Having enjoyed the tender mercies of military medicine as a child and the early days of HMOs as a young professional, I should be long past being surprised by the behavior of anyone working in what we jokingly refer to as health “care” in this country.
Still, even I can be taken aback from time to time. This morning, for example.
Our neighborhood doctor’s office was absorbed by a corporate entity a while back, and since has undergone the usual transformation, acquiring a “Brazil”-style voice-mail system, a shitload of attitude and a mania for following orders, as long as they don’t come from a patient.
For the purposes of our tale you should know that I’m a lifelong asthmatic, diagnosed around age 8 in Texas. And I like to hit the old albuterol inhaler a time or two before exercise, the way you might squirt a bit of ether into an old carburetor before firing up your ’54 Chevy. Last year, while getting a bum knee examined, I mentioned that I’d had trouble getting an albuterol prescription refilled and the doc grumbled, “We have to test for that, and I don’t have time today.”
Test for that? I’m only been asthmatic since 1962. The Air Force sawbones who diagnosed me is presently pushing up the daisies that are making me wheeze. “No, time, no time,” he said, scurrying off like a roach on a griddle.
Next time I saw him, concerning a tenacious case of Snotlocker Surprise, he had the time. “Wow, you really do have asthma,” he remarked, and wrote the ’script. No shit, Doctor Fuckin’ Welby. I examine the package upon pickup: One inhaler, “no refills, dr. auth. required.” Fuck me. Well, what the hell, I only use it before all the bike riding I’m not doing anyway.
Last week I noticed I was about two weeks away from running out of the stuff in one of the worst allergy seasons in recent memory and rang up the doc’s office to get a refill. Ha, ha, etc. The robot says doc doesn’t do that any more — patients are to phone the pharmacy’s robot, which will in turn ring up the doc’s robot, which will tip off the doc, who will OK the refill, whereupon the doc’s robot will give a thumb’s up to the pharmacy’s robot, which will call you when your prescription is ready for pickup.
None of this ever happens, of course, and my follow-up phone calls to both doc and pharmacy prove unproductive, like a bad cough.
So I pop round to the doc’s office, and that’s when it all goes pear-shaped.
The receptionist wears the expression of a intake officer at the county lockup. “Name! First name! Date of birth! When were you last here! Who did you see!” So right off we’re already enjoying each other’s company. I’m expecting the back room and the bullet-nosed flashlight at any moment.
And it got worse. The doc I saw was apparently not the one who wrote the ’script. That person works in another office. The robot spoke to her. She did not reply. Nevertheless, you were telephoned and informed that you must be seen before any drugs will be issued to you. You must see, you vill see Ze Doktor!
Um, no, Brunhilde. I couldn’t pick this ’script-writing phantom of whom you speak out of a lineup at gunpoint. I saw the dude, not her. Nobody ever called me or my wife — not him, her, or anyone else, including your robot. And no, I don’t need to be “seen,” what I need is some albuterol.
About this time someone in scrubs inserts her long and snoopy proboscis, like Brunhilde blessedly bereft of any glimmer of knowledge about the situation, and confirms that ja, ja, I must, I vill see Ze Doktor! Ve are only following orders! At no point, mind you, has either of these “health-care providers” apologized for inconveniencing a customer. I say “customer” rather than “patient,” because neither had either inquired about my actual health.
“Can you breathe? Sir, are you having an asthma attack? Your face seems to be swelling ominously and turning a fiery red. …”
And at that point I may have inquired whether my getting a simple prescription refill without physician intervention might free up Scrubby’s time for treating an actual sick person in dire need of her mad skillz, and she may have suggested that I seek my medical care elsewhere henceforth, and I may have praised her for providing the first sound medical advice I’d ever received from her organization, and proclaimed that I intended to take it straight away, while adding that under new ownership what once was a friendly neighborhood doctor’s office had become as penetrable as North Korea with the sort of customer service one expects from a pimply teenage malcontent stocking shelves at a K mart scheduled for closure and demolition.
Take a deep breath, you say? I got 17 more of ’em left in this inhaler.
Tags: albuterol, Health care, robots, Snotlocker Surprise™
May 7, 2014 at 1:55 pm |
Yeah, there’s something seriously f#cked up in this World. I can’t decide whether it’s one of those things where you just get grumpier as you get older or whether the jobsworths really have taken over the asylum. But there definitely seems to be a lack of initiative with everything now a form-filling, by the numbers, box ticking exercise in futility.
And I’ve noticed a new trick up their sleeve: they immediately play the ‘abusive customer’ card. One, speaking to someone sternly when they are failing to perform their function is *not* abuse and two, if you think this is abuse you really should get out more.
Anyway, keep breathing in and breathing out.
May 7, 2014 at 5:41 pm |
The audacity of it all was what set me off. Not so much as a “whoops, we screwed the pooch here, sorry ’bout that.” As though I were to blame for their execrable service. A bike shop that gave that sort of attitude to its customers wouldn’t stay in business long.
But a guy doesn’t have to have a bike. He does have to have health care.
Reminds me of the old Lily Tomlin bit: “We don’t care. We don’t have to. We’re the phone company.”
May 7, 2014 at 2:13 pm |
Meanwhile, you can’t watch 60 minutes, Mr. Rogers, or Celebrity Cook-off without getting a Viagra commercial in-your-face. And Viagra.com will fill out all the paperwork for you, find your nearest pharmacy, even deliver it straight to your house, presumably by a female FedEx driver wearing a French maid outfit.
