Welcome to my Office . . . uh, how thick is your chart?

March 22nd, 2006

To the Editor,

Mr. Salgo’s discussion left out one disasterous consequence of the ‘drive through’ doctor’s office. The patient who is sick with complex or uncommon conditions will be ostracized and forced to ‘hop’ from doctor to doctor. Professionals are mostly unwilling to undertake (no pun intended), the financial penalties of taking a patient with a third party payer, who cannot be cured or managed in a few simple visits.

There are articles in medical journals touting ‘diagnoses’ that can be made based upon the ‘thickness’ of a patient’s chart, or the number of doctors consulted. If a patient tries to help a physician save time by providing reputable research done on the (dare I say it?) internet or a medical library, it is often resented. I was disabled by commonplace, but rarely diagnosed, conditions caused by pesticide poisoning. Few physicians are knowledgable about toxicology. One doctor told me my insurance did not pay her enough to read my sizable chart. Her advice was to consult a doctor who does not accept insurance and pay for their time ‘out of pocket’. Of course I was expected to fork over my co-pay for that visit and was unfortunately much too ill to fight such [non] ‘treatment’.

I wonder if I should go to my accountant for medical advice and to doctors for their extensive knowledge on bookkeeping? My compliments to the devoted practitioners (I finally encountered some), who are willing to rise above such issues.

Barbara Rubin

Categories: NY Times

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