I find myself in a situation I'm not sure how to handle. A couple of weeks ago I had my annual physical with my PCP. I've been going to this MD for about 3 yrs and initially chose him because he's convenient location wise, I can get an appointment with ease (at least with his Physicians assistant who is very competant), pleasant office staff and he's easy to talk to and has never given me a hard time with any prescription requests. I'm an RN so he's always appeared to have respect for my judgements/opinions on on what I need to remain healthy. We usually cut through the "BS" and commisurate on the sad states of affairs that is healthcare and insurance companies.
The last couple of years I've noticed he's been a lot more rushed-performing his physicals in (seriously) less than 2 minutes (patient fully clothed). I've chalked it up to him getting a bigger pt load or perhaps just rushing things with me since I'm a nurse and generally very healthy. I did comment to his medical assistant last time "wow-that man gives the fastest physicals ever). She reposnded..."Yeah, that's how he always is...." My husband goes to him too, loves him, but not being in the medical field maybe doesn't realize he isn't the most thorough examiner.
Anyway, after my 2 minute health assessment while he was checking off/ordering my annual lab work, I brought up a couple of health issues I had been experiencing over the past year but certainly didn't require a separate visit for. One query regarded the best treatment for a post-nasal drip, and the other was a ? about IBS. He recommended for one: Nasal spray....and two, a particular probiotic. The converstation lasted maybe another 2 minutes.
A couple of days ago I received my explanantion of benefits from my inurance company which showed a billing for my physical ($200) paid in full as my inurance covers 100% preventative care. I'm on a high deductible plan for sick visits but my employer will kick in the first 2K and I pay the final 1K before everything is paid in full again. If I DON'T use all of my company's share of deductible in 2010 that they kick in, it rolls over to 2011 account. This same explanantion of benefits also showed another $100 bill for a physican visit which a call to my insurance company revealed was for a 'sick' visit. The insurance company allowed $75 for the visit and was covered by my employer as I hadn't reached my 2k deductible mark yet.
I called my docs office to inquire why I was charged for a 'sick visit" as well as my annual physical and after browsing through my chart (MD wasn't in) they said it looked like we 'dicussed things out of the ordinary for a regular annual physical". WHAT?!?!? SInce when is it not appropriate to ask a few general questions about health issues during an annual visit? My doctor was obviously milking the system for a few extra bucks and probably not realizing he was screwing MY wallet because he didn't know about my particular high deductible policy. I know it's not alot of money we're talking about, but his billing for a 'sick visit' results in me getting $75 less put in my company's bank for the deductible they can kick in in 2011. Maybe I find it particularly irritating since my premiums for insurance are going up 30% in 2011 and my deductible portion rising from 1K to 1.5K.
The office staff I spoke to obviously isn't going to admit that he 'did wrong' in charging me for asking questions but I could tell from their voices they felt awkward in trying to justify his actions. They kept telling me I'll have to talk to him about it. He returns from vacation in a could of days.
I just don't know what to say when I speak to him. Should I be honest and level with him that I understand the frustration of the insurance industry but can't condone the 'milking' of it when it directly affects my wallet? I can't see him admitting such an act of wrong doing, yet I don't see how he can justify in words charging me extra for what should be included in an annual visit. He probably figured my inurance would pay for it in full and I would never notice. I really don't want to begin a search for another doc at this time and my husband wants to keep him also as his PCP. It's just very awkward and not sure what approach to take.
Any thoughts....suggestions....? Thanks for reading this long post!
Specializes in Peds/outpatient FP,derm,allergy/private duty.
I'm sincerely surprised at the number of comments here about how specific acute c/os are not appropriate in the context of a routine PE/check-up. I've never had a routine physical where the physician didn't ask, up front or during the course of the exam, if I had any current c/os or questions about anything ... And I've never been billed for a conversation about any concerns that I had, or assessment of an acute c/o during a routine physical (now, if further testing and/or tx was needed, beyond writing a Rx right then, that would be different, of course). Maybe I've just been lucky. Wow, medicine is really going to !@#$ in a handbasket.
Those questions have always been part of the PE as far as I knew, too. Asking if you have any problems with the area of exam is part of the exam. If you are going to be charged for each "yes" or "sometimes" answer it could easily double the cost. If by some chance the person has a more serious problem and decided to keep the routine PE appt and not use the time to focus on that issue alone, the doc would usually have them come back on a different day to do a proper evaluation of that issue. Most people, from what I recall working in an FP clinic, don't come in for a physical when they are sick or having a set of serious symptoms pointing to a new diagnosis. There isn't anything wrong with that.
Some patients would make an appointment for one thing and pull out the laundry list when they got the doctor in the room. If the doctor were to say, "I've got you scheduled for a short recheck" or "pick one or two and come back at a later date for the rest" he or she has every right to do that. Same with "oh could you just check little Johnny and Susie for this n' that since we're here?" Uh, no! I don't think the OP's blink and you miss it PE falls into either of those categories.
SInce when is it not appropriate to ask a few general questions about health issues during an annual visit? My doctor was obviously milking the system for a few extra bucks and probably not realizing he was screwing MY wallet because he didn't know about my particular high deductible policy. I know it's not alot of money we're talking about, but his billing for a 'sick visit' results in me getting $75 less put in my company's bank for the deductible they can kick in in 2011. Maybe I find it particularly irritating since my premiums for insurance are going up 30% in 2011 and my deductible portion rising from 1K to 1.5K.
mappers
437 Posts
Why is that?