Why US Healthcare Sucks – part 1 of 243

I am preaching to the choir today so if you think any of the following list of things, fuck off and go read someone else’s blog.

  • The US has the greatest healthcare system on earth
  • If you don’t like it here, move to Canada

Early one Thursday morning, my family and I were visited by a bat.  We were all asleep in relatively close proximity, and thus were all exposed to the cute little critter for a good little while before someone had the consciousness, and good sense, to scream about it.  Good times.

dragonNow, I’ve had experience dispatching bats, and this one was no more difficult than the last.  In fact, I used an aquarium net to knock him down (and out), scoop him up and toss him out on the lawn for the neighborhood cats to deal with.   At left is an artist’s rendition of the foul beast in flight shortly before I smote him.

 

I immediately got on the trusty iPad to figure out what to do about the damned bats, this being #3 in the last couple of years.  In the course of my investigation, I was shocked (shocked I tells ya) to discover that, by Department of Public Health standards, I either needed to find and autopsy the bat, or we all needed to get rabies shots.  Because we were in the room.  With the bat.  While we were sleeping.  Here’s a link.  I didn’t believe it either.  But that isn’t the sucky part of our healthcare system, not by a long shot.

Annoyed but not alarmed, I searched the lawn in vain for my vanquished foe.  Alas, he was nowhere to be found.  I like to think that Nigel, the cat next door, got him because I don’t like Nigel either and that would be a two-fer. The family all slept for another hour, went out to see the Perseid meteor shower, then slept again.  The bat was unavailable for testing, and we would deal with it in the morning.

At this point, I have a family of four and we all needed rabies shots (according to DPH criteria) because we were all exposed.  And they needed to start before 1am Friday.  24 hours from exposure.

Here’s where the US healthcare system starts to shine its peculiar menacing glow.  My wife works for a hospital that self-insures.  That should have made this easy.  Instead, a voyage of discovery within her employers and her PCP’s labrynthine systems produced the advice that the entire family should go to the emergency room.  Not only that, but we should call ahead to make an appointment.  The irony of making an appointment at the Emergency Room did not make anyone laugh.  The irony of paying 4X an emergency room charge ($100 each) rather than the 20$ copay for an urgent care visit did not make me laugh either.  This was clearly not yet an emergency as any normal person would define the word.

But as any procrastinator knows, you can turn anything into an emergency if you wait long enough, and by early afternoon my wife (who has a job above and beyond finding out where to get rabies shots) was stuck with the emergency room as our only option.  We had about 12 hours to start the series, and about 4 hours before the healthcare system in general stopped answering the phone.  This was clearly not an emergency, but if it could stiff-arm us for another 4 hours the healthcare system would turn it into one.  My resolve not to contribute to the rampant abuse of emergency room care was wobbling.

receptionistSo off to MY PCP I went.  My PCP works in a big, nice, multiple-group practice.  I like the building, which has nice bathrooms, and many of the people within who sometimes help me feel better when I get sick.  That said, interacting with my PCP’s office is an act of desperation because they have always been dreadful to deal with.  They did not disappoint.  The moron who screens calls there seemed unable to comprehend that, at 3pm I didn’t have the luxury of setting up an appointment only for myself, and only to “talk about it”, when the entire family was exposed at 1am that day.  You have 24 hours to start the rabies series.  If I had to make “talk about it” appointments at 3 different PCPs we’d end up in the emergency room anyway.  I had other people relying on me to take care of them and this moron was simply unable to comprehend this, or more likely did not have the authority to do anything but repeat over and over again “do you want an appointment for yourself or not?”.  She does however have the authority to tell me she doesn’t like my attitude. She puts me, so she claims, in the queue for a callback.

Now I know that answering calls at a doctor’s office is not a fun job.  I know that talking to me is not always a fun job. I know that the men who profit wildly from the existing system (administrators, payers, doctors) hide behind the women who don’t (nurses, receptionists, assistants).  I know that the people I talk to on the phone do and say only what their tightly proscribed role allows because they need a job and, in an at-will state like Massachusetts, can be fired for no reason at all.  I know all that.

Still, the overwhelming impression one gets from working with my PCP’s office is that they really don’t like people who … need a doctor.  That the organization itself exists for some other reason than, for example, to give rabies shots to people who need them.  I struggle to imagine what that reason might be, yet there it is.

I received my callback from the PCP 5 days later at which point, had I waited for it, I would already have rabies.  I suspect that might have been okay with my PCP’s receptionist – after all, people with bad attitudes deserve to get rabies.  In any case, that fool, and that foolish system would have put four people in the emergency room when their PCP, Harvard Vanguard Braintree was perfectly well equipped to handle the issue in a timely fashion.

That’s why the US Healthcare System sucks.