Monday, November 11, 2013

Don't Call Us, We Might Call You

["Let Inga Tell You," La Jolla Light, published November 14, 2013] © 2013 

In one of my favorite wishful fantasies, every doctor in La Jolla cold-calls his office and experiences the response a patient gets from his staff.  He’d have to disguise his voice, of course, otherwise they’d be uncharacteristically helpful. 

OK, I realize this is an unfair slam of all medical offices.  In fact, we have been under the care of physicians who actually invite you to contact them by email – and even more incredibly, answer.  We have dealt with doctors’ offices who, when you request a copy of the labs, actually send them.  The first time!  We have interacted with office help who don’t act like your sole purpose in calling is to annoy them and who even get back to you if they say they will.  And to all of these people, we are so grateful we almost cry. No, we DO cry.

With two exceptions, we’ve been lucky to have excellent medical care over the years and the practices we deal with are all busy.  So why do some medical offices work so well and others so abysmally? 

Now, I realize that one of the purposes of front office staff is to run interference for the doctor.  One presumes, in fact, that they are following his or her instructions.  It also seems equally clear in some cases that he has sent them to the Mean Girls School of Medical Office Management where they are taught Surliness 110, Stonewalling 220, Terminal Ennui 330, and How to Frustrate Patients to the Point of Coronary Thrombosis 440.    

A friend of mine uses the wonderfully descriptive term “deafed out” to refer to office staff who, after she had a serious reaction to a newly prescribed drug, failed to ever pass on her messages to the doctor.  They just kept telling her not to worry about it. She finally ended up in the ER. She says she has long suspected that this office works on the premise that if you ignore patients’ calls long enough, they’ll die and stop bothering you. 

Given how often our insurance, and therefore doctors, have changed over the years, we always request a copy of every lab or test result for our records.  Some offices cheerfully hand them over (or post them on a portal).  Others just try to tell you that if you didn’t hear from the doctor, everything must be OK. Um, fine, but I still want a copy.  Others treat lab results like national secrets that pretty much any other person on the planet can see but you. They insist that the doctor has to OK it before they will (never) send it to you.  I’ve spent weeks wringing lab results out of some medical offices.

I think the All-Stars of the We Dare You to Contact Us contest goes to an office at Scripps Memorial.  My primary care doctor referred me there for a consult where merely achieving a human to schedule an appointment took the better part of three days.  Whether the office was open or closed, their line had (count ‘em) eight options, none of which were ever answered by a person.  In fact, even during business hours, I kept getting a message to “please call back during business hours.” 

On the third day, I systematically tried every one of the eight options but got a recording on all of them (even the one for doctors which I confess gave me a certain perverse pleasure).  On Option 6, the authorizations line, a truly crabby troll chastised people for taking up her time by calling,  admonishing them that if it hasn’t been at least two weeks, don’t bother leaving a message.   Good thing I didn’t need an authorization!

Of course, complaining to a doctor about his or her front office staff is fraught with peril. In fact, it’s a total loser.   You thought they were uncooperative before?  I always fear they keep a running list tacked to their phones of patients who will never ever get their lab results even if they call posthumously.  Instead I’ve tried to just praise the heck out of the ones who are helpful – both to them personally and to the doctor.  But it also makes me a little nervous.  You’re worried the doctor is thinking, “Hmmm, Debbie didn’t make these people work nearly hard enough to get in here. Back to the Mean Girls School of Front Office Management for her!”

It may not sound like it, but I actually have sympathy for doctors’ point of view since in my youth, I was married to a physician, and lived through the medical school years, internship, three years of residency, two years of Berry Plan military duty, National Boards Parts I, II, and III, specialty boards, and not a single holiday together until we’d been married five years.
It’s a really tough gig.  I know. But it would be really nice if someone just answered your phone.



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