May 7, 2014 at 5:42 pm |
I’m old enough to remember when it was them little white pills that kept your eyes open wide.
May 7, 2014 at 2:47 pm |
I would like to breathe but can’t seem to catch a breath between guffaws! Reminds me of some of the best rant blasts from the past. And that look would turn someone into a smoking hot pillar of salt.
I go to a private practice that has a doctor, a nurse practitioner, and a physician’s assistant, along with nurses. They assembly line you, and the last one you see depends on what you are there for. Refills are normally handled by the PA, who you see for most things. Neat system, similar to a dentist’s office, and the PA has much smaller fingers for the annual bend over exam. Doesn’t bother her or me.
May 7, 2014 at 5:45 pm |
I used to have a great MD. Gruff old dude, bike rider. I’d tell him, “This hurts,” he’d say, “Well, don’t do that.” Complained about my crooked left thumb once; he said, “That’s arthritis, Patrick — it doesn’t get any better.”
Rode the bike to a followup appointment a few weeks after a collarbone fracture, and he just rolls his eyes. “How old are you again, Patrick?” he asks. “Do you really need to be doing this?” And then explains how broken bones annoyed by boneheads never grow back together.
Dude never, ever, gave me any shit about an albuterol ’script. Ever. He retired, alas.
May 7, 2014 at 8:12 pm |
Yep, had one like that too. I miss that one on one, never rushed, relationship. When BC/BS dropped him, I had to move on. One of the last times I saw him, he decided he wanted to take my Bike E for a spin around the parking lot. I warned him it needed a light touch, and it gave him a scare but he didn’t go down.
May 7, 2014 at 2:54 pm |
There is very little ‘healthcare’ in this USA. Mostly we citizens feed bigpharma/medinsurance/bureaucrats, rather than using our $$ to restore our wellbeing and vitality. Go over the line to Mx to purchase inhalers/meds at a decent price. For right now, will mail a spare albut. if you email me: youngatart1 (Oregon)
May 7, 2014 at 5:51 pm |
Thanks, Karen. I may take you up on that generous offer. Happily, asthma in my dotage, in Colorado, isn’t nearly as bad as it was when I was a punk in Texas, where I was sick half the year with upper respiratory bugs of one stripe or another.
May 7, 2014 at 3:20 pm |
Hey Steve O a “female FedEx driver wearing a French maid outfit.”
Doesn’t sound to bad to me.
May 7, 2014 at 6:13 pm |
Just don’t send round no male FedEx drivers wearing no French maid’s outfits. Not in Bibleburg, nosirree. We want ’em in American maid’s outfits or nothin’ at all.
May 7, 2014 at 4:22 pm |
I used to be the IT director at a FQHC (look it up). We got federal and state grants for all kinds of shit, mostly, as I later discovered, to pad the bottom line of the business. We had good Docs (mostly), but these operations attract plenty of those who need to be in some other line of work.
Long story short – the Managing Director of the clinic had hired her two sons, her sons wives, and her sister. Most of “worked from home” on “special projects”. One son had a company vehicle, and the boss had an “allowance for personal vehicle use” on top of mileage reimbursement.
The corporate accountants and I attempted to stage a coup and failed. I quit before I was fired and got another job. Some of my employees were fired. Six years later, another coup was successful, but the boss now commutes from the east coast to Kansas weekly as a consultant.
Ther is little justice in this world.
May 7, 2014 at 5:54 pm |
That sounds like fun. About like working for the Corleones. Or maybe Kid Sally Palumbo.
Thing is, the top doc in this shop has a stellar rep. People sing her praises. But damn, I’ve had nothing but trouble with her minions. Could be she’s a top-notch sawbones and a shite manager. Well, she’s short one patient as of today.
May 7, 2014 at 8:06 pm |
Word, Patrick. I keep the Albuterol inhaler in my pannier this time of year. Yesterday I ran into another Old Fart who was commuting home from the BombFactory and we raced each other across town. Got home wheezing like the bad asthmatic that I am.
Was close to shutting down a few times back on Long Island to the point where I was lying on the side of the road wondering if last rites were appropriate.
Brazil is an excellent analogy. My bike racing orthopaedic sawbones in Honolulu and my uncle, an internal medicine M.D. in Buffalo, both were turned into cynics by the new rules of the medical profession, whereby bureaucrats, insurance corporate fuckwads, and government shitheads run the show. Kent Davenport, who used to fix what I blew up when I was doing finish line sprints with the Lanterne Rouge as a USCF fuckup, went back and got an MBA because he told me without one, he could not stay in business. My uncle just quit and retired, which he could do on his more than ample life savings.
It really does suck.
May 8, 2014 at 8:01 am |
Try getting a follow up about your kidney cancer surgery!
May 8, 2014 at 8:09 am |
Late December I sat in an emergi-care facility (prison) for 4 hours with H1N1. Meanwhile the junkie who was having anxiety from too much powder was wisked right in. “Do you have any form of payment? Well no I don’t. Come on in while our paying folk sit for hours.” No wonder I had a 103 fever and high blood pressure. I ran out of cell phone battery posting updates to FB.
May 8, 2014 at 8:47 am |
Very worrisome to be without an inhaler. I have asthma, too. It is scary that there is no generic inhaler available. It took me years to get diagnosed as an adult. Shocking, really. Finally, a NP with a special professional interest in asthma diagnosed me. Good luck getting help now. Long term, I wonder if you should go to a pulmonologist – that would solve the unwarranted skepticism and hard time you are receiving.