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What to do when you receive inadequate medical service

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Have you ever gone to one of those 'corner medical clinics' because, for whatever reason(s), you do not have a Primary Care Physician? If you have gone to such a clinic, did the medical professional you saw treat you like such an IDIOT that you were too dumbfounded to speak up on your own behalf? Below is a story which exemplifies such an incident.

A woman went to a local corner medical clinic because she had a very bad case of hives primarily on her face. She was seen by a male Physician's Assistant. The two of them discussed the probability that most cases of hives are due to stress. The Physician's Assistant quickly reviewed the client's medical history and list of current medications. He told the client that she was already on a lot of medications for anxiety and depression and, therefore, her stress level should be under control. However, since it obviously was NOT under control, her doctors didn't know what they were doing and they should try something different. When the client told him which medication she was usually given by previous physicians for this same problem, the Physician's Assistant said that particular medication was a steroid and he didn't believe in prescribing a steroid for daily use on one's face. The only prescription he would give the client was for a simple antihistamine called Hydroxyzine HCL 25 mg. The client was thinking, 'What's up with this? The hives are so severe that it feels like my face is on fire and my face itches so bad that I feel like clawing the skin off?' After hesitating for a moment, she actually said those exact words to the Physician's Assistant. His response was something to the effect of 'You want me to give you a magic bullet that will take care of all your symptoms immediately. I can't do that because there is no magic bullet. He told her to take Pepcid AC along with the Hydroxyzine HCL, and referred her to a dermatologist to whom she would have to wait over a month to see.

When the client got up the next day, the hives on her face looked and felt even worse. After much consideration and some miserable brooding, she called the clinic and asked to speak to the Medical Director or whoever was in charge. When the receptionist realized that the client wanted to file a complaint, she referred the client to the Patient Liaison who was based in another state. The client called and left a voice message for the Patient Liaison. For various reasons, the two were not able to connect on the phone until the next day. The Patient Liaison listened very carefully to the client's complaint, said she would look into the matter, and call her back. (Please keep in mind that, with each passing hour, the patient is feeling increasingly miserable like her face was on fire with almost unbearable itching.) The client waited for that return phone call all day with no results.

The next day was a Friday and the client certainly did not want to go through the weekend feeling so badly. She waited for a few hours and then finally called the Patient Liaison again, but had to leave a voice message. Just as the client had given up hope of her complaint being taken care of, the Patient Liaison called her back at about 6:30 p.m. and told the client she would need to go back to the same clinic and be seen by a different provider but she would NOT be charged for the additional office visit.

The client returned to the clinic on Saturday and, this time, was seen by a physician who listened to her story very patiently, said he had no problem giving her the medications she needed, and he wrote prescriptions for a different antihistamine and a topical ointment to apply to the hives on her face. And, as agreed upon with the Patient Liaison, the physician did NOT charge her for the office visit.

When the client got up the next morning, she was pleased to discover that her hives had significantly improved and she finally began to feel better although she still needed to finish taking all the medication prescribed to her by the physician.

At this point, ask yourself 'What would you have done if this happened to you?' Do you know how to successfully advocate for yourself in a medical setting or would you just bite your tongue, muttering various four-letter words under your breath on the way out to your car?

Listed below are some things you can do to improve the odds of getting your medical needs met when you visit the doctor.

Take your driver's license or other appropriate government-issued ID, your insurance card, and a list of all the medications, supplements, vitamins, etc. which you're currently taking, including dosages and number of times per day.

Be prepared for anything. Examples include:

  • being told that your name is not listed in the computer as having an appointment that day;
  • being told that you are 15 minutes late for your appointment but they only allow 10 minutes for being late and, therefore, you will have to reschedule;
  • being told in no uncertain terms by a new staff member you've never seen before that your insurance does not cover the office visit with the doctor.

Document everything.

  • the date and times when you have any contact with any staff members;
  • the names of the people you speak with;
  • a brief note about what is said--just enough to jog your memory at a later date, if necessary.

Make a list of everything you want to discuss with your doctor before you go to the appointment. Many of you will only have approximately 2 to 5 five minutes to spend with your actual physician so make every minute account by doing the following ahead of time:

  • make a list of symptoms;
  • make a list of questions;
  • don't feel so intimidated that you fail to cover all the issues you wish to discuss;
  • state your issues in a clear but somewhat brief way, and don't go off on an unnecessary tangent;
  • if the physician uses terminology you do not understand, ask them to please explain;
  • if you have problems remembering what your physician says, either write them down or ask the physician to write them down for you;

After the appointment when you believe a reasonable amount of time has passed but you feel no improvement, do not hesitate to call the office and ask to speak to the physician or someone in a higher position with more authority. This can be extremely difficult because, after a while, you might feel like it is the receptionist's job to make sure no one ever actually gets to talk to the doctor on the phone.

  • do your best to remain calm and do not get angry because, once you lose your temper, your phone call will go nowhere;
  • ask to speak to the physician or whoever actually treated you;
  • if that individual is not there when you call, ask to speak to his/her supervisor, the Medical Director of the Clinic, or the Patient Liaison

Be persistent and try to remain calm.

  • If the receptionist says she will have the physician or whoever call you back, allow them a reasonable amount of time to do so. Ask the receptionist if she has any idea what time the physician or whoever would probably call you back.
  • Know what time the office closes on that particular day of the week, pay attention to the time and, if it appears the physician is not going to call before the office closes for the day, call the office again. In many cases, it's very helpful to ask to speak to your physician's nurse and express your concerns to her/him.

Have an attitude of gratitude.

  • Each time you call the office and speak to someone, write down their name. At the end of your conversation, you can then say 'Thank you, (the person's name). I truly appreciate your helping me with this issue.' People like to be recognized and remembered.

By following the above suggestions, in most cases, you will be successful in getting the medical treatment you need.

However, there are times when, no matter what you say or do, you will NOT get the appropriate medical treatment you need. In such cases, you still have options such as filing a complaint with your insurance company or filing a complaint with the appropriate medical board for your state. However, choose your battles wisely because, if you make your provider angry, you might find yourself without a doctor. Know before you even file a complaint that the entire process is long and drawn out, not to mention extremely emotionally upsetting throughout the length of the investigation. Keep in mind that, when a complaint is filed against a physician, the governing board for that physician may investigate but the truth is that they tend to stick together and cover for each other.

In addition, if you file a complaint against a particular physician at a particular hospital, you will be told that their Review Board will investigate but that the results of their findings will remain confidential. Therefore, you will never know for sure if they took any action against the physician in question.

Last but not least, if you file a complaint against a nursing home or similar facility, you will be told that they will visit the facility without advance notice and do an investigation on the spot. However, what they do not tell you is that, as soon as they arrive at the facility, they are required to inform the Administrator or other appropriate person in charge that they are there to do an investigation. Obviously, that news travels throughout the facility by word of mouth or telephone within just a few minutes so the idea of the element of surprise is a joke. And, once again, medical professionals in these settings also tend to stick together and cover for each other. And, again, the entire process is an emotionally grueling experience for the patient and/or members of the patient's family. In most cases, the best thing to do is to find an appropriate facility with better ratings, higher staff to patient ratios, more variety of services available, and an American Medical Director who actually spends a lot of time at the facility itself. (Good luck with all of that.)

If you have experience with a similar story, please feel free to share, especially if you have more ideas on how to deal with the numerous problems which can occur in such facilities.

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