The State of Health Care in America:
Tell Me Where It Hurts? – Dr. D
I’m embarrassed to even write this entry because it shows how absolutely f***ked up health care is in this country. Here is the sequence of events:
Monday: 9 AM
Carey orders a refill of a prescription online at www.cvs.com. The prescription is for Clobetasol Propionate, a cream to treat psoriasis that I sometimes get on my scalp, and have since high school. The cream clears it right up when my scalp gets a little red.
Tuesday: 9 AM
Dave the secretary
David Cullen, my doctor’s “secretary” phones me to let me know that I haven’t seen the doctor in over 400 days, and that before they could authorize the prescription to be refilled I would have to come in and see the doctor.
I explained that I needed the cream now, as I am about to leave on some business trips. It wasn’t as if I was asking for Oxycontin (hillbilly heroin). I told “Dave the secretary” that I would come in for a checkup as soon as I returned from my trips. In the meantime, I asked him to authorize the prescription to be refilled. He dramatically said he would check with the doctor and hung up abruptly.
Tuesday: 2 PM
CVS pharmacy calls me to say that the doctor’s office refused to refill my prescription.
Tuesday: 2:01 PM
I called the doctor’s office and spoke to Dave the secretary again. Without telling him that the pharmacy had called me, I asked him what the status of my refill was. He said that they would not refill the prescription until I came in. I explained again that I was leaving town, and wanted the cream for my trip. I also said that I had been Dr. D’s patient for four years, and this has never been a problem in the past. At this point Dave got extremely agitated and said that he doesn’t need to listen to me anymore; at which point he hung up on me!
(Now, a little background. Dr. D used to have his own private practice. It was a small office, employing just a few people. The service was personal, the doctor professional and the staff fairly courteous. In May, I received notice that the office was closing and that the doctor was going to work for a large conglomerate medical facility called Synergy Healthcare Medical Associates. When I received the notice I remember thinking that my doctor sold out to corporate America and the big drug companies. Where before, I could call the same day and get an appointment, now I feared it would take weeks to get an appointment and the doctor would be either golfing or being wined and dined by drug reps. half of the time. But, since I rarely have to go to the doctor (maybe once a year for my asthma, and obviously not even that often since I hadn’t been there since June, ’06), I didn’t think it was that huge a deal.)
So, after being rudely hung up on by Dave the secretary, I called back.I asked to speak to the doctor, and Dave the secretary said, “You’re NOT speaking to the doctor” and hung up on me again.
I called back, and demanded to speak to the doctor. Dave the secretary hung up on me.I called back, and this time dialed the nurse, Judy Azar’s extension. When she answered, I told her that Dave the secretary had hung up on me three times and I asked to speak to the doctor. She said he wasn’t available. I said that I would hold.She put me on hold, and a minute later, guess who answered? That’s right, Dave the secretary, who hung up on me a 4th time.
At this point, I called back and left a message on the doctor’s non emergency voice mail. I told him what had happened, and I said that if he values his relationships with his patients that I would like a call back today. I then called the corporate headquarters of Synergy Healthcare and left a message for the General Manager, explaining how Dave the secretary had treated me.
5:15 PM
Ring….Ring
Carey: Hello
Dr. D: Hi Carey, this is Dr. D.
Carey: Hi doctor, thanks for calling me back
Dr. D: What can I do for you?
Carey: (Relaying the same story I told above, and left on his voice mail.)
Dr. D: Well, I wasn’t there, so I can’t really comment. All I can say is that all medical items that come out of this office must be billed.Everything is billable.
Carey: I told Dave the secretary that I was going out of town and that I would come in once I returned.
Dr. D: I get audited once a year, and if I’m refilling prescriptions without seeing patients I could incur penalties.
Carey: I told you that I would come in when I return. I’m just asking for psoriasis cream! Are you telling me that you need my $100 for an office visit that badly? Have you really sold out to corporate America to that degree?
Dr. D: I left my practice because I could no longer make ends meet. I was bringing in only $60,000 a month and I could barely pay the bills.
<cue the violins>
Dr: D: Take a look at your insurance remittances. Your health insurance only paid for ¼ of what I billed you last year. I had to incur the rest.
Carey: Trust me doctor, I hate the health insurance companies too, but they supposedly pay you customary payment for the services you render. Beside, I’m the one who has had my premiums TRIPLE in the past 4 years. Not to mention the fact that my asthma inhaler that used to cost $5 now costs $25. And God forbid I try to refill it before the 60 day limit, then it costs $300.
