Adventures in Waiting

So today I had a first experience in my new home.  I went to see a doctor.

After a little under a week of sniffles and a weekend of a rapidly disappearing voice and increasing cough, my dearest called the local clinic and got me an appointment.

I am used to the US medical system, under private PPO insurance, so I am used to making an appointment with a specialist directly, not having to go through a GP to get a referral to a specialist.  Additionally I am used to having my insurance billed, and then about a month later, getting an invoice for the uncovered amount directly from the doctor's office.  I have also had the same doctors (specialists) for the past 18 years at least.

First observation -- the office was well-run and organized.

Second observation -- I did not have to fill out the clipboard of forms that are common to US doctors' offices these days.  I didn't have to wade through HIPPA forms, or 8-10 page check-box medical history forms, or designate a person to whom the doctor can talk about my medical information.

I was planning to arrive about a half hour before the appointment in order to have time to complete all the forms I am used to filling out.  Still reeling from the formless check in, I followed my dearest to the exam waiting area and sat down.  I was stunned when I was called to the exam room before I had even read 2 words of my book.  I was equally amazed that there were no paper records.  Everything was computerized.  I was queried about my symptoms, asked what usually happens when I present with these symptoms -- my US ENT and I have a fairly good history and both of us know the routine.  I very rarely left his office without a prescription for antibiotics and a steroid injection.  Naturally I assumed this was the way that this visit would go.

I was very surprised.  I was seen first by a medical student -- this was not an issue for me, I have no objection to being used as a test subject for doctors in training;  how else do they become doctors?  -- and he did a preliminary symptom work up, querying me about the symptoms and taking a cursory look at my throat. My US ENT would usually take a look up both nostrils, in my ears and then down my throat. And naturally, my US ENT had my medical history as a result of the clipboard full of forms I had filled out or updated in the waiting room.  While he did ask if I was allergic to anything, I was truly shocked that neither the medical student nor the doctor when I saw him, asked me the question I was expecting... neither asked if I was or could be pregnant or the date of my last period.  That is almost a standard question for female patients at new doctors in the US as far as I can tell.

After the med student had a look at everything, he went to get the supervising doctor, who came in and queried the student as to what he did.  The student had not had a listen to my breathing, so I inhaled deeply four or five times while he got cozy with the stethoscope.  After a few more questions from the supervising doctor, mainly about the antibiotics I am used to being prescribed in the US, and a discussion of whether my US ENT used a steroid injection or a course of oral prednisone, I was handed a prescription for  an antibiotic and instructed to call back if I am not better by mid-week.

I stopped at the check-in desk to pay the bill on the way out and I was done in about half an hour.  My dearest then suggested that we drop the prescription off at the dispensary and see about getting it filled.  I used a locally-owned independent pharmacy in the US, and never had to wait more than 20 minutes for a prescription to be filled.  In fact, several times I walked out of national chain pharmacies when I had "emergency" prescriptions on the weekend and I was told it would be over an hour to get them filled.  I was genuinely surprised when the pharmacy clerk told me that it would be about an hour to get a frequently prescribed antibiotic filled.  I was really expecting while-you-wait service I was used to in the US.  Okay, new plan.  We headed off for an early lunch (potato pie and a meringue kiss for me; vegetable pastie and a latte for my dearest) and wandered back to the dispensary about 15 minutes before the hour had past.  I wandered through the shop while waiting -- finding a few things I thought I would have to import surreptitiously -- and picked up my prescription before heading home.  Price wise, the prescription was about what I would have paid in the US, given my insurance's prescription plan and the fact that my pharmacy always charged the lesser amount.

On the whole, I was pleased with the service I received, both at the clinic and the dispensary.  There are glaring differences between the system here and the system I am used to in the US, but I think more of that is down to the fact that I have been a patient of the same doctors for at least the past 18 years, and we have a good working relationship.  In fact, seeing the new doctor here makes me miss my US doctors -- some of whom had gone beyond mere service providers and had become friends.  It also made me realize even more than I already believed that is not health care that needs to be reformed in the US.  There is nothing wrong with the CARE provided.  The problem in the US lies in the delivery and payment methods.  Health CARE reform is not what is needed.  Health INSURANCE reform is.