ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Spotlight On: Doctor's Office Visits - Do You Get Your Money's Worth?

Updated on May 6, 2014

Your Healthcare Providers

Source

Questions about your care

In a little departure from the usual topics and format for my "Spotlight On" hubs, this hub can be considered:

  • a social experiment or
  • a way to see how people in other parts of the world receive their health care services and how they feel about the way they receive them.

In the United States (because that's where I live), how we receive health care has changed a lot over the last ten years.

Whether or not you have been impacted in any way by Obama's Affordable Health Care Act, you may be seeing a change in your doctor of record, your points of service (private offices vs urgent care or clinics), and/or your level of care and services (actual visit duration and the offered treatment plan).

I hate to start out with a lot of questions, but please be patient (no pun intended) with my polls. Your answers will actually provide other readers with good information so they can evaluate how good (or bad) their medical care and health insurance really is. At the end, I'll post screenshots with the latest survey information (as of January 2014) pertaining to most of the poll questions.

Thank you in advance for your participation.

The size of the city or town (just guess)

Thinking about the doctor you see MOST often, does the city or town where he is located have

See results

Physician availability

Considering where you live, do you think you have a good number of doctors available given the size of the population?

See results

About your insurance

Do you think having medical insurance means you have better access to doctors and medical care?

See results

Question about appointments

Thinking about the doctor you see MOST often, how long do you have to wait to get an appointment?

See results

Question about primary vs specialist appointments

I have better luck getting an appointment within what I consider a reasonable amount of time with my

See results

Question about waiting room time

Thinking about the doctor you see MOST often, how long do you wait in the waiting room to be called back to the exam rooms?

See results

Question about face to face time with your physician (see next question for NP or PA visits)

Thinking about the doctor you see MOST often, after you are placed in an exam room, how much time does the doctor spend with you (i.e. your face to face time with him/her)?

See results

Question about nurse practitioner or physician assistant visits

Thinking about the doctor's office you use MOST often, do you actually get to see the doctor for most visits, OR do you see the nurse practitioner or physician assistant?

See results

Interruptions

Thinking about the doctor you see MOST often, when you are having one on one time with him, are there interruptions with phone calls or asking staff to locate reports that should be in your chart?

See results

Frustration

Pertaining to the last question, do interruptions make you worry that you are losing time with the doctor?

See results

Question about attentiveness

Thinking about the doctor you see MOST often, do you feel your doctor takes time to listen to you during your office visits?

See results

Electronic records and visits

Thinking about the doctor you see MOST often, has your visit gone electronic where computers are used during the majority of the visit time?

See results

Meaningful use of electronic records

United States Health and Human Services Secretary Kathleen Sebelius asked for one thing to be a key part in President Obama's 2010 Affordable Health Care Law and it was a biggie.

It was written into law as such:

80 percent of physician practices or medical institutions (see chart below for qualifying entities) providing services or treatment in practices

  • whose income comes from at least 30% of their patients on MEDICARE or
  • whose income comes from at least 20% of their patients on MEDICAID

must convert over to all electronic charting by the end of 2013 and the remainder 20 percent to come into compliance by the end of 2014. While doing this, they must still maintain paper charting for up to ten years or until 2021.

The federal government gave these healthcare providers monetary grants to buy electronic technology for their practices. The money was paid to them out of funds from the Recovery Act of 2009 and the 2010 health care law budget.

Each year since 2009, to keep getting funds (see chart below for how much $$$!!!), these health care providers must show they know how to store the data, then track it, then show they are using it to electronically send prescriptions and referrals to the appropriate entities and obtain lab results and other reports. By actively using technology to show this, they were considered to have demonstrated "meaningful use."

By the end of 2013, more than 291,000 providers and 3,800 hospitals have received incentive payments because they are meaningfully using electronics in their practices.

Our tax dollars at work! Are you mad yet?

Source: USA Today

Click on the following two graphics to enlarge. It shows the percentage of cooperation and what each doctor felt were the benefits of using electronic charting.

