I wanted to write you this letter to let you know why I am going to have to find a new Primary Care Doctor.
It is nothing personal. I believe you are an excellent Endocrinologist and I am grateful you ultimately discovered my thyroid cancer. However, I believe you have gotten greedy. Now, I can’t say if this is due to a natural propensity you had to becoming greedy or if it is a general defect of the current condition of the state of Healthcare and HMOs in the United States. I would like to say that I truly, from the bottom of my heart, hope it is the later.
My issues were small to begin with– in fact, I was willing to overlook and even make excuses for you until I could not even fool myself into believing them any longer. Not being able to get an appointment with you for a month after my first referral was approved should have been my first sign. Waiting for up to an hour and forty minutes after my scheduled appointment time had passed should have been another. But you spent ample time with me. You were thorough in getting my medical history. You answered all of my questions and then some. I know you really cared about me. I still believe that.
So what’s my issue? What’s more important than being cared about when I’m in the office in front of you? All the other things related to your office when I’m not directly in front of you.
The waiting a long time to get an appointment. The waiting a VERY long time to see you for EVERY scheduled appointment. (In fact, now that I think about it, I had to wait an hour at the hospital for you to do my thyroid biopsy. The lab tech even said something about you never being on-time.) The number of drug reps coming in and out of the office. (Those people are a sign of a whole other problem… don’t get me started!) The way I can’t see you for general things like my sinus infection or this horrible upper-respiratory thing I have going on right now. The way your front office staff laugh about how behind you are on any given day. (“Ha, you’re lucky, he’s only half an hour behind so far today!”) The way your staff talk about how busy your practice is now. (“Being busy is a sign of a successful practice.”) The fact that your nurse can be bribed into seeing a patient with no appointment ahead of everyone with appointments just because he brought in a hot breakfast for everyone in the office. (Yeah, I was there that day with an appointment.)
But today was the kicker. Today I had an appointment to see your nurse practitioner about my chest congestion. The appointment went fine. In fact, I left relieved. (“Phew, I can see someone in this office when I am really sick! Thank God!”) She seemed like she knew what she was doing. So I went to the hospital with the order for a chest x-ray in my hand. However, when I got there at 12:10, I was informed it was NO GOOD because it wasn’t signed. The hospital tried calling to get verbal authorization, but your office phones are turned off at noon and go straight to voice-mail. I waited until 1:35 when someone finally got a hold of your office. It must be nice to be able to shut down for lunch for an hour and thirty minutes! Here’s the thing…. I know YOU are still working, you have to get caught up sometime, but why doesn’t anyone else answer? Can’t the front desk girls alternate lunch hours like most businesses? Or how about at least check the part of the voice-mail that says to “page the doctor dial XYZ”? Dr. Zemel, would you tolerate waiting anywhere for over an hour and a half because someone forgot a signature??? That’s what I thought.
The second item today occurred when I went to fill my prescription. Your Nurse Practitioner wrote me a prescription for a steroid inhaler that is NO LONGER AVAILABLE– generic or name brand. The pharmacist says she hasn’t seen it for YEARS. She looked it up and it is not even a medication she can order. I called 2 other pharmacies not related to the first pharmacy and was told the same thing. I can understand not being up-to-date on all medications available these days, after all aren’t hundreds of new medications available each year? But is it too much to ask that the NP have a current copy of The Physicians Desk Reference AND know when it is appropriate to check said reference?
Do you see why I’m frustrated? If your practice is successful and you want it to stay that way, some things have GOT to change. To my untrained eye, it seems like you have three options:
- Hire a new doctor to share your practice with.
- Stop taking new patients.
- Only be a specialist and stop being any one’s PCP.
And this is why I have called you out on being greedy. I realize that ANY of those above options will result in less money in your pocket. I don’t know anyone who would willingly take a pay cut. I know you have two teenagers who will be in college very soon. I’m sure you have bills like everyone else. And Dr. Zemel, I am sure you are NOT being paid what you are worth. However, my family of four pays $600 each month for our HMO plan, plus BIG co-pays for each office visit, and HUGE co-pays for any medications. We are tapped out. This is why I’m sure the problem is larger than both of us and boils down to one of the many problems with Healthcare in the United States.
But what can I do, the lowly patient? The only thing I can think to do: find a new Primary Care Physician. I’ve decided I can probably put up with your office for the 3-4 times per year I’ll need to see you as my Endocrinologist. Like I said, I trust you and your knowledge about my thyroid issues. However, I can’t do it to myself for everything else. I don’t know why it will matter to you, because now you’ll get a $25 copay out of me each time, rather than the $20 copay I pay currently since you’re my PCP. I don’t know if my HMO pays you some meager monthly amount to be my PCP, and I hope it doesn’t affect your bottom line. But I’m sure you will easily find a replacement patient. After all, your office is full of patients just waiting to be seen.
Sadly, I cannot send this to you if I still want you to be my Endocrinologist specialist. As much as I want to believe you would want to know these things I have written, I cannot be sure you would still treat me unbiasedly. I hope you’ll at least notice I’ve no longer listed you as my PCP and take a tiny moment to wonder why. Maybe a moment of self-reflection is all it will take for you to realize some things about your practice that can and need to change. However, I believe that since you are an extremely intelligent man that you already know these things about your practice. How can you not?
I wish you luck and continued success.
Sincerely,
Me
