Yes, and make sure that you understand your coverage and plan policy better than the call-center claims agent you talk to. Document everything. Yes, it is a pain. We have claims that are nearly 2 years old but the insurer paid while they work to figure out how to manage their self-imposed claims system.
And what will it mean when Oxford/ United Healthcare announces that it too is pulling out of Oācare on Dec. 31, 2016, which is GOING TO HAPPEN?
Private health insurance just doesnāt work.
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"A spokesman for HHS said Aetnaās decision was an about-face from its earlier statements about the Obamacare exchanges. In April, Bertolini called the marketplace plans āa good investmentā because it would have cost the company far more than $430 million to try to attract that many customers.
āIf we were to build out 15 markets, it would cost us somewhere between $600 million to $750 million to enter those markets and build out the capabilities necessary to grow that membership,ā"
(https://wamu.org/news/16/08/16/aetna_joins_other_major_insurers_in_pulling_back_from_obamacare)
Holy Fuck! Iām so glad you had this guy watching out for you. Iām almost speechless. I once knew a physician who abused drugs and had affairs with his patients. For a short period of time, I worked for him. He also had a habit of prescribing meds for patients who absolutely did not need them. They either abused them themselves or they sold them to others. Shortly after I resigned my position, the state started an investigation. Iām not sure what happened to him as I put that chapter behind me and never looked back. I just thank the universe I was never called on to testify before the medical board.
OMGosh, what an awful story ā but itās also a tale of triumph as well. You are here. I hope you werenāt permanently disabled in any way. Iām glad your doctor did the right thing. Iām also glad to hear you persisted.
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Amen!
Agreed. Good post. Thank you.
Thanks.
Anecdotally: My doctor runs a teaching clinicā¦basically the equivalent of an LLP. She has residents, nurses, nursing students, med students all in the clinic and meeting with/working with patients. This allows them to do a higher volume practice as it frees up the actual doctor to do the actual doctor work, and allows everyone else to have a hand in learning and practice. Every appointment Iāll usually see 2 or 3 people, depending on what the appointment is for. Itās quick, efficient, and friendly. (keep in mind this is within a universal health system)
But my doctor, being a physician and an educator, takes both roles VERY seriously. She had a resident performing a test on me who was taking it a bit too casual for her likingā¦she rode him like Secretariat until he did it to her standards. Then she said to him āIām not doing this to be a bitch or a hardassā¦Iām doing this to make YOU a better doctor, so you will take this seriously.ā I certainly appreciated it as a patient.
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An old boss of mine is a professor at a college in Argentina. She teaches medical ethics. Sheās also a tough ass, but itās nothing personal ā she has very high standards (I learned a lot from this lady) and wishes to pass along high ethical standards in her students, be they nursing students, administrators, dental hygienists or go on to become physicians. She and I had more than a few long conversations about what even many a doctors lack in knowledge from just the basics in running a practice to actual bedside manner or how their own interactions affect the relationships their patients form (and respect or not) with the staff member, etc. LOL. I used to get the occasional patient ask me how the heck I could work alongside her. My answer was always the same: I respect and agree with her high ethical standards; I know what she expects of me and she rarely ever waivers. Almost nothing is written in stone, so if I felt she deviated in my understandings of her expectations, I felt comfortable approaching her to discuss my concerns. She was great at reading people. She also listened, actually heard you. In many ways, she was also a good friend.
She is a dying breed, I fear. That said, the scene has changed as well ā the U.S. healthcare market and delivery system have undergone some drastic changes in the last few decades. Basically, progress. Still, there are some parts of the foundation that should never change. Iām heartened to hear about your doctor. Your story makes me smile.
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