Wednesday, October 07, 2015

Going to the doc costs--and I don't mean copays

Felice J. Freyer, Boston Globe, Oct 5, 2015, says Harvard Medical School did a calculation of how much it really costs you to go to the doctor.

They estimated a typical visit is 121 minutes--2 hours. That comes to 37 minutes in travel, 64 minutes waiting or filling in forms, and only 20 minutes with the physician.

Based on an average sum people make working, they figured it costs you $43 in lost time. Add to that the average cost of the copay--$32.

Nationally that comes to $52 billion a year--basically in sitting around.

Blacks and Hispanics spend 25-28% longer because of long wait times at clinics or bad transportation. People already marginalized are further marginalized and penalized for not having money.

What can be done? Same-day appointments would help, they said (how that would cut wait times is not clear to me).

Another approach could be virtual visits--via Skype on the phone or pad.

Doctors could improve their workflow--but the paper said this is hard when demand for primaries, for instance, is so high,

Also--and you ALWAYS hear this--the problems that come into the office sometimes cannot be solved in 20 minutes. This is their explanation when you complain--then they hit you with, "Wouldn't you want the same good care?"

The fact is, doctors often double book to be sure to get their quota of copays. Waiting is baked in.

One doctor they cited had 35 people scheduled for 8:30 AM. I can beat that--I once scheduled for 8 AM on their advice--and learned the doctor did not even come in until 9 AM.

That same doctor kept people waiting at least four hours. Sometimes they passed out crackers to diabetics about to keel over in the waiting room.

How about canning some of these "wellness" visits, these "talk about death" visits, the "let's see if you have Alzheimer's yet" visits, and the constant look-sees to get your medications renewed?

If you have a rash--call the primary, get the referral to the dermatologist and go--no trip to the primary first.

How about that?

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