Wednesday, April 20, 2011

Fired by doctor. Crime: being too healthy.

I called my son's medical practice. I needed to make an appointment to see the nurse, having just received a letter telling me that Mr 4-year-old was due for his 5 year jabs  as soon as possible.  First available appointment was next Friday (11 days).

But I wasn't allowed to book it.

Let's rewind.

A transcript of the call follows:

Medical Centre: "Hello, ***********Medical Centre.  Please state your NHI number."
Me : "Pardon?"
Medical Centre: (talking loudly, perhaps in case I don't speak Unglush): "PLEASE STATE YOUR NHI NUMBER."
Me: "Oh. Ummmm I'm actually just calling up to make an appointment with the nurse for my son's 5-year-old jabs. I got a letter the other day. I only need to see the nurse, not the doctor. Why do you need my NHI number? Or his NHI number?"
Medical Centre: "Answer the question."
Me: "No. You answer the question."
Medical Centre: "Do you have his NHI number then?"
Me: "Of course not!"
Medical Centre: "SIGH. Fine. What's your first name?"
Me: "The appointment is for my son to see the nurse. Do you want his first name, perhaps?"
Medical Centre: "No. I want your first name, your surname, any previous surnames you have had, your date of birth, current address, previous address if you have lived at your current address for less than 5 years....."
Me: (dutifully answered, stifling the tourettes syndrome infiltrating my brain)
Medical Centre: "Now give me his first name, his surname, any previous surnames he has had, his date of birth, current address, previous address if he has lived at the current address for less than 5 years....."
Me: (dutifully answered.)
Medical Centre: "Oh. He has a different surname to yours. You should have said. How do I know he's your son?"

Not surprisingly, she found my record. Then his record. But she noticed it had been 2 years since he last had an appointment.

Now I was in trouble.

I said, “He last came in for his 3 year jabs. He has visited a hospital in the meantime for a nasty injury, but aside from that, he's been healthy."

To which she said, “Well, I’ll have to e-mail the doctor. He’ll need to agree to the practice seeing him since it’s been so long.” It gets worse: “It’s going to be another week until we know,” she said. “He’s on leave this week, so it may not be until next week that you hear if your son can get in. Unless he is checking e-mail while away.”

Have we just been fired by his practice for not coming in?

"But", I countered, quite reasonably. "We never see the doctor with these vaccinations. The nurse sees us, and then sends us off once she's given the all clear. The doctor never makes an appearance. I just want an appointment for his routine jabs. What does it matter if the doctor is on leave?  ******stifling rant noises****** Ahjustforgetaboutit. Fine.  Let's grab that appointment then, so I don’t lose the opportunity. If need be, you can cancel it.”


Medical Centre: "I see you have health insurance for you and your children?"

Me: "What!?  Yes.  So what?"

She declined to make the appointment.

Having undertaken an empirical investigation of other doctors' practices, I am happy to say it didn't take long to find a much more polite practice, who seemed delighted that I have health insurance.

Health care isn’t supposed to feel like this. Doctors should never expect their patients to feel like they can’t access them, that they “expire” if they remain healthy, or that they are an e-mail decision away from being in or out of the fold of care. Their patients' medical record number should never usurp their name. This shouldn’t be about “working the system”, turning up for an appointment even when healthy just so that I or my children don't get fired from the books. This distance between doctors and patients is counterproductive.  Does the funding regime incentivise poor health and repeat visits?  I had the freedom, wellbeing and mobility to shop around for an alternative.  I feel for those who are trapped at that practice.

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