It would be a million times more awesome if she were in the Newport/Costa Mesa/Irvine areas. And a billion times more awesome if she served nachos in her lobby.