Electronic Charting Efficiency & Financial Benefits

How efficiently each doctor uses electronic charting
How efficiently each doctor uses electronic charting | Source
The financial and clinical benefits each doctor sees using electronic charting.
The financial and clinical benefits each doctor sees using electronic charting.

Typing

Thinking about the doctor you see MOST often, does he spend a large amount of time typing into his computer during your visit time?

See results

Click on the next two graphics to enlarge and see exactly how much money each healthcare provider got. I hope you will be as amazed as I was when I read these amounts.

So how much money did the grants pay each healthcare provider from 2011 to 2016? Wait until you see these two charts!

Health care providers can qualify for $44,000 or more. This is what they get if 30% of their patients are on MEDICARE
Health care providers can qualify for $44,000 or more. This is what they get if 30% of their patients are on MEDICARE | Source
This is what they get if 20% of their patients are on  MEDICAID
This is what they get if 20% of their patients are on MEDICAID | Source

Amazing!

Aren't the annual payments on those charts absolutely astonishing?

I don't know about you, but with all that money being paid to these doctors, I don't see very elaborate electronics or technology in use at any of MY doctor's offices. What do you see at your doctor's office?

I see each nurse practitioner, physician assistant and doctor partner with a laptop and I see the expected office equipment that I've always seen in my doctor's offices.

But I don't see any state of the art equipment or services in use that utilized between $44,000 and $63,000 of tax free "incentive payments" since 2011 for Medicare (continues to 2016) and since 2011 for Medicaid (continues to 2021).

Our tax dollars at work again! Are you mad yet?

This is who gets the money

Chart showing who qualifies for the grants
Chart showing who qualifies for the grants | Source

Your doctor's employer

Do you know if your doctor works for himself or if he is employed by another entity (hospital, HMO's, part of a physicians group)?

See results

Question about payment for office visits

Thinking about the doctor you see MOST often ...

See results

Doctor's attentiveness

I often feel my doctor has one eye on me and the other eye on the clock.

See results

Question about point of care

Thinking about your medical needs, which of the following 24 hour facilities do you use when you need medical care before you can get an appointment with your doctor?

See results

Prescriptions

Do you feel that a doctor has to give you a prescription for something to remedy the reason for your visit?

See results

By the way

Do you add on to the reason for your appointment with a "By the way, what do you think this is, Doctor?..." OR "Can I get your opinion on this...." after your original reason has been addressed?

See results

Your level of satisfaction

Overall, I am very satisfied with the health care I receive

See results

Poll results

Hopefully the poll results have given you a little peek into how other readers view the quality of their medical care and the way they receive it.

And oh my gosh, I hope you weren't the first person to answer the polls, so that there's no other results for you to see yet! If you were the first person, please share this hub with your followers so more readers will have participated. The next time you come to this article, the results will have been updated. Click "follow" on this hub so you get email notifications.

Now, why did I ask all those questions? Because I wanted you to voice your opinions but I also wanted to show you various pieces of information I found so you would get as mad as I am!

The electronics grants above is only one case in point. Read on for results of:

  • how medical insurance pays your doctor for visits and services,
  • how much your doctor respects your time (or not!)
  • how you are supposed to be respectful of your doctor's time (or not!)
  • how your doctor treats you and for how long at each visit

The results!

Source
Average wait times
Average wait times | Source

Merritt Hawkins is a national physician search and consulting firm. They conducted a survey of 1399 medical offices and tracked how long the average patient needed to schedule a NEW patient appointment in 15 of the largest metropolitan cities in the US.

Here are the results of average wait times to get an appointment in cardiology, dermatology, OB/GYN, orthopedics and family practice.

Boston was the longest average wait time overall: 72 days to see a dermatologist, 66 days to get an appointment with a family doctor, 46 days to see OB/GYN, 27days to see a cardiologist, and 16 days to see an orthopedic surgeon. See graphics for more detailed information.

