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Re: How would you handle this?...I have an appointment for October 26th! Should I keep it?
From: Angela (anonymous@obgyn.net)
Sun, 18 Oct 1998 21:32:34 -0500 (CDT)
At Sun, 18 Oct 1998, D. Ashley Hill, M.D. wrote:
>
>While I obviously can't say how things have gone astray with your
>doctor, I can offer some ideas why the patient/doctor relationship might
>have have problems.
>You are a rare find and and even better, an up-front, honestly speaking doctor. In following the posts on any of the subjects you truely try to be very helpful and forthcoming with info, even unpopular subjects like this.
I thank you for the service you are doing, as lay people we don't always
know there is something wrong and may see our doctor/patient
relationship in a different light than the doctor does. I have always
felt honesty from both parties is best, and that means letting the other
know when there is a problem of any kind, and what is expected to fix
it.
I realize my opinion probably isn't worth much on this forum but I'll
bet the regulars feel the same way. Thanks again!
Angela
mostly that they tend to
>pay far less than what most doctors (and, believe it or not, many
>patients) feel is reasonable for their time, expertise, and effort.
>Plus, their documentation and billing rules are extremely stringent and
>difficult to comply with. Capitation, on the other hand, is a process
>where a third-party payer (HMO, PPO, etc) pays a doctor or group of
>doctors a set amount each month for all the patients enrolled. For
>example, doctor X might get 10 dollars a month for the 1000 patients
>enrolled in his plan. If they all stay healthy and don't need surgery,
>that doctor gets 10,000 dollars a month. Of course, if patients come to
>the office, need operations, or need tests, the money is taken out of
>that amount. Some doctors actually lose money this way. Thus, under
>capitated plans, it does get the doctor more money if he or she keeps
>the patients healthy (that's the incentive) but, in my opinion, it
>destroys the doctor/patient relationship because there is a subtle
>pressure on the doctor to not discuss the more expensive treatment
>options, such as surgery. The doctor has to pay rent, nursing and staff
>salaries, and malpractice coverage before ever taking anything home. If
>it's the patients surgery vs your office rent payment, that's too much
>pressure, even for honorable doctors. Thus, I disagree with capitation.
>I think it's a scam, and I can't believe patients stand for it knowing
>that it may damage their health.
>
>Now, back to the original subject! I have only discharged 4 patients
>from my practice (out of over 1000 patients per year over the past 5
>years). One threatened my staff and myself and yelled the "F" word over
>and over in the waiting room (she was wacky). Another saw my wedding
>ring and told me "but I was supposed to marry you" then started berating
>me and my nurse. She accused me of being unfaithful. When I suggested
>counseling, she threatened to go to the TV stations with our "affair"
>and started threatening me. Believe me, *that* came out of left field.
>Another screamed and cursed at my office nurse when she told that the
>patient that it takes more than 1 day to get a Pap smear result back
>(the patient had 10 normal Pap smears in a row but demanded that her
>result be available the next day; they ususally take from 2-6 weeks).
>The final one wrote a letter to my partner that made the Ken Starr
>report look like Reader's Digest. I mean, this baby was *explicit.* She
>was 70 years old....my partner was 34. We tried to get her into
>counseling, but instead she started stalking another doctor whose office
>was nearby.
>
>Doctors get angry at patients sometimes, but hopefully not too often.
>Patients who berate staff members don't last long. Neither do those who
>are "inappropriate" towards the doctors (coming on to them, making lewd
>suggestions). Patients who don't take suggested medications, ever, yet
>come in over and over with complications from not taking the medications
>are very frustrating. Sometimes they need to see another doctor who
>they might have a better relationship with. Hostile patients, for
>example those that challenge everything you suggest by stating "you just
>want more money" or "you better not screw up or I'll sue the hell out of
>you" also don't last long either. In your case, there does not seem to
>be an overt reason why the doctor/patient relationship has broken down,
>although it is *possible* that your doctor (or his nurse) find you to be
>a "difficult" patient. Maybe he feels your pain is psychogenic, or
>perhaps he feels that you challenge his opinion too much, overutilize
>his office staff, make too many phone calls to him, or have unrealistic
>expectations. On the other hand, perhaps his nurse is way out of line
>and is imposing her views on you, which is unprofessional and not in
>your best interest.
>
>What would I do? I would make an appointment with your doctor and ask
>him if there is something that has gone awry. I bet that this is a big
>misunderstanding. Please note, too, that adhesion barriers are
>controversial. They do not always work, and the medical literature is
>unclear at this time. Thus, he may know a lot about them, but may not
>believe they work, or he may have felt they were not useful in your
>case. As you can see, the best choice is to address these questions
>directly to him, rather than guess about the answers.
>
>Best of luck to you. I sincerely hope you find resolution to your pain.
>
>--
>Ashley Hill
>David Ashley Hill, M.D.
>Associate Director
>Department of Obstetrics and Gynecology
>Florida Hospital Family Practice Residency
>Orlando, FL
>http://home.mpinet.net/dahmd
>
>The above is intended for general medical education,
>and is not for specific medical advice.
>I apologize, but I am unable to answer personal e-mail
>due to time constraints.
>
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