Commentary - August 2003

Joe Consumer Goes to the Doctor

A Cautionary Tale

by Lyle Brennan

Joe is a middle-aged guy with no serious health problems, but lately he has been getting heartburn and an occasional upset stomach. His wife finally nags him into making an appointment to see the doctor. In the good old days, he could have just called the doctor and made an appointment. But in 2003, the first thing Joe has to do is to check with his insurance company and see if his doctor is on their list and if they will pay for an office visit. His friendly family doctor has left the state because he couldn’t afford to pay his malpractice insurance premiums. So Joe makes an appointment to see someone he has never met before. The doctor’s office gives him the next available appointment, which is a month away. Joe wonders what would happen if he had a serious problem and asked to be seen right away. Maybe he’d only have to wait a week or two.

On the scheduled day, Joe arrives at 8:55 a.m. for his 9 a.m. appointment. He had asked for an early appointment, figuring the wait would be less. Foolish Joe! Since he is a new patient, he fills out 8 pages of information about his health history, his personal habits, the health of his children, siblings, parents, grandparents, neighbors, college roommates, etc. As 10 a.m. approaches, he asks the front desk person when he will be seen. "I have to go to work right after this," he explains. She gives him a pitying look. "The doctor will see you soon," she answers. At 10:30, Joe is shown into an examination room and told to undress. Around 11:15, a Physician’s Assistant arrives. Joe asks when the doctor will arrive. "Oh, you don’t need to see him," the P.A. explains. "This is just routine." The examination takes around five minutes, and by this time Joe has forgotten all the questions his wife told him to ask. He is given two prescriptions and told to schedule some lab tests. When he gets to work, the Boss gives him the third degree about why he took off the entire morning for a five-minute checkup. Joe gets the feeling this will be added to his permanent record. His stomach now hurts more than ever.

He stops at the pharmacy on the way home from work to pick up his prescriptions. "That will be $125.00", says the pharmacist. "What?" cries Joe. "I have insurance. That can’t be right." The pharmacist shrugs. "These drugs are non-formulary. They’re not on the insurance company’s list, so they cost more." Joe pays the $125.00 and makes a mental note to take his power bill out of the stack of bills he had scheduled to pay.

After Joe gets home, he takes the medicine that’s supposed to make his stomach feel better. Not only does it not make him feel better, it makes him worse. He is miserable all night long, and calls the doctor in the morning, but of course he can’t speak to the doctor. He has to leave a message on a machine. After Joe waits all day for a return call, someone phones from the doctor’s office at 5 p.m. and advises him to take another prescription instead. Joe is not surprised that this prescription costs $70.00.

The following week, Joe undergoes a series of tests that involve fasting, drinking foul-tasting fluids and having tubes put into body parts that he’d rather not think about. He misses a full day of work, which angers the Boss. His original stomach complaints are about the same, but the strange side-effects of the medications he’s taking make him feel worse than ever. Paying the deductible for the lab tests causes him to take yet another bill out of the "Bills to Pay" pile, and losing a day’s pay makes him take out another one.

After waiting several days to find out the results of his lab tests, Joe calls the doctor’s office and leaves a message on their machine. (By now, he despairs of ever hearing from the doctor directly.) Another day goes by with no reply. He gets an letter from the lab requesting him to call the doctor’s office for the results of his tests. He calls the office again and leaves a rude message on the machine. The next day, the Physician’s Assistant calls and says the lab results were fine. However, the doctor wants to schedule another set of tests just to be sure. These tests will be even more invasive and expensive than the previous ones, and won’t be covered by his insurance. Joe will have to ask his landlord if he can wait for the rent check until the next payday.

"If there’s nothing seriously wrong, why do you think I’m having these problems?" Joe asks. "The doctor thinks it may be stress," says the P.A. "Have you been experiencing any stress lately?" Joe throws the phone against the wall and jumps up and down on it after it hits the floor. "Stress? Me? No, I’m fine, just fine! Ha! Ha! Ha!" He is still laughing when the men in white coats come to take him away. He hopes the asylum is on his insurance company’s list.

Lyle Brennan Publisher
COMMENTS? email: lyle@nbj.com