ARRRGGGGGHHHHHHH!!! HMO's SUCK!!!

[BKcrazy]

They will pay for a higher dosage amount of medication because they are thinking you will split the pills up to a smaller dose to take. That happens a lot these days. I dealtt with that when I was verifying benefits for patients.

And that's a lot of money to pay for health insurance. I was self insured up til about March 2005, and I was paying about $370 a month and I had to pay a $30 copay every time I saw the doc. My scripts were $15. It was cheaper to go to Walmart and fill them without insurance.

[Minnymouth]

Don't misunderstand me, I don't feel this way about a lot of people in the medical field. I have friends who are doctors, nurses, scientific specialists, and ambulance personnel.

Many are very dedicated people. Without them our society would be loosing a lot of very well educated, caring, compassionate individuals. And many do put their jobs above their own families.

These people I do admire and respect...... I had one doctor that even called me at home to see how I was feeling. Now, That blew my mind.

Its the ones that are "move em in, move em out", make that almighty dollar ones that irritate me to no end. The ones that don't want you to see a specialist.... it takes money out of their pocket.

Sorry if I offended the many nurses and specialists who contribute on the forum.

That was not my intention.

I just feel that our medical system needs to be revamped, affordable to everyone, so that NO ONE goes without the care they need because they can't afford it. Money should not be an issue in determining whether someone lives or dies. Not in our day, time and society. Medical care should not be decided by how much money we can pay..... or whether we have insurance or not....

[Bandit]

But most medical professionals care. They send people to specialists and for additional tests. One because they can. Doesn't eveyon want to play with the newest toys and technology. It it a good reason? No, but it is one reason. Another reason you now get sent for more tests and referals is because everyone wants to cover their butts. If they don't be extra cautious and do everything possible to diagnose and treat you they worry that they can be sued and so they cover their butts by ordering every test imaginable and by refering people to specialists. And the last reason is simply that medicine has changed. In the last 50 years there have been unimaginable scientific advances. We now have better antiboidics, better pain meds, better treatment options and bettter diagnostic options then ever before. However, with all those improvements there has been a cost. Our care is better but it does lack the personal touch. Basically, because anymore one doctor can't know it all. There is too much to know. Just to keep up with new advances a doctor would have to read over 100 journal articles every day. They do the best they can.

Then why do they charge 2 to 3 times of what it really cost when they send the bill to insurance? My Dr. told me exactly what a lot of them are doing...The 20 minute office visit only cost 30.00 but they send it to insurance costing 90.00. I know this for a fact because my Dr. charges 90.00 a visit to people with insurance but if you have no insurance she is fair & only charges people with no insurance 30.00. Most doctors do NOT deal that way but I happened to find one who is a little more fair.
The girl in billing told me, "We are fair here and everyone pays the same amount with or without insurance." IOW- what it really costs is what you pay out of pocket and you know the physicians are still making excellent money for the career they choose.

I also know that Dr.s know how to do everything because I asked enough questions to find out what they know, but they do not want to do it so we end up marching around town & it depends on where you get the splinter is where you go for the Doctor. They know how to do it but they don't want to do it. Yes there is a network and every doctor knows every other doctor in town. That is fine but the network is itself is the problem not the Doctors field.

The hospital charged me $24,000 for one night! Then the woman in billing told me that if I pay 1000.00 a month I will get a 33% discount for self pay. She said it was high like that because it would all be charged to the insurance company!!! Then all of the sudden 6 months later they are giving me all these deductions that the insurance would have paid for. BECAUSE IT DID NOT REALLY COST THAT MUCH TO BEGIN WITH.

I went to 5 different specialtists for my teeth and I know everyone of them knew how to do it all. I was going to them long enough to ask enough questions to put it all together. Yes they care, I will agree with & second opinions are a good thing but half of them are scamming the system. You don't become a lawyer or Dr. just because you care- you also do it because it pays very well- and they should be paid well, but not robbing us.
Sorry, but it does not cost 450.00 to pull a tooth in a 15 minute office visit!

This is one reason why we do not have affordable health care/insurance in this country & this is what we are complaining about- not the profession itself. We would all be very lost without them. But after you do the running for a very long time without a dime of insurance to hide under you start to see what is happening.
I may be a very stupid man but I am not that stupid- it does not cost 350.00 for a pair of wire cutters either! At the most it might run about 5.00 including having it sterile & they could sell it for 100.00 and still make good money.
A pill in the USA costs 20.00 & you get the same exact pill from Canada for 3.00.