Results of January 2014 Survey

Merritt Hawkins did random surveys calling
Merritt Hawkins did random surveys calling | Source

Click to enlarge, it is easier to read

Average wait to see a dermatologist is 256 days!!!!
Average wait to see a dermatologist is 256 days!!!! | Source

Wait Time vs Visit Time

Have you noticed that your wait in your doctor's office waiting room has changed over the last few years? Is the actual time spent with your doctor in the exam room much shorter now?

If you answered yes, it is not surprising, given the number of patients a doctor has scheduled each day at his office.

If you are like most people, you expect your doctor to take at least a passing interest in your health issues, especially when you want to discuss new symptoms, medication reactions, long term care/treatment of newly diagnosed conditions or possible alternative medications or treatment plans.

With the new medical insurance plans offered through the health law's exchange website, doctors are finding that insurance companies want to pay them less money but want to send them large numbers of patients.

Doctors who are concerned with payments generally provide less actual patient services in person, but are able to charge for using the time and services of other professional (billable) personnel, like EKG technicians, phlebotomists, physician assistants and nurse practitioners.

In a typical fee for service office practice, the doctor is rewarded for seeing patients in bulk. He has to decide how many patients to see in a typical day of office hours, decide how much time he has to spend with each patient so that patients get enough "face" time and the doctor gets enough "billable" time, and then balance this patient load with his out of office commitments (surgeries, procedures, clinic or hospital time, family time) and still be able to run a profitable practice.

How many times have you sat in a doctor's waiting room to hear someone complain about how long they are waiting to see the doctor? Probably more now than ever before.

How many times have you learned that your appointment which was scheduled for say 3PM has another patient scheduled at 3:10PM and yet another at 3:20PM?

With patients complaining of long waiting room times and short actual one on one face time with the doctor, many practices are using nurse practitioners (NP) and physician assistants (PA) to help them see more patients per day which cuts down on patient frustration regarding waiting room wait times, provides time addressing their complaints and allows for the ease of getting a "sooner rather than later" appointment to be seen. This is so prevalent now in the US, that every 3rd or 4th office visit actually results in seeing the doctor whose name is on the door, while all other visits utilize the billable professionals.

Some practices have also used nurse practitioners or physician assistants to creatively (and legally) bill insurance companies for a patient visit. They make a patient see the NP or PA first, who takes their history or reason for visit, and then they make the patient go through the whole thing again when the doctor comes into the exam room to see them.

One of the reasons doctors do this is because they have to document the actual use of the NP or PA in billable hours. Another reason is a doctor is able to charge an insurance company for a different type of visit if it goes over a certain amount of time and if it uses other professional (billable) personnel.

This speaks to time management skills, and the lack thereof, but it also speaks to struggling to meet their bottom line, which is to pay their overhead, pay their staff and still keep their office doors open with what they receive as payments, either from direct pay patients or from insurance stipends.

Stipends

A stipend is a guaranteed amount which the health insurance company has agreed to pay the doctor (or health care provider) as per patient, per service and per length of visit.

Doctors had to give managed care networks discounts on their office visit rates and to reciprocate, the managed care networks sent more patients their way to make up the difference.

The doctor's regular rate may be $150 for a brief visit of up to 10 minutes but the insurance company will agree to pay the doctor $35 in insurance stipend. An extensive visit of over 10 minutes but up to 30 minutes may pay the doctor $75. An extended visit over 30 minutes but up to 60 minutes may pay the doctor as much as $125 for the visit.

It behooves him to see as many patients as he can for ten minutes each at $35 stipend, so he can reasonably see five to six patients per hour (@$175 to $210 per hour).

By scheduling as such, he can give every patient an appointment, so no patient can say they were denied an appointment date within a reasonable amount of time. The heck with whether they are getting actual care from him personally at the appointment, but they are getting an appointment with "a health care professional."

