You're in Room Three
The Patient Profit Optimization Analyst Will Be Here Shortly to Kill You
Welcome to August’s September’s October’s blog.
“Why the delay? I’m paying for this …. oh, wait.”
I’ve been clawing my way across the barren parking lots of strip-mall “patient throughput maximization” facilities, that used to be health care organizations, for 18 months. I’ve written about it before, so today I will distill my rant down to just two practical actions. Learn from my experience so my sacrifices shall not be in vain:
1) In any non-trivial encounter with the medical system bring someone to support you and provide an additional pair of eyes and ears.
All along my painful journey, “providers” have misunderstood, misinterpreted, misinformed, or dismissed me. This caused stress, made me forget important questions, put me in a one-down position, and created a hostile and confrontational environment requiring repeated attempts to address.
A fair witness can provide a more dispassionate voice of disagreement, offer emotional support, bolster credibility, and take notes.
You need a “consulting attorney” in the room to help manage the context and respond to transactional, if not adversarial, haggling over treatment deal points.
Remember, you’re not discussing your well-being with a trusted collaborator; you are talking to a claims representative proxy with marching orders defined by insurance company and medical group accountants and lawyers. They are on the other side of the table, whether they want to be or not.
2) Always review visit notes, impressions, chart annotations, any record of what a provider has put into your medical record. Information must be reviewed and vetted. Question or correct anything that is incorrect or even doesn't feel right.
After every appointment I saw notes in my chart that contained factual errors or created impressions detrimental to proper treatment. There were allusions to mental state, irrelevant side notes with no clinical importance, suppositions disputing or dismissing my information, wrong guesses and flat out incorrect and failed diagnoses. It became a full-time job just to try to communicate all the errors in the chart to the powers that be.
Your health history is a permanent record of patient-institution interactions and “encounters.” It’s a “patient behavior credit history.” It tracks whether doctors delivered the lowest-cost attention to you, consistent with statistical measures of acceptable outcomes, and whether you complied with their directives like “manage your lifestyle and take your pills.” It’s a risk management tool for institutions, doctors, and insurance companies. It has little to do with providing accurate information to treat you appropriately.
My medical-industrial complex encounters continue to be bad, going to worse, and then to hopelessly fucked. Messages not delivered or responded to, doctors saying, “not my job, go to the ER or call your primary.” And most recently, finding that one of my health issues carries a very high risk of serious adverse incidents, after 18 months of doctors writing irrelevant notes in a mildly disparaging tone, dismissing my warning signs as “anxiety” and recommending counseling.
See how cost-effective that is? I paid my insurance premiums, the patient contact optimizers endured an appropriate level of interaction to minimize cost and cover liabilities, expensive treatments were avoided, and if I give out it’s because “well, I am sorry for your loss but some things just can’t be avoided especially as we age, and especially because of his history.”
Don’t get sick in america. Your illness is someone’s profit center.
“Oh wait …. I’m paying for this crap!”
PS: Apologies to all those hard-working compassionate health care professionals who do want to help and heal. Thank you for all you do. You’re caught in a system. Help fix it with your push-back.