OH BRAVE NEW WORLD; the “Provider” as “Patient.”

An article I once read reminded those of us who practiced Medicine that we are all patients, but some of us are privileged to be physicians also. What is it like to become a new patient in a new healthcare “system,” after years of not having to?

Recently I changed my health insurance and made sure to sign up for additional coverage such as vision. My plan says I am entitled to a basic eye exam, a contact lens exam, and either contact lenses (which I’ve worn most of my life) or glasses. I made an appointment with an optometrist that was listed on my plan, G,B., OD, who works with a Bala Cynwyd, PA Ophthalmology practice. I explained my situation and was given an appointment, only to be told by the receptionist when I arrived that their office accepted my insurance for a “basic exam” only, and the rest would be out of pocket. This was never explained to me when I first called, nor was the ability to “cherry pick” the types of examinations covered explained in my insurance benefits information.

This seems to me to be the healthcare equivalent of “bait & switch;” the equivalent of my telling a new patient that I accept their insurance, but when they arrive with chest pain, explaining that I only accept it for checking their blood pressure, but not for an ECG. They got me into their office by not telling me they only accepted part of my insurance, then (I suppose) expected me to simply pay, out of pocket, for services I was supposed to be covered for.

Health care has obviously now become “Caveat Emptor” so, when you make your first appointment with a new physician or other “provider,” be sure to ask about the specific things you need before you go. Otherwise, you may wait for the appointment, wait in the “waiting room” and fill out your “paperwork,” just to find out that the doctor is listed as “in network” but is allowed to choose not to accept those things for which he or she can make more money “out of pocket.” GOOD LUCK!