Saturday, November 1, 2008

Finding a Good PCP is Like Finding Bigfoot

by Insurance Guru

If you have health insurance, I bet you have a PCP (Primary Care Physician). A good doctor is hard to find. If you have one, bless you, but I am very jealous. The problem is - it isn't enough to have a doctor you that will listen to you, but the office staff has to have a brain, too.

Think about it... your wonderful doctor has given you a thorough physical, but for a complete picture, you need some labs and maybe a chest x-ray. Insurance Companies usually don't let PCPs provide those services in their offices even if they have the equipment. They get a much better discount with a big radiology office or lab company. So off you go with your lab and radiology slips... What? The staff sent you to the place that doesn't accept your insurance? What? The paper work isn't filled out correctly? You want to take a sample from where? What?

I'm currently in a battle to get an authorization to see an orthopedic doc. I've been waging this war for two months-- and I "speak insurance"! I've talked to my PCP's office (when I can get them to pick up the phone) and the ortho's office (when I can get them to pick up a phone) and my insurance company (weird, they do pick up the phone). I just need my PCP's office to tell my insurance company that I have a bad knee and could someone pretty please look at it before my leg falls off.

It worries me that I cannot get this simple problem resolved with all my insurance experience. What happens to the folks that just give up because they can't navigate the system? "Press 1 for a black hole; press 2 if it makes you feel better."

You should be able to have confidence knowing that your doctor's office can handle all of your health care needs. They should speak insurance... how else are they getting paid?

I like my doctor, but hate the office staff and as I get older and need more services that can't be done by my PCP, this issue will become critical. So -- put as much research into finding a good doctor as you do buying a car. Check the internet, ask your friends, kick the tires and take a test drive. You don't like what you see? Open up that provider directory and see if you can find your and beware the office staff.

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Buck said...

Well, as you know, I feel your pain. I made the mistake of transferring my care to a place in AZ and as you saw on my blog it's been a debacle.

I was fortunate to have a close friend here who works for a great GI doctor. I saw him recently and was blown away by how wonderful he was. A true "old fashioned" mentality of patient first, profit last mixed with a keen intellect. He has a minimal staff who know there stuff as far as insurance.

I didn't have a PCP here, so he suggested one who shared his philosophy of medicine! So, I hopeful in that regard!

I really am so tired of corporate medicine practiced by people like "Dr. Kim" in your more recent posting. Give me a patient first kind of guy any day!

insuranceguru said...

I agree with a patient first philosphy. What I dream of is a return to not-for-profit medicine/insurance and an internet based grading/comments area so that comsumers can research providers as keenly as they do cars and computers.