If he gets enough of these submitted to insurance companies per month, he can afford to take a few extra minutes to

  1. schedule more new patients who require longer "first visits" to take a history, do a workup and deal with their complaint reason for visit, and
  2. take more time with certain patients who have terminal diseases or are "handle with kid gloves" types of patients.

Myth vs Fact

Myth: If a doctor accepts a lot of medical insurance plans, he is making a truckload of money.

Fact: If a doctor accepts a lot of medical plans, if he does not have enough patients who are on each plan, he is not making a truckload of money.

Professional business

Being a doctor used to be looked at as a profession.

Nowadays, it is viewed as a professional business.

If a doctor is not making money, his business will fail. If he doesn't see enough patients in the course of a day or a week, he is not going to make enough money to cover his employee and business expenses (rent, salaries, office equipment) and still have take home pay to support his family.

Add in how much managed care insurance actually pays a physician versus how much he would make with private paying patients and you have a doctor who is going to increase his patient load to accommodate the patients who use a medical insurance as their primary way to pay their doctor.

The only way he will make more money over and above the insurance stipend is if the patient has a copay (varies according to the plan) which he gets to keep. Usually even then, if the doctor has a practice with many patients who have one particular medical plan, he will receive even less of a stipend per patient because he has more participants paying the copay per visit.

This is why you will see each year around Medicare enrollment time (October to November) that your doctor's name is no longer on the provider list. You can get mad at the doctor assuming they are at fault for not taking your insurance any more, but it could very well be the other way around.

The insurance company could have dropped your doctor because he doesn't have enough patients on his practice for that insurance plan to continue keeping him on.

They only make money when they deal in bulk.

So who is really making money here?

The insurance company.

They get it on both ends - from your monthly premium and by not paying high stipends to the doctors who accept their plans as part of their professional "business."

When a doctor removes a health plan from his list of providers, he is not thinking about how many people will be impacted by his decision, because it is "business."

He has to do whatever it takes to keep income flowing to be able to meet his overhead and support his family.

Unless you can afford to pay his going rate, your best bet is to ask for a list of insurance companies he does accept and get the number (not the names) of patients on that plan. Then choose the plan with the highest number of patients.

He is more likely to keep that plan on his list because it is making money for him with copays and by stipends paid by the insurance company.

Time is money

The actual amount of time your doctor spends with you in the exam room or his consultation office has a direct impact on his earnings.

You might be thinking you waited three months for the appointment and took the afternoon off from work, that you now wasted two hours in the waiting room and have a long list to refer to for your appointment.

But the doctor is thinking, "I've only got ten minutes with this patient because I have to see at least three more in this hour in order to keep my earnings in line to pay for my expenses.

If he spends 45 minutes with you and, between you and your insurance, the total for 45 minutes is only paying him between $15 and $30 for example, then in those 45 minutes he could have seen three more patients at ten minutes a piece who may have had insurance that paid more of a stipend than your insurance, with patient copays higher than your copay.

If he wants to make any headway, he will have to conduct shorter office visits, and many more of them.

Patient-centered care

Patient-centered care is when you are involved in your care.

  • Does your doctor listen when you describe your symptoms or complaint?
  • Does your doctor interrupt you often or cut you off when you are speaking?
  • Does your doctor take the time to make sure you understand information he has given you about your illness?
  • Do you leave your visit feeling good about the outcome or generally how the visit went?
  • Does the doctor respect your wishes in accepting or rejecting a treatment plan or does he push the treatment at you as the only solution to your illness?
  • Do you have enough opportunities to ask questions?
  • Does your doctor hurriedly say “Any questions?" either at the end your visit or as a way to end your visit?

If so, do you answer “No” out of habit because you don’t know what to ask or because you see he doesn’t really have any more time to spend with you?

Patient Centered or Physician Directed?

Is the care you receive patient centered or physician directed?

Physician directed basically means the physician does most of the talking, asks the questions, interrupts the patient often and only gives the patient the information he thinks the patient needs and/or is capable of understanding. The doctor decides and/or tells you how it is going to be.