But it does not end with just that, these companies making the tools they need are also charging more than they should be so my Dentist goes to the Ace hardware store & gets certain things he needs for 95% less & it is the same exact tool.

aND THEN AT THE VERY BOTTOM OF IT ALL- the docotors make you sign a legal contract saying: if we make a mistake and mess you up for life we are not responsible!

[JollyGG]

Minny - you have mentioned issues with this Dr. before. What is stopping you from finding a different doctor?
I really do belive that most doctors are doing their best to help their patients the best way they know how. However, sometimes a doctor is just not the right fit for a person. It sounds like this doctor isn't the one for you. You need a doctor that you are comforatable and confident in. You need to be able to discuss issues with them and know that they have heard you and at least tried to understand. If you don't have that relationship with your primary care physician mabey it is time to start looking for another one.

Different patients have different physician needs. I personally am very scientific. I ask alot of questions and want pretty techical answers. I know what I want and need a doctor who is already aware of my background and knowledge so they can work with me to either 1. help me understand why they don't agree with me (usually with scientific tests and literature) or 2. help me get what I want in care for myself or my family.

It sounds like you need a doctor who is more hands off in the tests and meds and is quick with explinations and information. Have you thought about an DO instead of an MD. Both are licensed physicians who practice very much the same ways. However, a DOs education focuses more on treating the causes of symptoms rather than the symptoms themselves and their education is really more focused on preventative medicine and holistic medicine.

[Minnymouth]

Jolly G,
The doctor that I have now is the best out of 4 that I have found in the last 15 years. 3 of them were men, this is a lady doctor. She takes the time to listen, asks if I have any questions, explains her reasons for everything. And yes, I do ask questions. I am an "need to know" person..... I want to know what it is, what is consist of, and what future effects it has concerning diagnosis and meds.

Really I'm quite pleased with her though she's just a basic MD. She even notices if she sees me too often for my allergies. She is the one that called me at home and blew my mind. She made it perfectly clear that if I had trouble with my asthma or allergies to call in and if she couldn't work me in, she would call in meds for me. Most of the doctors here won't do that. They want that office call.

Like I said, its those doctors that don't care about their patients, and its evident are the ones that irritate me the most. They are all about the money.......

And this lady doctor isn't cheap either.... $75.00 an office call...
But she is caring, compassionate, evaluates what the problem is and the best course of treatment to get it under control and eliminate it.

She was a life saver during my bankruptcy, and if she gets a call that I have an emergency with my asthma she says "bring her now!!"

So I'm pretty well pleased with her.......

She listens, shows concern, and keeps up with what she's doing regarding your care. She doesn't look at you like "who are you?"

Like I said, some doctors are just looking at $$$$ when they see you, and that's all they see.

[Bandit]

She listens, shows concern, and keeps up with what she's doing regarding your care. She doesn't look at you like "who are you?"

Like I said, some doctors are just looking at $$$$ when they see you, and that's all they see.

That is right. Some care about the person and some care only about the $$$$. I tell you my dentist, I would travel 3,000 miles for every visit.

BUt the idiot guy who chopped my face up would not listen to a single word I had to say. One day he SHOVED about 40 needles into my gums & I screamed through the whole thing because he would not listen when I yelled over & over, 'It hurts.'. In fact he laughed and said, "it doesn't hurt."

Now my regular dentist could do the same exact job with the 40 needles and I would have barely felt any pain.

Some care & listen & some do not care & they don't listen to you. Any caring & honest Doctor will also admit that.

It is like any other job, some care, some don't.

[Cassiopeia]

Here's a little humor for this thread:

MEDICAL INSURANCE EXPLAINED

(Research done by the AARP Legal Department)


Q . What does HMO stand for?

A. This is actually a variation of the phrase, "HEY MOE." Its roots go back to a concept pioneered by Moe of the Three Stooges, who discovered that a patient could be made to forget the pain in his foot if he was poked hard enough in the eye.

Q . I just joined an HMO. How difficult will it be to choose the doctor I want?

A. Just slightly more difficult than choosing your parents. Your insurer will provide you with a book listing all the doctors in the plan. The doctors basically fall into two categories: those who are no longer accepting new patients, and those who will see you but are no longer participating in the plan. But don't worry, the remaining doctor who is still in the plan and accepting new patients has an office just a half-day's drive away and a diploma from a third world country.

