Reasonable-ation?

[susandennis]

I put this into an envelope, stamped it and put it into a mail box that was scheduled to get picked up at 11 this morning.

-----------------------------------------

Dear Dr. xxxxxxx,

I appreciate your kind and sharing attitude and your respect of my health decisions. But, I am so very frustrated trying to communicate with you and your office. I’d like to share with you what it’s like from my end.

When I was in your office last, I told you that the Lisinopril was making me cough. You said that if I wanted to try something else, to call you.

On Monday, September 25, at 9:30 a.m. I did. I explained to Marci that the cough it caused was not something I wanted to live with and so I stopped taking the Lisinopril. I said that I’d like to try something else. She said you were not in and would it be ok to wait until Tuesday and I said fine.

I waited all day on Tuesday and never heard anything. I called at 4:30 and learned that Marci had left and there were no instructions on my chart. But the person who answered the phone said Marci would call on Wednesday. I explained that I would only be available by cell phone and left my number.

I vigilantly kept my cell phone turned on and handy. But, I got no call. When I got home on Wednesday I found a voice mail on my land line that Marci wanted me to call. It was, after hours so I called Thursday morning.

I was told that it was actually you who wanted to speak to me but you were too busy so you would call. I explained that I would only be available by cell phone and I left my number. I heard nothing until...

When I got home on Friday evening there was a voice mail from you saying you had called at 4:30. I know you did not call my cell phone. I had it turned on in hopes of hearing from you.

So in spite of my efforts to the contrary, I will be at least a week without the medication that you think I need to keep my blood pressure in check.

This is not an isolated situation. I have not been a patient that long but it has been long enough for me to learn that when you tell me you will call, you don’t. When Marci tells me she will call, most of the time I have to call back several times over several days before she does.

I do not know what, if any, are the results from the pap smear you took on September 8.

I know you are busy and my health not in jeopardy but, being treated this way is not fun. It is frustrating and insulting and I am concerned about what would happen if I was suffering and really needed your help.

I wanted a doctor I could turn to when I needed one and I’m not sure I have that yet.

If you would care to call me, my land line number is xxx-xxxx and my cell phone number is xxx-xxxxx. If you cannot reach me please feel free to leave a detailed and complete message in either message center. I’d be delighted for you to use my email address susandennis @ gmail.com.

Leaving messages for me to call you is not working. Please either leave me instructions or complete information in a voice or email or just don’t bother.

If there is a different way to get your attention and/or for me to receive needed information about your instructions, please let me know.

Thank you,

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I worried about this all last week. I mailed the letter and now I'm stressing about whether or not I am just being petty.

I could have called back on Tuesday and kept calling until I got satisfaction. Ditto on Wednesday, Thursday and Friday. It seems a little rude. "I don't believe you are going to call me so I'm just going to harrass you instead." But, it probably would have gotten the job done.

I really am more insulted than worried about my health. I spent lordknows how many years with high blood pressure and no medicine at all. Now I'm still taking some (she had me on two different medications and I'm still taking the one) and probably am better off than not taking anything.

I'm not in peril and I'm not in pain. The only thing that hurts are my feelings.

On the other hand... Is it necessary to put up with this kind of crap? Is this acceptable behavior for doctors? I'm not being facetious here. I honestly do not know. I have not dealt with a doctor in 20 years. Maybe this is just part of the game. Lawyers bill by the hour and you should expect to pay that way. Maybe doctors just need to be harassed for communications and expecting anything more is just not reasonable.

I'm not wild about having to find another doctor. It would be easier on one hand to accept that I am just being silly and I need to get used to this because it is the way things are. Probably, this letter insults her enough that I don't have a choice. Crap.

Comments

[fj.livejournal.com]

Is it necessary to put up with this kind of crap?

No. The clinician works for you to help you maintain your health. Not the other way around.

[pheon.livejournal.com]

No, this is not acceptable behavior. Something is severely out of whack with that office.

[kyrielle]

No, it is not necessary to put up with this crap and it is not appropriate. If they are incapable of returning calls then instead of saying they will call you, they should say, "Please call back on Wednesday between 9 and 3 to check on that." (Substituting as appropriate for 9 and 3.) And even that is stretching it.

This is NOT part of the game. It is rude and inconsiderate at best, and possibly risky at worst (depending on whether more serious issues are also treated similarly).

Wait and see. Maybe the issue is Marci, who has made all the promises. If so, and if the doctor takes this as a wakeup call, Marci may find herself replaced. If the doctor is insulted, bothered, upset, curt with you, OR if the crappy handling of callbacks continue...go find another doctor. This is not the way things are and you shouldn't have to get used to it.

I hate to think what it might do to someone who was forgetful - or who was very worried/stressed about their health (whether it was merited or not).

