*gets on high horse*

I am a nurse with no small amount of expensive health care related education and experience who works in a health system that has its very own heath plan (partnered, of course) and I promise you it just took me 3 solid hours to find a pediatrician for my kid. AND THAT WAS JUST FINDING A NUMBER TO CALL. There was the extra challenge of subscribing to a HDP HSA (high-deductible plan with a health savings account), but that’s where the smart money is in the marketplace.

After I finally set an appointment got off the phone with the grumpy receptionist from the new pediatrician’s office, I immediately called the old pediatrician’s office to request that my kid’s records be put in le grand queue at the fax machine to be sent to the new doc. I was shut down HARD by this grumpy receptionist. I need a release from the new office first. To be signed by me. And the new office requested a release from the old office. To be signed by me. I have a fax machine app on my phone, but I can’t make this happen.

So we will go to the appointment and take the heat and compromise in care of not having his records at the time he is seen. No medical history at all. I will duplicate a small forest’s worth of paper writing out what my shoddy memory contains of his past years of life. It will be skimmed. No one will be happy.

My morning’s nightmare is comprised of two system failures: Who can I find that will take my insurance (bonus question, at what coverage level) and how do I get my medical records to a new provider.

Here is how this could work better:
1.) Stay within the same health system (Kaiser/Geisinger/Sentara/any odd number of university health systems) so that the records are within the same electronically record management program, the billing is the same, and you can assume insurance coverage is the same.

alas, this is not an option (I moved)

2.) Use a larger brand of insurance. More providers accept them. Makes the hunt easier, does nothing for the transfer of medical records.

also not an option (Are you crazy I can’t afford that!)

3.) Pray for the day that health care reckons with the IT future of an electronic medical record that belongs to the patient, not the health system. Throw in a hail Mary for universal coverage. The first I am convinced will happen. The second not really.

As of now if you establish a record of care with a health system you are held there by the inconvenience of moving to an outside provider. It’s a perverse way to get brand loyalty. The middle-weight systems are (wisely, as the motto is grow or die) consolidating independent hospitals and practices faster than you can say “who bought us?” Health systems are trying to grow as big as health insurance networks and become both payer and provider. I get it. The future of a small number of very large health systems and the demise of the independent practitioner is not the saddest thing in the world. Right now, though, things are getting more complex as dozens of regional players merge and partner and insist on keeping their name on the door. It reminds me of having 4 specialists involved in the care of a critical patient and all I want to know is who is the captain of this ship! But that is another issue entirely. Or is it, really.

To bring it right back to where the confusion started, my insurance card has four company logos at the top. And the website is bad. Also, my human resources person is an animated character. Man that took forever. But now I’m just quibbling.

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2 thoughts on “Finding primary care.

  1. I have some much to say about this! Also, thinking about making your blog required reading for my innovation work teams looking at some of these issues 🙂

    Like

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