re: General PSA to patients from healthcare providers: What we want you to know

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They are ridiculous and something fundamental in the current process needs to change.

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It all starts with Medicare reimbursement rates.

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I have a fee schedule in my office with a cash price for everything I can possibly bill for...exam, testing, procedures, surgeries.

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How close are those numbers to what insurance claims they paid on a statement?

I ask for two examples of services I personally see.

1. Calcium scoring studies. This test is performed with a CT scan (64 slice). It is at this point a cash only exam. $150.... This study is read by your cardiologist who ordered it and radiologist confirmation.

2. I had a kidney stone. Tried to set up an outpatient CT. Hospital called me back. My up front portion? $800!!!! I call an outpatient MRI place that does all modalities of radiology as well. 300 bucks. Mind you the previous hospital price was an estimate. I would have gotten a bill for 20% afterward. 20 percent of the facility charge and later a radiologist read.

Lots of talk about how docs run behind.

Many do. I know despite my best efforts I can get behind any given day.

Some are nonchalant and don't respect patient's time

Some are very concerned and still run behind due to the nature of working with so many variables that are out of their control.

Maybe a bit of insight into what really happens behind the scenes would be beneficial.

So here is a look at my Friday half day post 24 hr call clinic schedule.


23 patients seen from 9 am to noon.

After hospital rounds, 3 calls to specialists, 1 to pharmacy, 2 separate conversations with case managers in person, and 2 calls to medical records along with two texts with home health while I drove, I arrived at clinic at 0905.


apt time/ pt in exam room/ doc in exam room/ pt leaving clinic/ visit notes

1. 0900/ 0905/ 0908/ 0913
2. 0915/ 0918/ 0919/ 0950 (annual with labs after visit)
3. 0930 No Show
4. 0930/ 0933/ 0935/ 1013 (xrays during office visit)
5. 0945 No Show
6. 0945/ 0954/ 0954/ 0958 Lab done and reviewed in visit
7. 1000 /1014/ 1014/ 1019 walk-in seen as next available slot
8. 1000/ No Show
9. 1000/ 1019/ 1020/ 1030 swabbed before roomed shot given with visit
10. 1015 No Show
11. 1015/ 1038/1038/1044 xray prior to being roomed
12. 1030/ 1027/ 1027/ 1058 pt had labs xray done and read in visit
13. 1045/ 1054/1055/1107
14. 1100/ 1103/1105/ 1117 pt had shot
15. 1100/ 1113/ 1113/ 1118 walk in pt seen as next available slot had swab before visit
16. 1115/ 1116/ 1119/ 1126 pt had labs drawn after visit
17. 1130/ 1126/ 1130/ 1133 pt had swab before visit
18. 1200/ 1134/ 1134/ 1137 walk in seen as next available had swab before visit
19. 1130/ 1140/ 1140/ 1144 walk in seen as next available had swab before visit and then needed to use restroom before roomed also
20. and 21. 1145/ 1155/1158/ 1204 pts arrived late and had swab prior to visit
22. 1200/ 1202/ 1206/ 1215
23. 1215/ 1230/ 1231/ 1333 pt scheduled last because expected long visit, arrived late, had xray during visit





Somewhere during that whirling dervish of a schedule, making sure each patient was fully evaluated and correctly treated and that each patient was happy with their care, I managed to dictate all the xrays, complete 4 prior authorizations for meds and DME, refilled 12 medications separate from visits, had 2 conversations with the hospital about in patients, accepted and signed for drug samples from 3 reps, signed off on 43 labs and other scanned in material, filled out 4 face to face evals for home health, and discussed purchasing and inventory with my manager.

I also managed to go piss once and drink a cup of coffee my nurse was nice enough to make me.

228th down vote. I just can't today.

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This whole post is just embarrassing and makes me sad to be in Healthcare....

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Must be nice sitting up on that high horse of yours free of most of the responsibility and all the liability, all the while enjoying the luxury of clocking in and out of your limited role of involvement.

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I have one; When you wait until the end of the appointment, then say "Oh by the way ______________ has been bothering me as well" we want to rip your head off of your shoulders.

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my OB/GYN had a sign in each patient room that said, "We charge for 'Oh doctor, by the way'.." I always thought it was in poor taste.

And my doctors are so efficient that after my exam they are out of there in less than 10 mins and I understand there's no time for 'Oh by the way..' but seriously, there should be a minute for me get to mention my concern. Frankly, it is very rushed.

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Do you know why? Do you think the doctor is in the back screwing around? It's more likely they have encountered a patient with an urgent issue that requires more time than was allotted. Now, if you say that they should schedule fewer patients. then you are recommending reduced access for patients.

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I'm a business owner too, I understand that. However, fix it. I won't say which Dr's I'm talking about because that's bad business to complain about another business specifically knowing how hard it is to run a business. But those Dr's need to understand how it dismisses how important my time is to me. Ask another doctor how they control it. FIX IT.........