I had to make an appointment this week with my new primary care physician as I am no longer living where I usually reside because I cannot take care of myself and because the health care "system" (if you want to call it that) sucks in Deliverance Land. My primary care physician would not refill my blood pressure medication because they wanted to check my blood pressure first. I called and informed her office that my blood pressure was just fine, as I check it pretty frequently on my own. They did not accept this and required me to make an appointment so that Dr. Whatsherface could bill my insurance...errr...check my blood pressure.
This is a rough account of how this appointment went today. It was scheduled at 2:30 pm.
Jen arrives to her doctors appointment 12 minutes early because she is respectful of other people's time. Jen signs in at 2:18.
Front desk clerk: Insurance card?
Jen: You have my insurance information. It has not changed.
Front desk clerk looking impatient and bored: I have to copy your insurance card every time you have an appointment.
Jen looking skeptical: OK. Digs around in her purse for her wallet to retrieve her insurance card and hands it to the front desk clerk. Here it is.
Front desk clerk: Where is the insured's ID number?
Jen: I go through this with every doctor's appointment. My insurance card is weird. The plan number is in the upper right hand corner.
Front desk clerk: Yes, but I need the ID number.
Jen: The only ID number I know of is on the other side.
Front desk clerk: That is your prescription card.
Jen: It works for my prescriptions and my health insurance claims.
Front desk clerk sighs and rolls eyes: Hang on, let me check the computer.
Jen: This card worked just fine the last time I was here.
Front desk clerk: Oh, here you are. And, yes, it looks like that is your ID number. That is the strangest health insurance card I have ever seen. Hands card back to Jen after she scans it.
Front desk clerk: Looking at her computer screen. It looks like you have a $25 co-pay.
Jen: Not even trying to hide sarcasm. Yes, that is what it says on the card. Retrieves her debit card from wallet and hands it to front desk clerk.
Front desk clerk: Takes debit card and scans it. Credit card machine prints 2 copies. Hands Jen both copies. The top copy is mine. The bottom copy is yours. Still looking at computer screen.
Jen: Signs the top copy, thinks about handing the clerk the bottom copy to see if she notices, and decides it is not worth the effort. Hands the signed top copy back to the front desk clerk.
Front desk clerk: You may have a seat.
Jen sits down and begins to read her Kindle. She becomes so engrossed in the book that she scarcely notices that there is no one else in the waiting room. Later a man enters the waiting room, and Jen faintly hears the same voice (Insurance card, please?) Jen thinks, "What the fuck? I didn't get a please." What appears to be a mother and daughter tandem appear from the treating area where they do all of the important work. Jen wonders what time it is and digs in her purse for her cell phone. She is upset to learn that it is now 3:30. Five minutes later another nurse appears from beyond the door where they do the important work and calls for Jen.
Nurse: May I get your weight? Please step on the scale.
Jen: Joking, sarcastically. I guess I don't get a choice, do I?
Nurse: Does not look amused. 129 lbs.
The nurse directs Jen to room #2. Jen notices 4 other rooms that are open and empty and 2 nurses sitting behind a nurse's station where one nurse is playing solitaire on her computer.
Nurse: Please sit on the table.
Jen: Thinking, "Well, at least I got a please."
Nurse: I need to get your vitals. Checks pulse. 62. Checks temperature. 97.9. Checks blood pressure. 122/90. Your blood pressure is high today. What brings you in today?
Jen: Well, your office said I had to come in to get my blood pressure checked to get my blood pressure medication refilled. Yes, my blood pressure is high today. But, it is not normally high. It is high because I am in pain, and I am angry that I had to wait an hour for an appointment I didn't really want or need so that your office can bill my insurance and charge me my $25 co-pay.
Nurse: Seems angered. Dr. Whatsherface will be in shortly. Nurse leaves patient room #2 and closes the door behind her.
Jen gets off the table thinking she will have to wait at least another 30 minutes. She sits down in the chair in the room and begins reading her Kindle. To her surprise, Dr. Whatsherface opens the door in about 10 minutes.
Dr. Whatsherface: Hello, Jen. What brings you in today?
Jen: As I told the nurse, I am here to get my blood pressure checked so that I can get a refill on my blood pressure medication.
Dr. Whatsherface: Can you sit up on the table, please?
Jen sits on the table.
Dr. Whatsherface: It appears your blood pressure is high today. I would like to check it again.
Jen: Annoyed. As I just told your nurse, my blood pressure is high today because I am in pain.
