My screed on the health care system

I’ve been spending an inordinate amount of time in doctors' offices lately. Luckily, it’s for a good reason, but my monthly visits to the OBGYN to get my blood pressure checked and weight documented has brought to the foreground my seething distaste for the health care system. So here’s my rant about it:

Why do doctors' offices refuse to act like normal businesses? Why is it okay for a doctor’s office to say, “Sorry. You can’t call us between noon and 1. That’s our lunch break.” What other business does that? None. Because any business that did that would be closed after a week when their customers stopped showing up and paying money.

And why do they all have to take lunch together anyway? Can’t one person cover the phones while the rest go eat? Aren’t they all getting free meals from pharmaceutical reps anyway? It’s not that hard to have a staggered lunch schedule people. Give me 15 minutes and I’ll have it all plotted out.

But the lunch break isn’t the only thing that gets on my nerves. There’s the whole appointment scheduling thing. I have yet to find a doctor or dentist’s office that actually offers reasonable hours. God forbid anyone with letters after their name work past 4:15 or before 9 a.m. Why is it that offices that treat our pets have better hours than offices that treat humans?

Oh and don’t get me started about doctors cancelling appointments. In my line of work if I called someone five minutes before an appointment to cancel it, I’d be in big trouble. If I did it more than once, I’d likely be out of a job. But for some reason, doctors pull that charming maneuver all the time. And they don’t have the nerve to call you themselves. No, sir. They make their dim-witted front desk person call you and do their bidding. And then they offer you the least convenient time to reschedule.

I ask all these questions even though I know the answer. The problem with doctors’ offices is that they are built around serving the insurance companies and the bureaucracy of the system and the needs of the doctors/staff. They aren’t built around the patient.

I’ve written about health care and I’ve read enough hospital mission statements to know that they all claim to be “delivering patient-centered health care.” But in reality there’s nothing patient-centered about the majority of our health care system.

And I really think this feeds into our society’s general avoidance of preventative health care. I am loathe to make a routine physical appointment because it’s such a giant hassle, even though I have health insurance. I bet there are plenty of people just like me. And that’s bad. Because I get intellectually that annual physicals are where you find problems when they are small and before they get big. But emotionally I can’t get over the hurdle that I’m going to have to settle for a 1:15 appointment on a Tuesday when I have a big project at work and then I’ll have to thumb through a six-month-old issue of Car & Driver in an uncomfortable waiting-room chair for 30 minutes and then sit in the boring exam room just to get five minutes with a nurse practitioner who has the bedside manner of a household mop.

What’s the solution? First, doctors offices need to start behaving like businesses. And to get them to do that, I think you have to rework how doctors are paid. The whole insurance/Medicaid/Medicare system really incentivizes doctors to put their focus in the wrong direction – away from patients – and towards paperwork and red tape. In some ways you can’t blame them. The system grew into an angry beast and it’s hard to fight it. But it’s time to take our health care system back. And that process starts with the patients and the docs.