[kitashla.livejournal.com]

Agreed. I mean, the only doctor I ever see is my OBGYN, but it's a pretty large practice with tons of patients and most of them on medicaid.

They have always called me back in the time period they have given me and have called me back at whatever number I needed them to reach me at. I've never been on hold for longer than 15 minutes at the most.

Now as for how long I have to wait when I go down there...that's a different story. It's not unheard of for me to spend 2 hours there for a routine prenatal check up. (Which involves being weighed, having my blood pressure taken, measuring my stomach and listening to the baby. Not exactly in depth work.)

[katbyte.livejournal.com]

I believe your letter was justified, and you covered all the points. You are right.

sounds right to me ...

[henare.livejournal.com]

... but i think there are plenty of doctors who are just out of touch with their office staff and with their patients. i'd put up with this sort of thing for a while with my doctor ... and then i wrote a letter like you did and now the only problem i have with my doctor is that he's never on time for office visits ... by a lot.

and the find another doctor thing sucks in its own special way (particularly since i've been seeing my current doctor for something like 15 years).

[davmoo.livejournal.com]

I have a VERY low tolerence for that kind of crap too. It comes from having a country doctor, when I was growing up, who felt that it was only necessary to tell the patient the bare minimum the doctor felt like telling. And if the patient was under 18, the doctor said even less. It was for this reason that after I turned 18, I didn't even bother to visit a doctor again until I was in my late 30s, and then it was only because I developed a large cyst on my back and had no other choice.

The first time I saw my current doctor, I probably scared the hell out of her. She was rather new, and I was her only male patient over the age of 15 (apparently, at least in this area, most males want male doctors...I'm just the opposite, and what I described above about my first doctor is 99 percent of the reason why). Before she even began her examination, I very directly gave her a 15 minute "I'm paying your bill, not an insurance company, and this is what I expect in return, or I'll find someone else" speech.

A couple of years ago, after she had been my doc for 4 years, I informed her of a set of new requirements...she's not allowed to die, move, change her practice to a specialty, or retire before I die :-)

[seattlejo.livejournal.com]

If it was not your doctor, but another business would you hesitate?
I think sending the letter is the right thing. You were so open and honest with her, and forthright with your concerns about even visiting the doctor that this behavior is just inexcusable.

[qnetter]

This is the opposite of my experience with the Polyclinic, with either primary physicians or specialists.

I'd suggest that if you don't get satisfaction you contact either Dr. Chris Pepin or Dr. Emily Transue there.

[susandennis]

Thank you! It is very hopeful to hear that about other doctors at the Polyclinic. I now have these two plus one other there (originally recommended to me as someone who's practice centers around older women). I remembered this latter recommendation last night and dug out the name. I am feeling very very less stressed about it all. Either this situation will get fixed or I'll get a new situation!

[melodysk.livejournal.com]

What a wonderful letter.

You are clear in your explainations without being rude. Under the circumstance I think that I would have been far more abrupt!

She has a duty of care and she is failing in it, you are correct in thinking that she should stick to what she says

Bravo!

my 1.5 cents

[bemocked.livejournal.com]

there are doctors who operate differently out there... most of them I have dealt with actually.

I strongly believe that it is important to have a personal "relationship" or at least acquaintace with a doctor when all is well, so you are beyond the basic "hi nice to meet you" stage if there ever is an emergency. I think you should try another doctor, personally.

I know it is a hassle to no re-invest in a few introductory visits and such again - but I think it will be worth it?

[zusannesuzanne.livejournal.com]

The ONLY defense for the doctor is that none of them will leave you personal health information on an answering machine due to HIPAA privacy laws. It doesn't seem to matter that you are the only one that listens to that machine, etc etc... they need to speak with you directly. My doctor doesn't seem to have a problem calling my cell phone however. I agree that most of their actions are inexcusable.

[susandennis]

Good point ... Except that I had to fill out and sign 3 different HIPAA forms - one general and one for each phone. On each I explicitly checked all boxes that gave them persmissions to leave detailed information on voice mail, email and/or with anyone who answered the phone.

[i-count-crows.livejournal.com]

If you fill out that form indicating permission, doctors can leave explicit information at the numbers indicated. I get such messages regularly. If I didn't, I'd be up a creek with my docs, as I do need to communicate with them regularly, and our schedules don't always jibe, so trading messages is sometimes the only way. They are allowed to be detailed if you sign permission.

And I'd have sent a copy of your letter to the managing clinician at the office as well as to the business office. You'd get results right fast that way, if only because the business office gets, even if no one else does, that an unhappy patient is one who leaves, and a patient who leaves generates no revenue.

[susandennis]

My game plan is that no response or an unsatisfactory response will trigger a copy of the letter to the Clinic management. I'll use it for the 'please help me find another, better, doctor who is just as nice as but runs a more efficient office as this one' note.