Dr. D: You should talk to your health insurance company. They are the ones that are cheating both of us. They’re taking your money and not paying me.
Carey: Are you telling me I owe you money?
Dr. D: No, the health insurance companies don’t pay me enough to keep my practice open.
Carey: Doctor, with all due respect, I’ve never heard of a doctor who doesn’t make well into six digits. I do not make well into six digits. I have a very hard time feeling sorry for your plight. Besides, if I had called you a year ago to ask you to refill that prescription before I went out of town; you would have had no problem with it.
Dr. D: You’re right, I would have filled it a year ago.I would be remiss if I didn’t tell you that other former patients haven’t complained about the same thing, but my hands are tied.
Carey: I’ve always liked the care you provided but I cannot continue a relationship with a doctor whose staff treats me so rudely.
Dr. D: I wasn’t there, I can’t speak to that.
Carey: It doesn’t matter that you weren’t there. Did you ask Dave the secretary if he hung up on me?
Dr. D: Yes, he said he did.
Carey: Well then, I would like an apology.
Dr. D: I’m sorry if he hung up on you.
Carey: Thank you, but I want the apology from Dave the secretary.
Dr. D: I can’t tell him to apologize, he doesn’t even work for me anymore.
Carey: Again, with all due respect, just because you’re not signing his paychecks doesn’t mean he doesn’t work for you. You hired him, and you can fire him. If you ask him to apologize, I suspect he would think long and hard about it.
Dr. D: I can ask him to apologize but it’s his decision. If he chooses not to, I’d be happy to forward your medical records to a new doctor, just let me know.
Carey: Thank you very much.
Dr. D: You’re welcome.
So, that’s the gist of the conversation. Of course I’m paraphrasing, and of course I’m making fun of Dave the secretary, and making myself look better, but that’s basically how it went down.The next time Dave Cullen the secretary googles his name, I suspect he will read this. (Apologies in advance to Dave Cullen the guitarist, and Dave Cullen the author of the Brokeback Mountain Guide. (??)) I intentionally filled this entry with links and metatags to make Google’s robots move me to the top of the search list. Don’t you just love the blogoshpere? Though the doctor made some good points, the fact of the matter is he sold out. Yes, the insurance companies suck, and trust me, I’ve fought with them before (last year they insisted I was a woman, because it said so in their computer, but that’s a story for another day). I hope that any American who reads this realizes what a crisis we face. America lags behind much poorer countries in health care. I do not believe socialized medicine is the answer, but I do believe there are Democratic candidates out there who have better ideas than I do. Please think about this as you ponder your choices in the next year. It affects all of us.
Went out to dinner with Tyson tonight.
On the way there I saw this billboard.
Apparently “geeks” are in. The first 4th season of “Beauty & The Geek” started tonight. I recorded it, but haven’t watched it yet. Ironic though that Tyson was one of the geeks from Season 2. I have a feeling he started the whole geek trend. 
Anyway, we had a nice time.
I’m heading to San Diego tomorrow, then Phoenix. I hope everyone has a good week! –Carey
While sharing from his heart with humor and passion, Jamie challenges his audience to think differently – to view failure as a worthy experience – to learn the art of grunt work – to conquer fear through focus – to live life with passion on their own terms.
LOL We were talking tonight about those rare moments in life where one tiny action can change the course of your entire life. Kind of like the movie 
) Miggl and I are travelling in Northern India at the moment – since a month we are in ladakh also called “little tibet”. tomorrow we are leaving for pakistan where we try to drive the karakorum highway (the old silk road) to kashgar/china and from there we want to travel into Tibet … so far nothing is sure as we don’t know how safe the situation is in northern pakistan and if we make it to kashgar it’s not sure if we can enter the Tibetan Autonomous Region from the north west … but you know that it is my life long dream to go to the heart of Tibet, to Mt. Kailash and it is soooo great that Miggl also could take three month off and we can travel together … As Internet access here is not so easy and teaches you a lesson in patience (all the buddhist way 
As I type, I can hear the noise from the after-party at the Mondrian Hotel next door. I just walked over there to snap some photos, but couldn’t get very close like last year. The ceremony ended a little after 7 PM Los Angeles time, so the parties are starting to wind down. Here are a few of my observations about the show:
