The New-Patient Appointment (Part I)

I need a new primary care physician on account of I haven’t got one.  The last person who said she would cover me quit when she found out that I couldn’t take drugs.   (see “The Desta Anthony’s of the World, Parts I, II, III” at http://annecwoodlen.wordpress.com/2011/08/31/the-desta-anthony%e2%80%99s-of-the-world/ ) so one of the doctor’s from the hospital has been writing orders while one of his minions tries to get me a new doctor.

One day the minion called to say that she’d just found some papers on her desk—she’d found me a doctor but had she told me?  Ah, no, she hadn’t.  The entire humongous medical industry is based on one thing—the patient—and the patient is always the last to know.  The end-point-user who drives the whole system is not in the driver’s seat.  This makes me crazy on a regular basis.

So a few days ago I showed up at the office of Dr. Suzanne Lamanna for a new-patient appointment.  I wheeled into the waiting room and up to the receptionist’s desk—well, actually, you know, it’s not a desk anymore.  Presumably there is a desk, but what you wheel up to is a window in the waiting room wall.  When did we decide that the receptionist is not on the patient’s side and needs to be walled into a separate room behind a closed window?  (News to young people:  it didn’t used to be that way.)

So, okay, the receptionist asks for and gets my name, rank, serial number and insurance cards.  She does not hand me fourteen reams of forms on which to record everything from my mother’s maiden name to the age at which I had my last menstrual period.  She does tell me to sign the box.

Say what?

What box?  Oh, the little black box on the counter.  It’s one of those electronic things like the one you sign for your charge card at the cash register in the department store.  So I ask the receptionist what it’s for.  She says, “HIPAA.”

I ask her where the paperwork is.  She looks at me dumbly and says “Duh?” 

Where do I get to read what I’m signing, I ask?

Ah, uh, um, she says.

When I sign something then I get a copy of what I’m signing, I say.

Uh, um, ah, we don’t do that, she says, adding “You have to sign it!”

My mom said of herself, “I am not cooperative but I am reasonable.”  What she meant was that you don’t get to order her around, however, if you appeal to her intelligence and give her a good reason then she will do what needs to be done.  I am my mother’s daughter and when people—particularly young, stupid receptionists—give me orders then I tend to get pissy.  I say to the receptionist, “I do not sign blank contracts.  I want to see what I am giving away and what I am getting.”

She consults with someone off-camera and states emphatically that they do not have hard copies.  “Then you do not get my signature,” I reply crisply and wheel away from the window.  What I mean is, ‘I ain’t your bitch.  Treat me with respect or treat me not at all.’

So while I sit in the waiting room I read an old news story that has been laminated and posted on the wall.  It says that Suzanne Lamanna is a nun who got permission from her religious order to become a physician.  She wants to treat the whole person, physically, emotionally and spiritually.  The reporter asks if he should address her as “Sister” or “Doctor.”  That’s a no-brainer for me.  I am seeing her in her capacity as a physician and I will call her doctor.  Her religion is her business, not mine.

In just a few minutes, a female person wearing scrubs comes and ushers me into the treatment room.  She does not tell me her name.  She and I both know that she intends to lay hands on me but she doesn’t introduce herself.  Where else in our society do we have physical contact with complete strangers?  Name one single situation, outside of medical care, in which you let a person you don’t know touch you.  Oh, that would be in prison or whenever you experience a police intervention.  So what medicine shares with law enforcement is coercion by strangers.  How nice.

I ask the girl her name.  “Nicole,” she says, adding that she’s studying for her LPN at BOCES and today’s her last day in this placement.  She does not ask anything about me, like why I’ve come to the doctor’s office, what’s wrong with me, or what I need.  I don’t matter; she matters.  Then she tells me that today’s appointment will “just be a meet-and-greet.”

Say what?

What the heck is a “meet-and-greet” at a doctor’s office?  The student tells me that she will take me around and introduce me to everyone.  You’re kidding me, I’m thinking, and will there be punch and cookies at the end?  Do Medicare and Medicaid know that they are paying for appointments at which no services are provided?  How about the fifty dollars that the taxpayers forked over for Medicaid transportation?  How about the fact that I need a doctor’s order for the home health care agency to change my catheter?  How about the painful ulcer in my mouth that, despite my dentist’s best efforts, hasn’t gone away?  How about the two months I’ve waited for this appointment?  Do you expect me to wait another two months for an appointment for diagnosis and treatment?  And why wasn’t I told on the phone that this wasn’t an appointment for treatment—this was just a social get together?

I sit there speechless, my gast having been utterly flabbered.  (To be continued)