A daughter came to her parents’ office visit, wanting to discuss their care. I found that the seniors had not listed this daughter on the Health Information Portability and Accountability Act (HIPAA) form that gave me permission to share medical information. Also, the seniors were scheduled for only blood pressure checks that day, not full office visits. I asked her parents to add her to the form, and I directed my staff to make copies of the instructions her parents received in the past. I also asked the family to schedule a conference.The daughter was irate. “I took off work today. The least you could do is have the courtesy to talk to me.” I tried to tell her that other patients were waiting for their appointments and deserved the time they’d scheduled. Again I offered several conference-time options including a telephone conference at her convenience. She stormed out, and her parents never came back to my practice.
If you want to ask your plumber a question, do you yell down the drain? No. You call and the plumber either calls back, or sets up an appointment. It’s the same with your doctor. There’s no way to do address an entire list of questions in a 15 minute office visit, let alone during a quick BP check. I call this “interaction by ambush,” when what you should do is make appointments. You’d do that with any other professional, right? These are the steps:
Make sure the doctor has permission to talk to you. Health care providers can give information only with written permission from the patient. If you aren’t on the list, take it up with your folks.
Make an appointment. The days are gone when a doctor will come right to the phone when you call. Medical practices just don’t work that way anymore. Ask for a phone appointment, or a meeting. Most docs communicate by email; some even SKYPE. I’ve scheduled conferences in the hospital, or nursing home to accommodate visiting family. Often, I did conference calls with a speaker phone, so the local and long-distance family could be involved. This can happen; and the key word is SCHEDULE.
You and your family have to communicate. I can’t schedule conferences, or phone calls with a million different family members. Pick a point person to communicate relatives who can’t come to the conference.
Prepare for the fee. Some supplemental and long-term care insurance policies will pay for conferences, but Medicare and other health insurance policies typically pay to do things TO people not FOR people. It’s only recently that there’s reimbursement for education as well as tests and procedures. Ask about the conference fees when you schedule. Why is this a problem? You pay your attorney, don’t you?
HIPAA says I can’t talk to you; it doesn’t say that you can’t talk to me. If I’m investigating why Dad falls all the time, I need SOMEBODY to tell me he drinks a six-pack every night. Even if your name isn’t on the list, you can send a letter, fax, or email. I won’t be able to answer, but I can incorporate that information into the examination. Most of us are skilled enough to slide the questions in without suggesting where they came from.
If a doctor won’t ever arrange to talk to you, won’t respond to communications, or treats you disrespectfully, find another doctor. Today, medicine is a customer service industry. You wouldn’t entrust your car to a mechanic who won’t tell you what’s going on. Isn’t your body more important? My mentor, the great James R. Webster, Jr., MD always said, “Doctors don’t have patients; patients have doctors,” BUT…Please understand that we’re not your enemy. Most of us still care about helping people. The current health care climate is changing so rapidly, and it’s so different from the way we were trained; many of us are overwhelmed, but most of us want to get it right. Please give us a chance.