Patient centered means you have a team of health care professionals and you share in the decision making process for your treatment plan and ongoing care. Your doctor invites your questions and answers to participate in your visits and if he is not available, there is always someone who "knows you" whom you will have access to and will be able to provide for your needs. The relationship between a doctor and patient very much determines the outcome of any treatment plan.

The video below explains more indepth the team approach to patient centered health care.


Patient Centered Care Explained

Resource List and Further Reading

Huffington Post - Slideshow of all 52 states in order of longest wait times to shortest wait times.

One doctor blames patients for long wait times - lateness, emergency delays and Oh, by the way!

Overheard while waiting at the doctor's office

Health insurance 101 - how it all works

Why is your doctor typing?

Blue Cross Blue Shield - what to consider when choosing a healthcare plan.

Your money's worth - what really matters

Making you feel that you have been heard is very important because if you don't get the chance to say what you want to say (with or without referring to notes or a list), you won't feel like you got your money's worth in the fifteen or less minutes it took to get through your long-awaited doctor's visit.

In the end, it is not really the amount of time the doctor spent with the patient, because a short visit can be just as productive as a long visit.

It is how the doctor made the patient feel by the end of the visit as he is walking out the door. That will determine if he will ever return for another visit, or if he will go in search of another physician.

Last opinion poll

Did you find this topic interesting? Thank you for your participation in this important issue.

See results
Thank you for not copying my work.
Thank you for not copying my work.

Copyright Notice

© Rachael O'Halloran. April 26, 2014 All Rights Reserved.

No part of this article may be reproduced without prior permission from the author. Use the following link to refer to this article. Do Not Copy. TYVM

http://rachaelohalloran.hubpages.com/hub/Spotlight-On-Doctors-Office-Visits-Do-You-Get-Your-Moneys-Worth

© 2014 Rachael O'Halloran

Comments

Submit a Comment

  • RachaelOhalloran profile image
    Author

    Rachael O'Halloran 3 years ago from United States

    #kenneth avery,

    Hello new follower,

    Thank you for your glowing comment.

    I try not to have selfish motives in my writing, and although no one has ever said that, it will be something I watch out for a little more closely.

    I'm pretty much a "what you see is what you get" kind of writer.

    Your enthusiastic comment is appreciated, but if this is the first hub of mine you have read, I invite you to read others because clearly this is not my best work lol.

    I will definitely check out some of your hubs and follow you. Thank you for following me and your generous votes.

    Rachael

  • kenneth avery profile image

    Kenneth Avery 3 years ago from Hamilton, Alabama

    Hello, Rachel, (WOW! What a great hub)

    This is an excellent piece of writing. Amazing, to be precise.

    I loved every word of it. Voted up and all the choices because you deserve it.

    You have such a gift for writing. Just use it without a selfish motive and no telling at how far you will go and how many people you will touch.

    I have just left you some fan mail and become a follower.

    I cordially invite you to read one or two of my hubs, and be one of my followers.

    That would make my day.

    I am so honored to meet you and follow you.

    Sincerely,

    Kenneth/ from northwest Alabama

  • RachaelOhalloran profile image
    Author

    Rachael O'Halloran 3 years ago from United States

    #teaches12345

    Doctors are supposed to teach patients, but in this case some doctors need patients to teach them that time is money for everyone, not just them. Long waits should not be happening given all the personnel in the office, the electronics to make each task easier, and the level of education each person has to be able to do their jobs more efficiently. It is more likely the system that may need overhauling, not necessarily the people in it.

    Unfortunately we have to work within a system that is already in place. It is not a perfect system but it is the one we have at the moment. Making it work for us - the patient - until something else comes along is the long term goal.

    I am glad the poll questions were effective and thank you for reading and commenting.

    Rachael

  • teaches12345 profile image

    Dianna Mendez 3 years ago

    This was an interesting approach to healthcare concerns of Doctor visits. The present goal is to shorten waiting time for patients and I do hope it improves over time. Love your poll questions and the current trends in waiting time you posted.