Dr. Whatsherface: Why are you in pain?
Jen: I have chronic pelvic pain, pain in my left hip, pain in my left thigh, pain in my left flank, pain under my ribs, and pain in my lower back.
Dr. Whatsherface: Looks concerned. What is causing this pain?
Jen: Dr. Whatsherface obviously did not look at Jen's chart before coming into the room. Well, as I told you the last time I was here, I have a history of endometriosis. I have had 4 surgeries since September 2010, one of those a spinal fusion surgery. I am having surgery again in a couple of weeks for the chronic pelvic pain, so I would prefer not to tinker around with my medications until I have that surgery.
Dr. Whatsherface: What is the surgery for?
Jen: It is for the chronic pelvic pain.
Dr. Whatsherface: Yes, but why are you having surgery again?
Jen: Because I have pelvic pain.
Dr. Whatsherface: Who are you having surgery with?
Jen: With Dr. xxxxxx at the Center for Endometriosis Care.
Dr. Whatsherface: I've never heard of the Center for Endometriosis Care.
Jen: Well, you can look them up on line. They operate out of Northside Hospital.
Dr. Whatsherface: Why are they operating again?
Jen: Getting impatient. Because I have pain and because I am having difficulty eating.
Dr. Whatsherface: Why are you having difficulty eating?
Jen: Because it hurts to eat.
Dr. Whatsherface: Looks at my chart briefly. Yes, you have lost 12 pounds since you were here last.
Jen: Yes. All of the muscle I once had has turned to fat because I can no longer exercise and because I cannot eat.
Dr. Whatsherface: Why are you having surgery for endometriosis again? Didn't they remove it all?
Jen: I don't know. I may just have adhesions. I've already had a hysterectomy and my left ovary removed because it was severely adhered to my lower intestines.
Dr. Whatsherface: Adhesions do not cause pain. Have you thought about whether it could be something else causing your pain?
Jen: Yes. I have. I have been to a urologist who checked for stones and a UTI because I am having pelvic pain and flank pain. I don't have a UTI or kidney stones. Before I had a hysterectomy, I went to a gastroenterologist and had a colonoscopy because I wanted to be sure before I had my uterus removed as I have not had any children. He did not find anything wrong with the inside of my colon. The colonoscopy did reveal something, though, because I woke up during the procedure in severe pain. It told me that there was indeed something wrong with my colon, but I think it is on the outside.
Dr. Whatsherface: Have you considered seeing a different doctor? I don't think this is endometriosis since you have already had a hysterectomy and had the endometriosis removed.
Jen: Blood pressure rising higher, really angry with Dr. Whatsherface because she is just repeating what she vaguely remembers from medical school. What doctor do you suggest I see?
Dr. Whatsherface: Perhaps you could see someone from Emory?
Jen: What kind of doctor from Emory?
Dr. Whatsherface: I don't know, but this seems like a lot of surgery.
Jen: Thinking, at least she said the magical words, "I don't know." Yes. But, how is any doctor going to figure out why I have excruciating pain and difficulty eating besides to cut me open and find out?
Dr. Whatsherface: I think it might be something different since you've already had surgery for endometriosis. Maybe you should get a CT scan.
Jen: Can feel blood pressure rising, just wants her fucking prescription and to have some time during the day not spent in a doctor's office or pharmacy. If it is endometriosis or adhesions, it will not show up on a CT Scan, and I don't want to waste more money on another scan that will likely show nothing. I have a lifetime limit on my health insurance. My back surgery alone was a quarter of a million dollars. I've had three surgeries for the chronic pelvic pain in the past 2 years. Every time I have to make a doctor's appointment to get my prescriptions refilled, your office is billing my insurance company hundreds of dollars. I've already made the deposit for the surgery. I'll let you know what I find out. Can you please give me multiple refills on my prescription?
Dr. Whatsherface: Puts the blood pressure cuff on Jen and squeezes her arm. Your blood pressure is even higher now.
Jen: You don't say?
Dr. Whatsherface: OK, I'll go get your prescription. Leaves room and closes door. Comes back 10 minutes later and gives Jen the prescription.
Dr. Whatsherface: Best of luck with your surgery. Make sure to have them fax me your records.
Jen: OK. Will do. Leaves Dr. Whatsherface's office without looking at congenial front desk clerk and heads straight to the Big Apple nail salon for a pedicure she cannot afford so she doesn't punch someone in the face. Ahhhhh...pedicure.