Tag Archives: Health Care

It Was the Understatement of the Year

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Planned Parenthood’s president Cecile Richards said it this morning when she testified before the Republican-run House Oversight and Reform Committee:

It doesn’t feel like we’re trying to get to the truth here.

If only Ms. Richards had noticed the inscription on the wall behind her.

Richards

“We are not trying to get to the truth here” is the committee’s official motto.

Of course, I made that last part up (with apologies to the Associated Press), but it might as well be true.

For more sober coverage of today’s event, National Public Radio has a few choice audio clips that “you should hear”, Jezebel has a summary that’s painful to read and Mother Jones shows how to make a misleading chart by leaving out the y-axis.

It’s My Blog and I’ll Rant About My Visit to the Doctor If I Want To!

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Yesterday, a friend and I happened to get on the subject of restaurants, waiting rooms and (yes) elevators that have televisions. We agreed that the relatively recent practice of putting a TV everywhere possible in order to entertain or distract us is annoying. Obviously, some may enjoy watching TV while they’re waiting to see their doctor or eating lunch in a cafe or riding in an elevator. Also obviously, some people don’t. 

So I was psychologically primed when I entered a doctor’s office today and found a TV in the far corner of the empty waiting room. It was tuned to a talk show about cooking. Even worse, the sound was extremely loud. Instead of politely asking the staff if it would be possible to turn off the TV, I did it myself. In retrospect, I should have asked, but since I was the only one in the room, pushing the “off” button seemed like an acceptable thing to do. (Have you ever noticed that they never leave the remote control next to the television, a courtesy we patients might appreciate? Given how loud that TV was today, I think it’s really there for the office staff, who happen to be in a different room.)

After a while, one of the staff noticed that the TV was off and used the remote to turn it back on. I objected, saying that I had turned it off. We went back and forth a bit, and I raised my voice a little (no personal attacks were made). The staff member said the TV was there “for the entertainment of the patients” and having it off was merely my preference. Since another patient had entered the waiting room by then, I gave up. Even when I was alone again, the TV kept going, albeit with reduced volume.

Eventually, I got to see the doctor. He seemed upset about something. He spoke very fast and not very clearly. He was brusque, interrupted me when I asked questions, and kept telling me I didn’t understand his precise reasons for doing an MRI of my hip. Near the end of the examination, I said “Well, it will be good to find out what’s going on in there” (referring to my hip). I thought that was a pretty innocuous thing to say, but he insisted on again repeating why an MRI was a good idea (it was merely to rule out the presence of an anatomical abnormality or a tumor, not “to find out what’s going on in there”).

Having agreed about getting an MRI, I then made the mistake of asking about a different bone-related issue, since this doctor is an orthopedic surgeon who specializes in knees and shoulders and similar bones. My question was “Is surgery often done for bone spurs in the foot?”. He told me in no uncertain terms that asking a doctor a question like that is the worst thing a patient can do. He gave me a brief lecture, explaining that you should never ask a doctor about anything the doctor isn’t prepared or qualified to talk about. He seemed quite upset and left the room. I called after him “Should I follow you?”, he made a noise and I did.

While waiting for the MRI to be scheduled, I asked him if I could speak to him about something else. He said “No”. I then said I wanted to discuss the TV issue. I said that if a patient wants the TV off, it would be a good thing for the staff to honor that request. In response, he severely criticized my failure to initially ask the staff to turn off the TV, instead of pushing the off button myself. “How would you like it if I came to your house and drove your car? Or came into your house and turned off your television? It’s not your television. It’s ours.” (Gosh, I thought the TV was for the entertainment of the patients.) I admitted I would have asked if there had been anyone else in the room, but still felt what I had done wasn’t so bad.

At this point, I told the doctor that he had the worst bedside manner of any doctor I’ve ever visited (and I’ve visited a lot). Talking fast, interrupting, constantly correcting my choice of words, saying he didn’t “give a sh@t” about something and generally looking and sounding pissed off. He said he was still willing to treat me. I said “I don’t think so” and left. (This area isn’t short of orthopedic surgeons.)

Now, I assume this guy was angry about the TV thing when he entered the examining room. Maybe he heard my exchange with his staff. Maybe one of them mentioned the difficult patient in the waiting room. But if he was already angry with me, it would have been much better (and more “professional”) if he’d said so up front. He might have even declined to treat me. I would have been surprised but would have left quietly. Instead, he behaved like a jerk (another word came to mind, but this aims to be a family-friendly blog). Or maybe he treats lots of patients that way and it had nothing to do with the television.

So here’s a good part of this story (ok, this saga). I thought it would be appropriate to share my strange experience with the rest of the world (meaning the part of the world that, for some mysterious reason, doesn’t read this blog). Since we now have the internet, I went to a couple of those doctor-rating sites, Healthgrades and Vitals. That last site allows you to enter comments. So I did.

My conclusion was that this doctor might be very good, except for his personality. The treatment plan (the MRI) he recommended made sense. But I wouldn’t recommend him and would never see him again. 

After entering my comment, it occurred to me that maybe I was being a little unfair to the guy. Maybe he was having a bad day. So I looked at the other comments. These are some of my favorites:

Only drawback – he is very hard to talk to or get understandable information from. He gets very impatient with explanations.

He has a big ego. He does not like being questioned…. Instead of giving you understandable answers and showing that he cares, he gets impatient and annoyed very easily.

AVOID [Dr. X] AT ALL COSTS. There is not enough room for his ego and the patient in the exam room.

My experience with [this doctor] was disastrous.

