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?"

Me: "GRRRRRRRRRRRRRRRRR."

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.”

But.......

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.

WARNING: food is a choking hazard

How about just putting warning labels on everything.  Including the danger that a warning label can present.

This piece of pointless drivel from the NY Times:

Pediatricians Urge Choking Warning Labels for Food 

Published: February 22, 2010 

CHICAGO (AP) -- When 4-year-old Eric Stavros Adler choked to death on a piece of hot dog, his anguished mother never dreamed that the popular kids' food could be so dangerous.

Some food makers including Oscar Mayer have warning labels about choking, but not nearly enough, says Joan Stavros Adler, Eric's mom.

The American Academy of Pediatrics agrees. The nation's largest pediatricians group is calling for sweeping changes in the way food is designed and labeled to minimize children's chances for choking.

Choking kills more than 100 U.S. children 14 years or younger each year and thousands more -- 15,000 in 2001 -- are treated in emergency rooms. Food, including candy and gum, is among the leading culprits, along with items like coins and balloons. Of the 141 choking deaths in kids in 2006, 61 were food-related.

Surveillance systems lack detailed information about food choking incidents, which are thought to be underreported but remain a significant and under-appreciated problem, said Dr. Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio.

Smith is lead author of a new policy report from the pediatrics academy that seeks to make choking prevention a priority for government and food makers. The report was released Monday in the journal Pediatrics.

Federal law requires choking warning labels on certain toys including small balls, balloons and games with small parts. Unless food makers voluntarily put more warning labels on high-risk foods, there should be a similar mandate for food, the pediatrics academy says.

Adler, a Warren, N.J. attorney who pushed for more warning labels after her son died in 2001, says she hopes the academy's efforts will work. Several efforts to pass federal legislation for labels have failed in Congress.

The group also urges the Food and Drug Administration to work with other government agencies to establish a nationwide food-related choking reporting system; and to recall foods linked with choking.

Adler considered herself educated about children's safety. Her son had eaten hot dogs before without any problem.

Hot dogs are ''almost as American as apple pie,'' she said. ''You really don't know how horrible it can be.''

Perhaps it is not the food that requires the warning label?