Physician, Heal Thyself

Physicians just do not seem to get it: their business and administrative practices drive customers away more than their medical skills. A few examples from my own life:

• I left my former ENT specialist because his office began charging five dollars extra for paying via credit card.

• We left our former children's dentist because his office insisted on total payment up front and consistently overcharged us. That forced me into the unwanted role of bill collector, wrestling with the task of collecting our overpayment after each visit. That same office also had the audacity to charge a late fee one time despite the fact that their invoice was dated and mailed two weeks after the supposed payment due date!

• We left our original pediatricians because of their completely unworkable scheduling system. With most physicians, when you are told to come back in x number of weeks, you schedule the next appointment before you leave the office. Not so with those pediatricians. Their scheduling system looked ahead only one month, so if you had to return in six weeks, you had to wait until the following month to even attempt to schedule the appointment. And invariably when we called on the first day of the next month to schedule a visit, somehow the schedule was already full.

  In fairness, the scheduling system was inflicted on them by their affiliation with a particular hospital. (I won't mention the hospital's name, but its initials are Southside Regional Medical Center (SRMC) in Petersburg, Virginia; more on them in a moment.)
  

  A year or two after we left, we were amused to received an advertisement in the mail from those same pediatricians touting the fact that they were no longer associated with that hospital—as if to say, "It's safe to return now!"

That same hospital deserves special attention in this rogue's gallery of medical administrators:

• One morning in July of 1993, my wife was rushed by ambulance to Southside Regional Medical Center after suffering severe stomach pains and eventually collapsing unconscious at home. My saga began at 6:00 am when we first arrived at the hospital. I was not allowed to accompany my wife into the emergency room's treatment area; indeed, there was an armed guard at the door to block any and all visitors. Furthermore, the hospital's ER personnel declined to provide any information whatsoever regarding her status. Despite my repeated attempts to elicit any tidbit of information, it was not until 11:30 that I was allowed to see her and talk to a doctor about her condition. The hospital staff held me totally incommunicado from my own wife for five-and-a-half hours. Absolutely unconscionable!
• In July 2003, my wife had x-rays taken at SRMC to diagnose a lump on her breast. The radiology department would not or could not deliver the resulting report to my wife's ob-gyn for almost three weeks. Excuses ranged from "Our fax machine broke down" to "We can't find a typist to type the report."
  
  At one point I myself called the radiology department and was told to have my wife appear between the hours of 8:00 and 4:00 on a particular Friday for her to pick up the report herself and personally deliver it to her physician. She showed up in mid-morning as directed only to be told, "Oh, we can't give x-ray reports out to patients."
  
  In short, the fumbling incompetence of the radiology department caused several appointments with her ob-gyn to be postponed. This in turn delayed the eventual surgery, and all the while the threat of possible cancer loomed large.
  
• As they say on the shopping networks, "But wait: there's more!" On the scheduled day of surgery, after my wife was already heavily sedated and ready to be rolled into the operating room, the surgeon casually dropped in to discuss surgical options. WTF??? That should have been addressed in the three office visits my wife undertook in the weeks prior to surgery. You can bet that when I myself needed surgery seven years later, I studiously avoided any surgical practice with that surgeon as a member.
  
• Even after the surgery was over, there was still no escaping the bungling ineptitude of Southside Regional Medical Center. They sent me an invoice dated 2 December 2003. I received the invoice in the mail on 8 December and mailed payment on 14 December. My bank received the canceled check on 31 December, so SRMC clearly must have received and deposited the check sometime before the last week of December for the check to have cleared the Federal Reserve banking system by the end of the December.
  
  Despite that, toward the end of January, we received a letter from a collection agency dated 20 January. If SRMC forwarded this account to the collection agency in December, then that is absolutely unreasonable because their invoice was not even prepared until early December, giving us almost no time to respond to the invoice. And if SRMC forwarded the case in January, then the obvious question is why? They already had payment in their possession in December and in fact had already deposited it.
  
  I continued to receive threatening telephone calls both at home and at work through the end of March. The collection agency refused to confirm with its own client that payment had been received, and staff at SRMC steadfastly refused to respond because their accounting was handled by a commercial contractor, not SRMC direct-hire personnel.
  
  In light of SRMC's non-response to numerous telephone calls, my wife even drove to their office in person in an attempt to resolve this problem. Astonishingly, SRMC's response was to blame the entire problem on me for entering the wrong account number in the memo field of my check.
  
  When I heard that, I was irate because SRMC's accusation was totally bogus for two reasons. First, I did not enter the account number on the check. I made no entries in the memo field because I refuse to do SRMC's clerical work for them, and even the most cursory scan of the check revealed that the handwriting in the memo field was clearly not the same as the handwriting on the rest of the check.
  
  Secondly, on behalf of whoever did transcribe the account number onto the memo field, that person transcribed it correctly: the number exactly matches the account number shown on SRMC's invoice. Consequently, any account number error lies with the invoice that SRMC's own people generated.
  

This last incident was the straw that broke this camel's back. In baseball, it's three strikes and you're out: Southside Regional Medical Center has had four strikes. Perhaps you can now begin to understand the reasons behind my unyielding policy that neither I nor any member of my family will ever again knowingly set foot in any facilty administered by Southside Regional Medical Center.

Postscript. There is an addendum to my first run-in with Southside Regional Medical Center involving my wife's severe stomach ailment. I strongly suspected that the cause of her illness was a jar of shrimp paste that my wife purchased from a small grocery store in Hopewell, Virginia. I had retained the jar in our refrigerator for later testing.

After we arrived home from the hospital, I called the governmental offices in the city of Colonial Heights where we lived. They directed me to Petersburg as the site of Southside Regional Medical Center where my wife was treated. Petersburg referred me to the city of Hopewell because that is where my wife purchased the suspect product. Hopewell claimed to have no authority to investigate because the contaminated product was not served at a sit-down restaurant.

In the course of speaking to all of the respective city governments, I learned that the only testing laboratory in the region was located in Chesterfield County. When I called that laboratory to ask if they could test our food item for pathogens, they told me I would have to tell them exactly what pathogen to test for. Well, if I knew what the offending organism was, I would not really need them to conduct a test, would I?

So, to all of you radical right-wing Republicans espousing the virtues of smaller government, I say "Hogwash!" The lesson I learned from this experience is that small, local governments can pass the buck and shirk their responsibilities every bit as well as any federal agencies can.

Final Postscript. Now that I have thoroughly castigated the medical community in our area, allow me to step out of my curmudgeonly character to highlight a hospital that does things right. In early August 2010, I underwent hernia surgery at John Randolph Medical Center in Hopewell. While I am still wrestling with the discomfort of the surgery itself, dealing with the administrative folks at John Randolph was a breath of fresh air, especially compared to the dolts at Southside Regional Medical Center.

Statements from the anesthesiologist, the surgeon, and the hospital facility all went to my insurer within a week or two after the surgery. I then received statements of benefits from my insurer followed soon thereafter by final correct invoices from each of the three medical offices, enabling me to settle all three obligations within a month. And best of all, I received no obnoxious inquiries from collection agencies seeking payment for bills already resolved!

It is a sad commentary on the state of American medical companies today that something so routine merits special praise only because it stands out in stark contrast to the fumbling inadequacies of other organizations. In any case, kudos to John Randolph for their swift and efficient administrative process.