... a horrible and unprofessional surgeon… As [the vomiting] got progressively worse I decided to page [Dr. X]… His words went something like this (and keep in mind I could barely talk because I was vomiting so often) He basically told me that I was interrupting his dinner and that it was not right that I was doing so….I actually started crying so my amazing sister took the phone … This is but one of my horrible experiences with [Dr. X]. Please Please Please Please, I beg you not to see this Doctor!!! 

One of the worst experiences of my life… I told him about the problems I was having after the surgery. He went off the handle and acted very unprofessionally by yelling at me. His behavior made me cry and I never went back to him.

I echo all of the negative comments already posted here: he is impatient, belligerent, insulting, difficult to comprehend, excessively … antagonistic when you explore his incomprehensible answers, actually told me one of my questions was “Bullsh-t”, and that I was wasting his time by asking questions…I would not feel comfortable going under the knife of such a disordered personality. I think he’s sociopathic.

Of course, there are glowing reviews as well. But the lowest grade he gets is for (surprise!) “bedside manner”. All I can say is that if you’re ever in the market for an orthopedic surgeon in or around Springfield, New Jersey, be careful. It’s a jungle out there!

PS — Other people object to all these televisions. From a doctor:

Welcome to the world of the “captive audience… Take them out. Take them all out. That includes the four flat screens on different channels at the local restaurant. I can’t find a single study that shows any legitimate health benefit to support their presence in a doctor’s office, but I can think of 100 reasons to take them out.

From an educational site for doctors:

An informal survey conducted in a variety of waiting rooms found that the presence of television adds to stress, especially when people believe they are unable to control the volume or programming…. If your waiting room includes a television, consider offering patients options. Rather than exposing them to specific programs at a certain volume, for instance, offer television with closed captioning or hygienic headphones on loan from the waiting room desk.

And keep them out of the damn elevators too!

A Bit More on the Cost of Health Insurance

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A Vox article cites a report from the Center for American Progress that helps explain why many employees who get health insurance at work don’t like the Affordable Care Act and believe it’s causing the cost of health insurance to go up:

In recent years, the growth in overall health care costs has slowed dramatically. But for millions of Americans with employer-sponsored insurance…, this slowdown is illusory. From 2008 through 2013, the average annual growth rate of employees’ monthly premium contributions and out-of-pocket expenses, adjusted for inflation, was more than double that of average annual growth in real per-capita national health care spending, which was less than 2 percent per year. This growth has also outpaced employers’ costs of offering these benefits by more than 40 percent.

Employees experiencing higher health care costs tend to blame the Affordable Care Act, or ACA, even though the law largely leaves the employer-based system alone….The actual reason why employee and employer costs are increasing at different rates is because employers have, over time, shifted greater responsibility for health care expenses to their employees through higher deductibles, higher copayments, and higher coinsurance—a practice that began long before the passage of the ACA. Other employers pay smaller shares of their employees’ health care premiums….

In other words, almost everyone in the health care system is realizing savings, but employees’ costs are rising.

Or as Vox puts it, in still other words:

Your company’s health insurance costs are going down. But yours are going up.

This is in addition to many companies incorrectly telling their employees that the ACA is to blame for rising costs.

Sarah Silverman Receives Divine Guidance

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I like Sarah Silverman a lot. She’s funny and does good work. Plus she has eaten popcorn with Jesus (who apparently looks like a West Coast hippie, just like in the movies).

The Burdensome and Anti-Christian “EBSA Form 700”

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As noted in the previous post, a majority of justices on the Supreme Court granted Wheaton College a temporary reprieve from having to fill out and distribute EBSA Form 700. That’s the form that’s supposed to be used by non-profit religious organizations to say they don’t want their employees’ health insurance to cover some or any forms of contraception.

Wheaton told the Supreme Court that Form 700 constituted a significant burden on their religious beliefs. They preferred writing their own letter to the government instead. Understandably, the three women on the Supreme Court thought that was crazy (I’m guessing that the other Democrat on the Court, Justice Breyer, agreed with Justices Sotomayor, Ginsburg and Kagan, but this isn’t the kind of issue that requires the whole Court to express an opinion. Maybe he was out of town or so fed up with some of his colleagues that he’s thinking of giving up the law.)

As government forms go, Form 700 is simplicity itself. Here are its key features:

This form is to be used to certify that the health coverage established or maintained or arranged by the organization listed below qualifies for an accommodation with respect to the federal requirement to cover certain contraceptive services without cost sharing…

[Enter name of objecting organization, individual authorized to make this certification, name and address, etc.]

I certify that, on account of religious objections, the organization opposes providing coverage for some or all of any contraceptive services that would otherwise be required to be covered; the organization is organized and operates as a nonprofit entity; and the organization holds itself out as a religious organization.

[Signature and date.]

The organization or its plan must provide a copy of this certification to the plan’s health insurance issuer (for insured health plans) or a third party administrator (for self-insured health plans) in order for the plan to be accommodated with respect to the contraceptive coverage requirement.

That’s basically it. The form doesn’t even ask for the name and address of the health insurance issuer/administrator, something I certainly would have included if I were the senior bureaucrat responsible for EBSA Form 700.

I think Wheaton objected to this form because they didn’t want to send a copy to their health insurance issuer or third party administrator. Apparently, they thought that doing so would amount to being too cooperative with the government in its anti-Christian effort to make sure health insurance covers contraception. Justice Sotomayor argued in her dissent that forcing the government to identify the issuer/administrator and then send them a copy would be wasting the government’s time, especially if such religious exemptions become common.

Her main point, however, was that it’s the Court’s job to determine whether a law is too burdensome on somebody, not simply take their word for it, as the majority on the Court did here. But the activist Republican judges on the Supreme Court are clearly making this stuff up as they go along.

The burdensome (?) and anti-Christian (?) EBSA Form 700 is available here.

The Court’s brief ruling and Justice Sotomayor’s lengthy dissent is here.