  • RachaelOhalloran profile image
    Author

    Rachael O'Halloran 3 years ago from United States

    #Glenn Stok

    While my other healthcare hub centers on incentive payments for doctors by switching over to electronic patient records (EHR) from paper records, I also will be interested to see if there will be evidence that incentive payments ended up being money well spent.

    Right now, they are exactly that - incentives to get them in compliance with EHR.

    Thank you for reading this hub and the other. Our healthcare is one of the most important things all should value, as well as the time we spend in acquiring it waiting in doctor's offices and the kind of treatment which is dispensed.

    Thank you,

    Rachael

  • Glenn Stok profile image

    Glenn Stok 3 years ago from Long Island, NY

    I don't see any state of the art equipment that the "incentive payments" would have paid for in my doctor's office. I'm curious now to see if things change for the worse based on what I read in your hub. So far my doctor is still pretty good towards his patients. This was an interesting hub and your survey questions were very meaningful and useful.

  • RachaelOhalloran profile image
    Author

    Rachael O'Halloran 3 years ago from United States

    #AliciaC

    I have a couple of friends who live in Canada and from what I hear, your country has the best health care system in the world. No wonder it is different than what you are used to!

    Our system is not as good (or as free) but it gets tweaked every year depending on whatever laws Congress passes to make insurance companies put other things in place trying to keep status quo, or worse cut out things we are used to having.

    With the new Affordable Healthcare Act, it compelled more people to get insurance who didn't have it, and who possibly felt they didn't need it because of their good health or because their finances told them they couldn't afford it, and some feel they now are paying for something they will rarely use.

    I look at it like flood insurance. If I live in an area that gets flooded, I need flood insurance. If I have particularly bad or compromised health, I need health insurance. If I need something for just in case, why can't I have a bare bones policy that doesn't cost me an arm and a leg? (no pun intended). The cheapest policy I could find for someone in excellent health in California was about $140 a month, including prescription, primary and specialist care, dental and eye exams (just exams, nothing else). That's pretty bad. My daughter who lives in Virgnia has similar coverage, is 29 years younger than me and pays nearly half of that. Now that I am on Medicare, but because I still work part time, the numbers will change a little,but not by much.

    I've rarely been sick a day in my life, am a good risk as far as insurance companies are concerned but yet I have to pay very high rates for health insurance because of where I live (California at present, soon to be Virginia in about 2 months).

    My husband on the other hand is in very poor health, greatly needs health insurance so we can afford the care he needs, and because he is on Disability (and early Medicare), his insurance cost him nearly nothing in premiums and copays when we lived in Delaware and now in California he is paying through the nose.

    Part of the reason we are moving back East is because we want to be nearer 3 of our children and majority of our grandchildren, but the other part is because healthcare is almost free and at our ages and limited income now, free looks real good. lol

    Thank you for reading my article and when you write a hub about Canadian Health System, I will be extremely interested to learn more about it. I think it would be of great interest to your readers too.

    Thank you,

    Rachael

  • AliciaC profile image

    Linda Crampton 3 years ago from British Columbia, Canada

    There is so much useful information in this interesting hub! I will return again to see more of the details and more of the poll results. The healthcare system in the United States is very different from the one that I'm used to. I want to learn more about it, and reading your hub is a great way for me to do this.

  • RachaelOhalloran profile image
    Author

    Rachael O'Halloran 3 years ago from United States

    #MsDora

    Thanks for your endurance in reading this long hub! "He" is a generic term so no offense meant to anyone with a "she" for a doctor. lol

    I found the financial background of our (USA) healthcare system interesting and thought others would too and that's how I got the idea for this hub. Thank you for reading and for your comment.

  • MsDora profile image

    Dora Isaac Weithers 3 years ago from The Caribbean

    My doctor is a she (smile) and I could not answer all the questions, because we just met. However, your information on who gets the money is very revealing. Thank you for making us aware.