Q. Do all diagnostic procedures require pre-certification?

A. No. Only those you need.

Q. Can I get coverage for my preexisting conditions?

A. Certainly, as long as they don't require any treatment.


Q. What happens if I want to try alternative forms of medicine?

A. You'll need to find alternative forms of payment.


Q . My pharmacy plan only covers generic drugs, but I need the name brand. I tried the generic medication, but it gave me a stomach ache. What should I do?

A. Poke yourself in the eye.


Q. What if I'm away from home and I get sick?

A . You really shouldn't do that.


Q. I think I need to see a specialist, but my doctor insists he can handle my problem. Can a general practitioner really perform a heart transplant right in his/her office?

A . Hard to say, but considering that all you're risking is the $20 co-payment, there's no harm in giving it a shot.


Q . Will health care be different in the next decade?

A. No, but if you call right now, you might get an appointment by then.

[Bandit]

Q . Will health care be different in the next decade?

A. No, but if you call right now, you might get an appointment by then.

I liked poke yourself in the eye, the best. BUt this one is literal factual. When a Dr. says it will take about 10 minutes that means you will be there at least an hour. If they say an hour you will be there for 5 hours. Thier idea of time is totally different than what it really is...I know this because I used to drive patients to see their Doctors and would need to know (how long)...well, it is just one of those areas of I dont care because I am not paying attention to the question or the time it really takes.

I do think there are some good ones though, who are in tune with the time and how long people have to be there for so they only schedule certain things that way on certain days.

I really was supposed to be in surgery for two hours. BUT! I was really in surgery for 9 hours.

[PaKettle]

Okay there has been lots of bashing of doctors and the medical profession in this thread. I agree our current medical system is broken. There are lots of options out there to fix it. No option is going to be perfect. I favor the "medicare for all" approach, but you know what they say about opinions and a**holes. However, I clearly see that every option has it's advantages and disadvantages.

But overall I don't think any doctor, nurse or medical professional goes into practice to make money and screw the public. Medical school and just plain being a doctor takes alot of hard work, time, continuing education, comitment. Doctor's do not go play gulf every afternoon dispite popular opinion. They work very hard and often sacrifice alot of family time to care for their patients. Are they looking to be well compensated for doing so? We heck yeah. I would be too. Are they conserned with covering their own butts so they don't get sued? Oh yeah.

But most medical professionals care. They send people to specialists and for additional tests. One because they can. Doesn't eveyon want to play with the newest toys and technology. It it a good reason? No, but it is one reason. Another reason you now get sent for more tests and referals is because everyone wants to cover their butts. If they don't be extra cautious and do everything possible to diagnose and treat you they worry that they can be sued and so they cover their butts by ordering every test imaginable and by refering people to specialists. And the last reason is simply that medicine has changed. In the last 50 years there have been unimaginable scientific advances. We now have better antiboidics, better pain meds, better treatment options and bettter diagnostic options then ever before. However, with all those improvements there has been a cost. Our care is better but it does lack the personal touch. Basically, because anymore one doctor can't know it all. There is too much to know. Just to keep up with new advances a doctor would have to read over 100 journal articles every day. They do the best they can.

I'm not here to bash doctors (though some I've encountered do warrant bashing, and if you ask I will be glad to share my experiences with you).

What I'm "bashing" is the System that we have, particularly the HMO system which is all some of us can afford. And while HMO's do vary in quality, for the most part, all of them are bad because they are out to make money for their corporation, not help the patients. Helping patients is secondary to making money for the stockholders. Period.

I agree that doctors work hard. Too hard. In many cases they are so backed up with too many patients that this is part of the reason we don't get good care. They are over-worked and actually many of them have had their pay go down under the HMO system. So I do see their side of it, too. Not to mention all the paperwork they have to do (or their office has to do).

So the problem is not the doctors themselves, as I see it, the problem is the HMO system and the lack of a Universal Health Care system in the U.S.. WE ARE THE ONLY WEALTHY INDUSTRIALIZED NATION WITHOUT A UNIVERSAL HEALTH CARE SYSTEM.

Look at the stats for our health care as compared to other industrialized countries. We are way down the list. We spend the most and have the least results for the buck. Even many developing countries have a longer life span and lower infant mortality rate than we do. It's a fact. Look it up on the net. This proves one thing for sure: We have a problem that needs to be fixed.

[Bandit]

They may not go golfing every day but they do spend six weeks a year in Aruba.

