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Opinion: Doctors and their offices are stuck in the 20th century

By Laurel Busch

Last week I spent two insulting, invasive and uncomfortable hours at my doctor’s office. Five minutes of that time were spent being examined, and the rest of the time was ruined by office procedures.

The person calling to remind me of the appointment had been careful to say 2:45 was my “check-in” time, so I knew I was in for some paperwork. I was handed the usual forms when I arrived. I have never understood why I need to fill out the same forms with the same information every time I visit the same doctor, but I do.

The insurance information
First they confiscate your insurance card along with your driver’s license, and then they hand you a bunch of forms to fill out with all the insurance information that’s on the card they haven’t given back yet because they’re copying it for the file. And they don’t just need the information on one form—they need it on several. Why?

Computers have been in the business world for more than 25 years. Why don’t doctors’ offices have all of their patients’ information on computers? Actually, some of my doctors have started handing me computer-generated forms when I arrive and just ask me to verify what’s in their records. There is no reason all of them can’t do that.

The patient history
Doctor’s office receptionists claim insurance companies require their patients to fill out health histories at just about every visit, so I’ve started to think the whole point is to gather evidence to deny coverage. It’s an easy way to catch you in a contradiction or omission because there’s no way anyone can fill out the forms consistently or remember every past medical symptom, event or treatment over a lifetime.

Putting down a certain symptom may tag you with a pre-existing condition, but sometimes a specific symptom on the form provides evidence for your doctor to bill using a certain code or order a certain test.

I would much rather just tell the doctor why I’m there and let him or her put it in my record.

The financial probe

It’s not labeled a credit application, but that’s what one of the forms is. They treat all their patients like deadbeats who won’t pay what the insurance doesn’t pay. Even though I have insurance and I’ve been a patient for years and I’m just there for an exam, they still have to have not just my employment information and Social Security number but my husband’s, too.

And they always need the name of the “nearest relative not living with you.” I used to think that was the person they would call in case of an emergency while I was in their care or on their premises, but then I realized they just needed someone to harass if I don’t pay my bill. I always pay my bills promptly, so I’ve started giving them my senile father’s name and his phone number at the nursing home.

When I’d finished filling out all the forms and returned them, the receptionist told me they weren’t able to find my file but assured me it was nothing to worry about. I sat down to wait and tried not to think about the impending exam. (Hint: I was at the gynecologist’s office.)

The identity test
I ended up sitting there until 3:30—45 minutes past my appointment time. The nurse who finally came to get me led me to the scale and on the way casually called back to me, “What’s your birth date?” It was obviously a test that only I should be able to pass. I was in a foul mood by then. I told her the date and added that she was treating me like a thief.

She explained they did that so someone else couldn’t steal my medical identity. I certainly don’t want anyone else getting medical care under my name (and insurance), but I’d already had to give them my driver’s license when I checked in. That should have been enough.

Privacy? In a gynecologist’s office?
A few minutes later, the same person was explaining to me how I will learn the results of my routine Pap smear. A third party will call me and leave a message saying the results are ready and I will have to call another number, put in a code and listen to a recorded message to learn whether the results are normal or I need a follow-up visit. The doctor’s office used to mail a postcard when results were normal and call if they weren’t. Now they seem to think it’s more efficient to give my name, phone number and medical information to a third party and presumably pay the third party to communicate with me via recordings.

I waited another half hour on the exam table, and the doctor finally came in. She didn’t really apologize for the wait, but she explained that the staff had not been able to find my file. They had eventually figured out that a doctor who left the practice a while ago had taken the file with her. It seems the same color label was used on both doctors’ files. Something tells me I’m not the only patient this happened to, which makes me wonder why they didn’t check on this possibility as soon as they discovered the file was missing.

There’s got to be a better way

I know that one of the ideas for cutting health care costs has been converting to electronic records. Every time I hear about it I’m surprised doctors haven’t been using electronic records for years the way most other businesses have.

I do hope that the third-party telephone notification of test results is not an example of the conversion to “electronic” records. I don’t see how something like that will result in anything but confusion, frustration and annoyance for patients, unjustified expense for medical providers and lots of new data for the third party to store and sell. (As a matter of fact, I wonder if the third party is providing this message service to the medical group for free or at a very low cost just to acquire the patient data.)

I also hope that medical office staffs will figure out how to use the capacity of computers to store and update patient information rather than gathering and inputting all of it all over again every time someone comes in for an appointment the way they use paper forms now.

I’ve been uneasy at the thought of all my personal information sitting on a medical provider’s computer, but are paper records any more secure? After all, my paper file was removed from my doctor’s office months ago and no one even noticed until I showed up for my appointment.

The only way to improve efficiency in the doctor’s office will be for the entire staff to begin handling information the way the rest of the business world does now. Frankly, I’m not confident they are capable of doing that.

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