  • RachaelOhalloran profile image
    Author

    Rachael O'Halloran 3 years ago from United States

    #vocalcoach -

    As soon as I think I'm done with a hub, I think of something else and all of a sudden, the hub becomes epic in length, so that's why there is a mountain of information in most of my hubs. LOL

    Thank you for reading, voting and most of all sharing (I like that part best! because it brings other readers) Have a lovely day.

  • vocalcoach profile image

    Audrey Hunt 3 years ago from Nashville Tn.

    A mountain of valuable information very well presented! Thank you and big votes and sharing.

  • RachaelOhalloran profile image
    Author

    Rachael O'Halloran 3 years ago from United States

    #FlourishAnyway

    Yes, it seems the clue was when no patients were going back to his exam rooms. I'd have been on my feet asking just like you were too. The least any office personne l can (and should!) do is INFORM waiting patients that the doctor is running late or is on his way - anything to placate patients waiting in a waiting room.

    I had a similar incident with a specialist that my husband goes to, we also got up and left but not without my leaving an indelible mark on the doctor's practice because two other patients followed us out the door as loudly as we left. Whether they ever went back for future appts, we'll never know, but we told my husband's insurance we wanted another doctor from their list.

    We let the new doctor know right up front, that if we have to wait an hour or more, we will be looking for someone else, that our time is valuable as much as his. We've been with him about 3 years now and so far so good. It is like our time wasn't worth anything and that is just downright disrespectful of other people, their time and their good nature.

    We originally balked at being "passed off to a NP (that is how we looked at it, since we were new to California from NJ) but when we saw that in California that is the way most doctors handle their large practices, and when we saw the NP would give us what we were after - medication refills - then we saw it as an acceptable practice.

    If we ask to see the doctor, he comes in, but the NP can take care of most needs so we do see the doctor every few visits or on demand as we see fit.

    I am glad you stood up for yourself and demanded better service because we always have to keep in mind ... while going to a doctor serves us as patients, they ARE a business and are bound by customer service etiquette rules, the same as any high volume business like hotel chains and places where you are a fee for service customer.

    Though we do have insurance, we are still a fee for service customer because we pay for the insurance, often more so - because of our additional copays. The doctor is the one who provides a service because it is HIS name on the door, no matter if he is the one personally giving the service or if he has employees who deliver the service by his proxy. He is still the one where the buck stops. It is our right to demand to see him and not settle for a PA or NP and good for you! So many patients accept things as status quo when they should question. It is interesting to hear how others deal with their health care insurance issues, doctor's office etiquette ( or LACK of!!) and I thank you for sharing your story and leaving your comment.

    Rachael

  • RachaelOhalloran profile image
    Author

    Rachael O'Halloran 3 years ago from United States

    #DDE, Now you live in Croatia and you've lived in other places too. From your comment it seems you have good experiences with doctors and dentist in your country. How does the health care system differ from where you used to live? Is it the same or is it different? Do you have a system where you pay for the service as you go or do you have an insurance system the way most of the US does? Thank you for your comment and I hope you'll check back to see if any dialogue is going on that you would like to comment on further.

    Rachael

  • DDE profile image

    Devika Primić 3 years ago from Dubrovnik, Croatia

    We have a doctor's room in the area close by and don't go often We have a dentist I have been a few times and have no complains. I did get my money's worth and was quite pleased with my results. Interesting and most informative.

  • FlourishAnyway profile image

    FlourishAnyway 3 years ago from USA

    I waited in one doctor's office for 30-45 minutes with no explanation regarding why he was running late. Patients were not even going back into the office for examination. I went to the desk and told them I was leaving. They were floored. Apparently his rounds at the hospital lasted longer than intended and he wasn't even there yet. They aso constantly tried to make me see an NP when I was being charged the same. No deal. Done. I am a customer with good insurance, and I don't have to tolerate that poor service.