July 3, 2022
My 12-plus years of intimate involvement as a patient in our medical community. Sadly, gone are the days your doctor was “family.” Today, the system is red tape paperwork and no insurance company accountability. The unnecessary time to obtain approval for your healthcare needs. Why go to a doctor when it’s inevitable that an insurance committee who never sees you can determine your treatment? The doctor is limited in providing his opinion for tests and treatment; all is dictated by your insurance plan coverage. The clarity gets lost in translation with the red tape, codes, and a chain of people involved. I compare it to a team-building exercise to teach better communication. We would form a circle. One person would start by whispering a sentence in the person’s ear next to them. It was repeated around until back to the beginning. We did it several times in this circle. The original sentence was never repeated correctly; it was totally ripped apart. It’s a full-time job for a chronic patient with a critical illness or a complex injury. The medical industry can be agonizing with ongoing calls either on hold for several minutes to speak to someone or through an automated system of several questions. Once you connect with a person, you provide the same information. This can lead to several more transfers requiring more documentation, resubmission, denial, or appeal. If lucky, approval promptly.
A chronic patient is categorically filed under “no man’s land.” Many are directed to a pain management clinic. I was one of many every month who spent much of a day sitting in the waiting room of a pain clinic, only to get the same prescription refill. A cost of $180 to $360 a visit. I assume the difference was for the 5-minute to 15-minute actual doctor conversation. Just kidding, but still wasted time and expense for all. The injection cost $1,000. – $4,000. recommended; at least 2 or 3 likely more. The urine sample costs $50 to over $1,000.00. Yes, a $1,000.-plus? This is no joke. Insurance denied this invoice for no apparent reason leaving it my responsibility to pay. Of course, no explanation for this excessive amount for a drug urine test when provided free as a drug addict or criminal. If treated like a criminal, pay as a criminal. A tad sarcasm but in the emotional moment. It is real. It is extremely lonely. I was getting nowhere with the doctor’s office or insurance company. I was directed to call the independent lab. The lab immediately dropped my cost 1/2; by the end of the conversation, I agreed to pay $50. One of the craziest of the several invoices was the cancellation fee for the pain clinic of $50. The one where they called me to cancel an hour before my appointment. When I called them to explain, they canceled, not me. Their response was we have no record of this call. They continued to send an invoice for 3 consecutive months, with the last stating sending to collections, pay in full. I sent a detailed letter with my phone record of their incoming call. I received no more invoices. I can go on and on with invoices and denied insurance claims. It is torture, not healing. It can be hopeless. The hours of being on hold or transferred endlessly, each having a different answer and most never resolved. It’s an ongoing battle. It has been a year and a half and no prosthetic. I will elaborate on that later. I am grateful. I have the time, too much. I am not dependent on a job nor a full-time single mom. I have the best support system. I am one of the fortunate in the “system.”
The vulnerable experience was making me deranged. I was not being heard or helped, passed on to pain management. I felt like a lab rat. They controlled my life with injections and different concoctions of mind-altering drugs. A slow death with no quality of life. It was depressing. Oh heaven, if you say that to the doctor. The first 10 questions were about your state of mind. The resolution was more medication and psychological therapy. Thank God, It was a blessing that the pain clinic discharged me as their patient. I became an advocate of my care through intense online research to educate and connect worldwide on my treatment options.
My personality will get to the truth and fairness; I will fight any bully. So, this blog is my experience to share and advocate for the underdog, which is most in America. I hope this blog can help change and evolve a better healthcare system. This is not just a patient problem. Most of the medical workforce are beautiful people getting bullied by our current healthcare “system. “As I get older, I want to simplify my life, laugh more, and live in the moment. Carpe diem. Is it possible to simplify the healthcare system for a win-win for all?
Everyone is human – those giving the treatment, those who are getting treated. What they all deserve is compassion and kindness, as a part of the best “care” they can get.
Patch Adams
The arrival of a good clown exercises a more beneficial influence upon the health of a town than of twenty asses laden with drugs.
Thomas Sydenham, 1624-1689
Physician and founder of clinical medicine and epidemiology
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