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05 September 2008 @ 04:08 pm
Foul Friday  
I have had a day. :/

Between the usual work yuck, I had some extra-special disasters today. On the work end, our 2009 formulary was rejected with over 50 things to change - and last week they had blackmailed us into signing a document that pretty much says we will make all the changes they ask for. Nevermind that the week before that we got crap for our per member expenses and over-use of certain medications. How can we control cost if they will not allow us to control the formulary or other services? By and large these are people who will make use of every last service and pill they can get their hands on... Granted, a looser formulary means fewer patients, nurses, pharmacists, and doctors yelling at me. Right now I have the definition of a thankless, Sisyphean job.

Then I tried to make an appointment to get a new primary doctor, since mine is leaving. The scheduler brightly informed me that she'd be happy to help me schedule with my MD of choice... What day in the last week of April 2009 would work for me? If I want anyone with any sort of GI/Neurology specialty, it will be even longer than that. I CAN get in to see one of the new MDs in the next couple weeks, but by new I mean just-out-of-residency, not-yet-Board-Certified new. As is no experience with complicated problematic cases new. Add to that that English is not the first language for either of them and they both just came to the US for their residencies about two years ago. Fantastic. I went with the Russian one, since at least I know what pathologies to expect with that and know how to handle them. At this point I'm just hoping I get written off as too much of a complicated mess and get referred to a specialist.

*sigh* I'm crispy, can you tell?

EDIT: OK, I realize I am lucky to have decent health insurance coverage and all that, but it just doesn't seem to be of much use when I have to wait eight months to get a basic appointment with a GP.  :/   So much for the superiority of the for-profit medical world. I can haz socialized medicine now?
Tags: ,
Current Mood: gloomygloomy
teffanteffan on September 5th, 2008 09:37 pm (UTC)
Egads. Who gets to decide if your formulary is "good for them" or not? Is it someone else in your company, or a gov't agency, or a consumer-advocate group of some sort?

Who knows, maybe the fresh doctors will have entirely new perspectives on your condition or a freak knowledge of some newly-discovered disease that's curable with a particular combination of vacation in Scottish caves and mojitos....
eithni: coldeithni on September 5th, 2008 09:53 pm (UTC)
Patients can look at our formulary and decide whether to enroll with us or regular Medicare/Medicaid. However, we offer A LOT more services, so pretty much anyone who is poor enough and sick enough to be eligible joins. The Feds are the ones who decide that the formulary "passes" or "fails" but they don't really provide clear guidelines about what they expect and they are heavily influenced by Evil Drug Companies.

Regarding caves and mojitos, I only wish... That's the sort of therapy I could really get behind!
teffanteffan on September 5th, 2008 09:55 pm (UTC)
I had a feeling only the Feds could be that ridiculous and still be in charge....
Mark Gordonmtgordon on September 5th, 2008 09:49 pm (UTC)
Russian doctors, ugh. I've met a few, and I haven't really been impressed. Biology wasn't the Soviet Union's strong point; there's too much politics in human health, and their medical education system suffered horribly as a result.

If you're lucky, either they'll bounce you to the specialist ASAP as you asked, or they're sufficiently pliable that they'll defer to your judgment if you know exactly what you want from them. I'm not sure whether young Russian doctors are brought up to be self-righteous prima donnas; you may be fortunate in that regard.
eithni: ?!?!?!?eithni on September 5th, 2008 09:56 pm (UTC)
Yeah, I'm aware of those issues, as well as the machismo that is endemic among Russian men, but like I said, I was choosing the known evils as opposed to the unknown quantity of a Malaysian MD. Besides, if they are undertrained, it will be that much more appealing to make me just go away. Win-win. :P
CeNedra_Nasiocenedra_nasio on September 6th, 2008 03:54 am (UTC)
I'm sorry you've had a craptacular day, but cheer up kid there will be sunny skies soon! "I am a cool and clear mountain lake. My crummy day is but a cloud casting a shadow upon my surface. I will be here far longer than it will be."
DameJdamej on September 6th, 2008 10:07 pm (UTC)
If you wanted an appointment for a cosmetic procedure that you were paying for out-of-pocket, they could get you in this month, I'll bet. At least, that was the finding in a recent study of wait times for dermatologist appointments. It's basic market economics -- a certain number of appointment times are kept available for profitable cosmetic procedures, just like airlines may make you wait for another flight if you are using frequent flyer miles but get you seated right away if you are paying full fare.

Maybe you need to check the menu of HMO services to see if there are any relatively low-cost but out-of-pocket cosmetic procedures that your GP can perform. Then, while you are in his office, you can talk to him about your real problem.
eithni: ?!?!?!?eithni on September 7th, 2008 07:31 am (UTC)
Yeah, but there's a problem with that - you can't schedule ANYTHING until you have had the intro appointment with your primary. :/
eithni: yipes!eithni on September 7th, 2008 07:32 am (UTC)
OK, I suppose you could go to the ER. Almost did that last night, on unrelated symptoms. :(
doc_jockdoc_jock on September 8th, 2008 04:11 am (UTC)
I have gotten to the point that if I have an issue I end up just going to urgent care as that is about the only place I can get into within 5 months.

I feel for ya

eithni: coldeithni on September 8th, 2008 06:11 am (UTC)
Thanks. :)