RATS IN THE MAZE OF MODERN MEDICINE

AAAARRRRRGGGGGHHHHH!  That's me screaming in frustration.

Backstory:  The local multi-specialty medical clinic here was, until a couple of years ago, physician-owned and operated, founded by a handful of doctors in 1924.  When my husband joined the clinic in 1982, there were 33 doctors (one female!)  He went through a round of interviews, two of which included me.  These were social events, but I was aware that we were being evaluated as to whether we'd be a good "fit".  For my part, I was asked if I was sure I wanted to move so far from my midwest home and family -- they didn't want the little wifey to get homesick and demand to move back home to Illinois.  I told them we were looking forward to our new life in Washington.  Assured that he wouldn't flake out and quit, Hub was hired.  The docs in those days committed their entire careers to the clinic.

The clinic has grown tremendously since those early days and now has 500 care providers and 2,000 staff members and dozens of satellite clinics in outlying communities.  My daughter-in-law manages one of them and got the position all on her own!  No nepotism!

In 2016 the Board made the controversial decision to "merge" (which was a sneaky way of saying "sell") to a larger corporate outfit.  Big payouts went to some shareholders, to the consternation of others (us), and many took their wad of cash and quit or retired; everyone was in a state of flux.  No  one knew what to expect of the new bosses.

Well, the new bosses got in over their heads, grew disillusioned with their purchase and now have sold the clinic again!  The new new corporate bosses will come on board within the next year.  So the place is still in a state of flux.  Doctors are bailing left and right because they are overworked and understaffed and the bean counters want them to work harder for longer hours.  Support staff, as well, never know what the new decree from on high will be.

And patients, like me, are being jerked around!  Let's just establish that I admit to being bitter about this whole debacle because of my constant loyalty to and belief in the excellence of this clinic and it's doctors for the 25+ years Hub worked there.  To see it struggle now and to find myself a victim of the transition and the business (not the quality of care) of medicine is aggravating.

I had an excellent primary care physician for a number of years.  I loved her.  We got along great. But she decided to close her practice in 2014 and work in a different medical model (which is really cool and how all medicine should be practiced!)  I went to another doctor the following year and that did not go well.  She treated me like a warm body passing through the exam room, focused primarily on that stupid Medicare questionnaire about whether I've fallen lately and do I eat enough vegetables, etc.  She ignored what was important to me, brushed off my questions, and didn't order any routine labs.  Nope!  Not going back.

So I looked for another doc and found a woman who was sort of great. She helped me through a number of issues and I had a good rapport with her.  Whew!  I was relieved to find a new doctor I could rely upon.  Nope.  She quit.

I was "assigned" a doctor at that point, a man.  I hadn't had a male doctor in decades, but I was a bit worn down and decided just to check him out.  I liked him.  He was friendly and funny and listened to me and we were on the same page about being partners in my care.  I was happy.  I saw him a couple of times....before he quit.

Before leaving he referred me to a woman in the department, an Advanced Registered Nurse Practitioner (ARNP), who are being utilized more and more to "extend physician access".  Basically you don't have a doc, you have a Nurse Practitioner, who are also skilled primary care providers.  Anyway, he said she would be a great fit for me.  She was interested in a holistic approach to health care and would be open to me pursuing my interest a healthy lifestyle rather than taking medications.  I made an appointment in May to see her in August for my first visit with her.

I got a call last week confirming my August 13 appointment.  Then I got a call on Monday telling me she had to reschedule my appointment.  I was annoyed, because my last three doctor visits have been rescheduled due to the doctor needing to change the appointment.  This was becoming a trend.  But oh well.  OK.  I called back to reschedule and the gal in the Resource Center (nowhere near the doctor's office, in a separate building 3 miles away!) told me my new provider was leaving the clinic in September which was why she was cancelling and rescheduling some appointments.

My initial response was to laugh maniacally, I'm sure startling the gal on the phone.  "You've got to be kidding me!" I said.  "I've had 4 primary care providers in 4 years and I haven't even seen this one yet!"  I felt myself becoming angry, then sad, then discounted....I started crying as I talked, then sobbing.  Geez,  I could just imagine this poor young woman putting Behavioral Health on speed dial as she tried to help me with this dilemma.

I quickly calmed down and told her I knew a doc I wanted to see at an outlying clinic 20 minutes from my home, which frustrated me because I live 3 minutes from the main campus but it appears there are NO doctors there!  Whatever.  She checked and then told me the doc I wanted was no longer accepting patients.  I burst into tears again, ranting that I could have gotten in to his practice had I not wasted my time waiting to see the ARNP who had the gall to freaking quit on me!  I assured her several times this was not aimed at her and I was sorry for my reaction and I thanked her for her help.  Still, I hung up without an appointment with anyone.  But just before our goodbye, the gal in the Resource Center whispered, "Bless you."  So I guess I scared her into thinking I was a helpless lunatic.

An hour later I got a voicemail from the clinic from a nurse in the ARNP's office telling me I should have my labs done prior to my appointment on 8/13.  WHAT????  I thought they just told me I had NO appointment!  I called back and after 13 minutes on hold finally talked to the Medical Assistant in the office who confirmed the ARNP is leaving the clinic but she would still see me once and that my appointment shouldn't have been cancelled after all.  NO!  Why would I establish care with a provider who has one foot and half her brain out the door, only to have to establish with another doctor in short order?  The MA agreed this made no sense.  She recommended a few other providers, but I hung up with no appointment.  I have research to do and a letter to write to the CEO and Board President of the clinic.

I'm grateful to be healthy, able to navigate this craziness to some degree, articulate enough and savvy enough to know what I want and have some idea how to get it, but still I feel ultimately at the mercy of a system that no longer treats patients with the respect and care we deserve.  I'm sick of being a "customer" and paid the lip service of being their "#1 Priority"when the reality is anything but.  I'm sad for the many, many people who don't have the confidence, the courage, or the inside info I have to advocate for themselves.  I'm sad for those truly ill, confused, and those with hearing issues who likely can't navigate the six automated options offered every time you call the freaking doctor with a simple question!

We come to health care providers in a vulnerable state.  Our very lives are at stake.  We share with them the most intimate details of our physical and emotional selves.  Being shoved around like rats in a maze, expected to adjust to a new system (devoid of friendly faces now that check-in is completely automated and no receptionist is in sight!), and then expected to accept any care provider who happens to have an opening at any given time  (and who barely look up from their computers and are loathe to see us unclothed or have to touch us) is disrespectful and dismissive.

I guess I'm old enough now to compare this experience to the "good old days" and I hate that stereotype of being stuck in the past.  I'm all for change and modernization and generally welcome it, but in some cases we got it right back then.

At least, that's the view from here...©

Photo Credit:  www.pixabay.com

https://www.nbcnews.com/business/business-news/doctor-out-why-physicians-are-leaving-their-practices-pursue-other-n900921?cid=sm_npd_nn_fb_ma