Wednesday, April 24, 2013

Medicine on the Decline Story

Here is another story about medicine on the decline from a friend who read my blog

I was taking a small dose of medication for my thyroid prescribed by a doctor down here in Texas.  When I moved to NH the medication ran out and nobody will give a prescription without seeing you.  So I went to my annual physical with an internal medicine specialist ($) since the concern was about a thyroid growth.  Well, I also had a small bump on my skin and the internal medicine specialist thought it looked like a cyst but I would need to see a dermatologist.  She also recommended I have another ultrasound and see a thyroid specialist.  So, I schedule the ultrasound at the local hospital ($$), then went to the thyroid specialist ($$$) to get the results.  After about 10min with the Dr. he told me the ultrasound didn't show the growth and it was up to me if I wanted to continue taking the medication or not.  From what I remember, this was about $300 for that conversation... and as you pointed out, that could have been communicated over the phone for free.

Next was the dermatologist.  He confirmed it was a cyst and asked if it hurt or anything.  I said no, and he asked if I wanted it removed.  Again, I said no, I was fine with it, just wanted to make sure it wasn't something serious.  He told me to just let him know if I wanted it removed in the future.  About a year later, it had grown some more so I called to make an appointment with the same dermatologist and told the receptionist or nurse that I wanted to come in to have a cyst removed and he had seen me before.  Keep in mind I'm missing work for all of these appointments.  So, my appointment day comes, I see the doc, and he takes a look and says, "well, I can't do that here, you need to see a surgeon for that but I can recommend one."  Apparently, he can remove topical moles and such but not something under the skin.  He also goes on to tell me it won't be covered by insurance because it is considered elective.  As you can imaging, I wasn't too pleased with any of it and decided I could live with the cyst even longer.  Finally, I get the bill for about $250.  That kinda put me over the edge so I called billing and told them the story.  Why would they schedule me again if they couldn't remove it in the first place?  They finally cancelled the charge.
It just seems to me we have lost common courtesy.  It's all about the money and herding people through like cattle.  I think the real problem is more about the lawsuits than the doctors themselves.  If I try to look from their viewpoint, the internal medicine specialist doesn't want to say it is a cyst because it could be something else like cancer and then she gets sued.  So to be safe, send the patient to a specialist.  Same with the ultrasound and thyroid... no use taking a chance on that one.  Need to order the test to CYA.  What if a doctor did call or have a nurse call on their behalf to give a patient results?  No real way to confirm the patient received the information... another lawsuit waiting to happen if something goes wrong.

Transport that same childhood doctor and have him practicing today I would be willing to bet he would have sent you to a specialist.  The general practitioner would be sued if you had died but it he sent you to a specialist and maybe you died before you could even get an appointment (which could easily happen under Obama care) or he couldn't figure it out and then you died, everyone did their job's.  But even then, with the lawyers, someone and everyone would probably still get sued.


  1. Great post, Patrick (both of them), and you are not alone in your anger. Just recently I had an experience that fits well with the theme of this post. To make a long story short, I spent 2 ½ hours in urgent care, out of which time I saw a doctor for perhaps all of 5 minutes. I think the bill was about $275, including $100 for an x-ray that I didn’t really need and shouldn’t have consented to. I had to pay that out of pocket because our deductible is $3,000. I wasn’t given any clear diagnosis and the problem still comes and goes.

    As an engineer, you know that if you were presented with a problem, your job was to figure it out. Same for me as a bank analyst. We’d be fired if we continually shrugged our shoulders and said, “I don’t know. Try this or that.” But doctors today take the attitude that if they don’t immediately recognize what’s wrong with you, they aren’t going to invest even one additional minute to figure it out. It’s rare that they say, “Let me go check this out,” or “Let me go discuss with a colleague.”

    Our system has been ruined. One of the reasons doctors don’t invest the time is because they don’t have to in order to get paid. There’s no competition because they’re pretty much all the same.

    1. I am hearing these types of stories from just about everyone I talk to. If you live long enough you will have some medical issues and everyone seems to have their horror story. It is concerning.

  2. Just FYI, CW and PT, my experiences are entirely different. My main doc (internist) and I communicate between semi-annual visits via a secure portal w/ Q&A. Had him refer me to a neurologist. Went yesterday for nerve testing in my legs, then met with the neurologist who accessed anything germane from my internist along with an MRI from an outside lab from 7 months ago, performed retests of the leg nerves along with spinal. Walked out 2 hours later with diagnosis, prognosis, and exercise prescription, fully expecting steady improvement. Got blood drawn upstairs just to check and dot i's and cross t's, and paid %50 copay. Seamless. Incredible competence. Both spend whatever time I need.