Donald needed to talk. He was very upset. He and his wife, Susan (names changed), moved to Greater Cleveland in 2020. He came to see me for health insurance when his COBRA ended. They had a choice between Medical Mutual of Ohio with access to University Hospital and its affiliate doctors and facilities or the Cleveland Clinic + Oscar policy that would get them into the Cleveland Clinic. They had yet to see a doctor and had no preference. Medical Mutual was a little less, so University Hospital won this round. Donald was calling to change policies and provider networks.
Donald’s problems started when he tried to schedule their initial appointments. Friends had recommended a couple of doctors. None of those doctors had an opening for a routine exam for three to six months at the soonest. Annual Preventive Care is a covered benefit under the Patient Protection and Affordable Care Act (Obamacare), but the money is in treating conditions. Very little time is set aside in today’s medical practices for routine care. Donald gave up and scheduled an appointment. Susan had more immediate needs and accepted an appointment with a physician who was very available.
Susan’s appointment did not go well. The doctor failed to focus on her patient, or ask good questions, and seemed intent on getting the exam done as quickly as possible. Follow-up testing was ordered without adequate explanation. This precipitated Donald’s first email to me. No action was taken at that time. Today’s call came after they saw Susan’s medical records. They were shocked to learn that the doctor had completed a series of questions as if she had actually discussed any of these topics with Susan. She hadn’t. Their solution was to schedule a meeting for next week when they would drop Medical Mutual and move to Oscar so that they could access the Cleveland Clinic and get better care. They will be here on the 11th.
To be clear, I receive most of my health care at University Hospital facilities. The facilities are world-class and a lot of the doctors are excellent. A lot, but not all. There are great doctors and there are people who might do a better job at something else. Donald and Susan may live in a Cleveland suburb, but this isn’t about University Hospital or the Cleveland Clinic. They could just as easily have encountered the same level of care in Philadelphia, Seattle, or any other place in this country. One of the complicating factors in our health care system is the number of medical practices owned by the institutions, corporate entities, and private equity firms as reported in the recent Radiology Business:
The COVID-19 pandemic has accelerated this decade-long trend as business interests “dramatically” reshape the practice of medicine. Corporate entities own half of the nation’s medical practices, with private equity and similar stakeholders producing the sharpest increase (32%) in acquisitions between 2019-2020.
I would like Donald and Susan to think this through before we change plans and networks. Politely, but firmly, they need to assert their rights as consumers. I needed to remind them that the doctor is a PAID service provider. If the service provided is less than satisfactory, you should fire the doctor.
All large institutions have a patient care office / ombudsman / patient experience office. I urged Donald to find the one for University Hospital and call it. Susan should tell UH about her experience and the substandard level of care she received. Sure all of the medical systems send out surveys, but who knows if a human being every reads them. It is time to let someone, other than me, know about this visit.
Some of us still remember House Calls, when the doctor came to your home to treat you. That time has come and gone, but you can still demand the undivided attention of the person you hire to attempt to treat your illnesses and keep you healthy. I don’t know if Donald and Susan will follow through and call UH, and if they do, whether anything will come of it. My job is to help people access and pay for health care. I also think that my job is to help people understand that they should expect to be respected, valued as customers (patients), and given the best care possible.
Donald and Susan deserve better. And so do you.
Picture – What Could Be Better Than A Lake Erie Sunset? – David L Cunix