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Health care calls for 'care' as much as 'health'

My mom showed me the spot on her face recently diagnosed as skin cancer.

"I showed it to my dermatologist last time, but he just kept saying it was psoriasis," she said. Finally, on her last visit, she insisted he take a closer look, and bingo. Basal cell.

"You need a new dermatologist," I said, and she looked at me in dismay. She'd apparently already gone through three others who didn't work out to get to this one.

I felt her pain. Finding new doctors is just as much fun as blind dating; you start out hopeful, but chances are good that there might be some sort of compatibility issue, such as his inability to ask you a single thing about yourself while he shares an hourlong recount of his 1993 weeklong trip to Shenzhen.

I've been relatively lucky in finding new doctors since my move to Maryland. My new dentist seems marvelous. And I love my dermatologist, so far, and my new internist, too.

So odds were against me when I tried a new eye doctor. The blind date with the team that would help keep me from actually going blind began with an exam by an ophthalmologist who exuded competence. Then, two weeks later, I went back for a contact fitting. When I scheduled the appointment, I had asked if we could do everything at once, but I was assured that this was not their policy. But again, things went well. Nobody even bored me with a word about China, for example.

"That's $150," said the man who was charged with checking me out after the contact fitting.

"I'm pretty sure my insurance pays for some of this," I answered.

He looked at his computer screen. He had no record of my insurance, although I gave his front desk my card just two weeks before. He went to the website for my insurance company but couldn't find any records of me there. I suggested he call, but he told me only patients were allowed to call, and he didn't have the number. So I got out my phone, Googled, dialed and was connected to a health care representative who told me that my insurance only applied if I had the contact fitting at the same time as the checkup. They had already processed my claim from the first visit.

You see where this is going, maybe? Pretty soon I became that person, the one with a problem. An office manager was called. I explained that I was in some sort of No Mans Land: Insurance won't pay unless the exam and fitting are together, but her offices policy prohibited that from happening.

So she got mad at me. More than once it was suggested it would be easier if I just paid in full, and then dealt with this on my own through my insurance company. Easier for you, I said, envisioning long hours on hold while people pretended to be solving my problem but were probably really going through potential dates on eHarmony.

An hour later, I was presented with my bill for $120, with a terse explanation of what insurance paid for. Meanwhile, the nice guy whose time I had been using up at an alarming rate by refusing to budge from his desk told me his personal story about when his old employer stopped paying his insurance and didn't tell him and then the poor guy had a heart attack.

Later, pondering this frustrating visit, I chose to focus on how lucky I am. I'm lucky that I have the flexibility in my schedule to sit and wait. I'm lucky that I know how to be an active consumer, that I have a smartphone and that I have a basic understanding of how health insurance works. I'm lucky I have health insurance.

How many people with insurance would have just paid the $150 because they don't have all or some of these resources? How many people without insurance can't afford the luxury of my bad day at the doctor?

Here's the bottom line for me (one that I can actually see, quite clearly, as clearly as my new contacts allow me to see the clumps of cat hair under my bed): It doesn't matter how good or bad our health care system is if we take the care part out of the equation. We need doctors, nurses and office workers to care about patients and listen when, for example, they say they think a spot looks wrong or a bill is incorrect. I know that more do than don't, and I am so grateful for the great doctors I've had in my life, but wouldn't it be nice if this niceness were universal?

It may not lead to lifetime relationships, but at least some of us might have more second dates with our doctors.

Catherine Mallette is a senior content editor in The Baltimore Sun's features department and the editor of Chesapeake Home + Living magazine. Contact her at cmallette@baltsun.com.

Copyright © 2014, The Baltimore Sun
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