Of all the 10 doctors I saw this year their schedules were almost identical.
open 8 hours a day with one hour for lunch but only 4 days a week. Closed on one of the 5 work days.
open sat for 4 hours or every other saturday for 4 hours.
Closed sunday and all holidays. They even closed on election day, veterans day, presidents day....ROFL!

They all worked less hours than bankers do. The guy who did my surgery was pissed at me because I decided to wait until monday to have my surgery which he is usually off and wanted me to do it on a day he worked.

After he released me, my regular dentist tried to send me back to him for some other complications & I told him there is no way in hell I would ever go back to that Doctor.

You must be thinking of ER, Trauma & county hospitals because most of the Doctors I have ever had choose their own hours & do not put in extra hours.

[JollyGG]

Of all the 10 doctors I saw this year their schedules were almost identical.
open 8 hours a day with one hour for lunch but only 4 days a week. Closed on one of the 5 work days.
open sat for 4 hours or every other saturday for 4 hours.
Closed sunday and all holidays. They even closed on election day, veterans day, presidents day....ROFL!
.

Yes those probably are the office hours. Lets see most doctors I know are at the hospital at 6am to do rounds, order tests for the day. Then they work 8 hours in the office. Then if they were backed up during the day (which your way too long wait would indicate they probably were) they still have to do their dictations and charting. Then it's off to the hospital for any consults that were requested during the day. Plus see any paitents that were admitted during the day and deal with any issues that came up while they were in the office. Then it's time to do dictation and charting again and time to go home and hope than none of their patients take a turn for the worse during the night. Because if they do dr. gets awakened at 2 am to call new orders, tests, and meds into the nurse.

They are usually in office only four days a week because they work somewhere else the other day. They are often at an urgent care, or a satelite clinic (rural area or other underserved area), or at the hospital in meetings. Plus the days the office isn't open they spend several hours each day at the hospital doing rounds or at the very least answering messages from the hopital left with their answering service.

I'd want 6 weeks in Aruba after all that too. And, mabey I've always had good luck with doctors but no doctor that I have chosen as a family care physician has ever left me high and dry for vacation. When I was pregnant my doctor was very clear that she was going to be at her in-laws for Easter (I had my son four days after easter) but she introduced me to the doctor covering for her and made it clear that the in-laws place was only three hours drive away and if she could make it back in time for the deliver should I need her she would. She actually delivered my son on her day off (she was a family practice doc.). I called the clinic and they told me it was her day off. They called right back to say actually she was off for the day because she had meetings at the hospital all day and she had requested that I go directly there so she could check me. My current family doctor has three boys of his own just my kids ages and doesn't mind my rambunctious son in the least. He takes the two visits for stitches in the last six months in stride. But I kept looking until I found doctors that would give me the care I wanted.

Yes there are doctors who, don't care, who want to put in the minimal effort and care and get the most money out of it. But I don't know a single doctor who is in it soley for the money. Or at least none started out that way. If they wanted to spend 8 years in college and graduate with over 100k in student loan debt. A doctor could make way more money with an MBA, computers, engenering, or any number of other professions. Most are drawn to the carreer because they care.

I just think we need to keep our focus on the parts of our system that are broken, hospital beuacracy, understaffed hospitals, cost of health care, cost of insurance, stupid HMO rules. And work with our doctors to help them give us the best care possible. The only way to get quality care is to be a partner in your own health care. You can't be a productive partner if you always belive that your doctor is out to screw you. If you belive that find a different doctor. Because if he is trying to screw you or not it really doesn't matter because your healtcare partnership is not working.

We need to make our health care professionals (doctors, nurses, PAs, ect) responsible to us. If you have questions or concerns ask them, don't leave until you have things explained in a way that makes sense. If you don't doesn't answer your questions, respect your right to be an informed parner in your care, respect you, or make you feel comforatable with your care then find a new doctor.

Sorry this has gotten so long and that I seem to always be defending the doctors. It just annoys me when I see people getting less than the best care they should because they are busy blaming other instead of insisting on the care they deserve. I pay good money to stay in a hospital and to visit my doctor. I demand answers and respect. In return I respect the doctor and the demands placed on them. If I don't get what I want I keep looking until I get answers. I am actually only defending doctors a little bit, mostly I am trying to urge people to be active participants in their own care.

[Bandit]

Doctors are the highest paid of all jobs with exception of a couple.
BTW- a good caring, honest Dr., is harder to find than a good attorney. Meat on the rack-Parts on the Assembly line.

I am not going to tangle. I feel like I am at the Doctors office with one who does not listen and one who does not care....