[jimcarson.livejournal.com]

Great letter. (You rock!)

Yeah, I've had callbacks on my cell phone, even a message; though the message was "This is Doctor Whitecoat calling for (me). Please call me back at (number)." And he picked up.

[joyoflj.livejournal.com]

Bravo! I have done similar in past only I worked at a hospital, saw the doctor in the hallway and let him know. And it got straightened out FAST.

It is your right to expect decent care and call-backs.

I would of changed docs and sent the letter as part of my please send all records over to so and so's office.

Remember my crazy dentist? Well he tried to bill me for that last time when I walked out and the visit before when the police were there. He sent me a letter threatening to go to a collection agency. Well after the letter I sent him he dropped the matter. Probably wrote DIFFICULT next to my name but so what.

Health care is a business and like any business they ought to treat customers in the manner in which you expect.

[jwg.livejournal.com]

Your letter is fine, and the behavior of the office to your request is unacceptable. It shouldn't take more than 24 hours to respond and they should pay attention to you request to call the cell phone number

It will be interesting to see if you get a response from the doctor; if not, perhaps someone in the office (Marci?) might have processed the letter.

Is there a doctor in charge of this practice that you could contact if you don't hear from them on Monday?

[susandennis]

Yes, it did occur to me that she might not get the letter. I addressed the envelope by hand so that it could not be mistaken for a business letter. But, we shall see. I'm expecting to hear from her Monday since her Friday afternoon call said she would call back then. I will give her a few days/instances to respond to the concerns addressed in the letter.

If no response, then... yes, I will go back to the Clinic person who referred me to her in the first place (customer service) and I will share my experience there in terms of 'you might want to reconsider recommending this doctor to others and here's why...'

We shall see....

My husband takes enalapril for high BP

[vixter.livejournal.com]

and it works great and doesn't give him a cough. And it's supposed to be good for his liver. And comes in a generic, too.

I agree with the others that you are getting lousy service and they are lucky be getting a warning letter.

[keelamonster.livejournal.com]

Everyone up there has all said a lot of the things I wanted to say: it's not acceptable and find another doctor, but on behalf of the doctor, I'd actually like to applaud your letter.

I have a lot of patients who have migrated to my clinic from other clinics. Their number one complaint? I can't get an appointment over there for a couple of weeks. So they love the docs there, but they can't get in and they can't get their calls returned so they come to me.

Now, I'm not gleeful that my colleagues are losing business, I am, however, happy to accomodate patients who feel like their other physicians are missing something for them. I tell them, though, to just drop a letter in the mail to their previous docs and say why they're leaving. It helps the doc to understand what went wrong. Now some people are busy enough that they just don't care. But people who have a bad experience somewhere are likely to tell at least 10 more people. If they have a good experience? They tend to tell 3 others. Bad word of mouth is expensive.

Also, though, from your point of view, you don't owe the doctora thing. Even if you'd been seeing her for 50 years, you don't owe her anything. If a mechanic screwed up your car, you wouldn't go back. If a vet took your cats and then never called you back to let you know to pick them up or similar, you'd find another vet. So treat your health with the same respect. And expect the doctor to respect your time. There are things we can't control and there are things we can. But doing what we say we'll do when we say we'll do it is a responsibility we all have, your doctor included.

[susandennis]

Thank you so much. I'm always very careful not to presume to know someone's business model when I don't and my very limited experience with the whole medical thing leaves me a bit mystified a lot of the time but, I'm beginning to 'get' it. What you say makes a world of sense and I'm delighted to know that I can apply the rules I do know and understand to much of the medical stuff.

[dizzdvl.livejournal.com]

Doctors are on doctor time. Is your doctor in a clinic or in a private office? If the doc is in a clinic see if there is a Nurse Practitioner you can see. They tend to be more patient friendly and spend more time with you. (And my mom and sister are NPs, so I am biased, but I almost see NPs exclusively.)

Marcy seems like an idiot MOA (medical office assistant.) I worked with enough of them to know that quite a few are true turnips. If she is a nurse well she is just one that needs to take better note.

I think you should investigate finding a new doc or finding a nurse practitioner. That is depending on what you hear back from your doctor. If she is apologetic and has valid explanations you might give her a chance. Or not. I used to work in a clinic (the same one mom and sis work(ed) at) and it pisses me off to NO END when I don't get promt service. I loathe waiting. But I have learned that the doctors overload themselves with patients because of the allmighty dollar. And I have found docs I like, so I wait.

Sorry that you finally went to the doc and you had this sucktastic experience. I hope you don't give up on finding one you like. They are out there.

[dizzdvl.livejournal.com]

Oh yeah, and I asked my sister and she said there is a high blood pressure medicine that makes people cough. She also said there are lots of other ones that don't make you cough.