How it works
Tuesday, October 7 2008
Despite my views on certain doctors , I do respect the doctors I interact with on a regular basis. This is intentional: I don’t bother with doctors I can’t respect. My PCP, Gastro, and C-R surgeon are all smart, caring people who excel at what they do while acknowledging that I alone am responsible for managing my health.
Lately, I’ve added a dermatologist to the list, and she seems to be all these things as well. For example, at our first appointment I pointed out some red spots on my face. “Actinic keratoses,” she told me, and suggested we freeze them off. I asked for more information; she explained there is a 1 in 1000 chance they might turn into cancer, but that I would notice changes. Since the spots have been there for years, and I can examine them closely when I shave, I decided to not to have them frozen off. A mole on my back, however, was more problematic, so she and I agreed to get that taken care of sooner, rather than later. She gave me the information and the latitude I needed to make decisions about my care: that’s the kind of doctor I respect.
So, of course, it broke my heart today to see her bullied into submission by two underlings. For a little bit of back story, you can read my post from yesterday. One of the things that I left out of that post was that I called my dermatologist’s office, and asked to reschedule my appointment. This was at 8:57 AM October 6th, according to my phone’s memory. Meanwhile, I got the insurance thing sorted out. At 1:50 PM, the office called me to remind me of my appointment. I asked whether they had received my voice mail, and I was told “no”. I said I wanted to keep my appointment anyway, and was told where to report at 1 PM today.
So I showed up, only to have the receptionist tell me: you canceled your appointment. Well, no – not exactly, I explained, and I told her about the two phone calls. She asked me to wait a minute and took some papers back into the office. After a few minutes, the nurse called my name. She asked me whether I canceled my appointment, and I explained again about the two phone calls. She told me the doctor had another patient, but could see me shortly.
I was taken to a room and asked to undress from the waist up, and given a paper half-gown. I waited a while, and then the doctor came in. She asked why I canceled, so I explained again about the two phone calls, and why I had made the first call. “Are you sure about your insurance?” she asked. “Pretty sure,” I said. We decided to proceed with the procedure.
I took off my gown and lay belly down on the table, naked from the waist up, ready to be cut upon by the derma. Then the door swung open – no knock, just open, and me gaping at two women wearing earpieces. “He canceled,” said the one. “He has no insurance,” said the other. I have to give them credit: their steely determination to deny me the procedure almost concealed their sheer panic that I might get it anyway.
“No – it’s okay, we’ve got that figured out,” said the doctor. “He has no insurance,” said the other. “He canceled,” said the one. “He called this morning at 9:15 and canceled his appointment.” “No,” I said, “I called yesterday.” I started to reach for my phone to show them the logs, still naked from the waist up.
The thing about me from the waist up: I have an ostomy sited a few inches above my waistline. So I was standing there with my (bag of) shit hanging out in the breeze, arguing with two women I’d never met – and who aren’t medical personnel – and suddenly I realized some cause for embarrassment. You know how guys talk to tits, and not eyes? These women were having a hard time looking me in the eye. “I’m feeling a little vulnerable,” I said, “do you mind if I cover up?”
The doctor – thank God – recognized the problem and just slammed the door on the two drones. She did, however, strongly suggest that I wait. “I’m ready to go,” I said. “Still, I think it would be better if you made sure your insurance paperwork was taken care of,” she said. “I don’t want you to get stuck with several hundred dollars in bills.” So that was it: no surgery today. I’m supposed to call back to see if I can be squeezed in sometime before the end of the year, contingent on the completion of my COBRA paperwork.
Needless to say, I’m annoyed. I understand the doc was trying to do the right thing, and I respect her for that. She was clearly embarrassed and flustered by the episode, but I don’t know if she’s going to be able to sanction her staff for their abysmal disrespect for both us. In the meantime, I’m not the least bit motivated to get this mole taken off – certainly not her clinic, but it’s not like I’m convinced things are so much better anywhere else.
I told this story to a close personal associate before I posted here; said person was furious at my treatment, of course. It should be infuriating to me, too, but I’m merely annoyed. Stay sick long enough, and you’re inured to this kind of bullshit. This time it was a little more slapstick than usual, but basically this is how things work.
