Re: Question for DR. SANCHEZ

Rich256 wrote:
> "jay1000" <jfschonSpamguarD@xxxxxxx> wrote in message
> news:iyWrf.214131$0l5.213674@xxxxxxxxxxxxx
>> A doctor can opt out of medicare for a minimum of two years by
>> filing an opt-out affidavid with medicare and having his
>> medicare-eligible patients sign a contract that they will not file a
>> claim with medicare. But the physician cannot accept any medicare
>> patients during the two years, i.e., no "cherry-picking". There are
>> exceptions for emergency treatments.
>>
>
> When I have encountered the "the doctor is not accepting new Medicare
> patients", I wonder if he continues to see his previous ones.
>
> I can understand them wanting to do that if suddenly their practice is
> overloaded with Medicare people.
>
> It's a tough field and they should be rewarded for the long time they
> spend in preparation and that in just keeping up with the state of
> the art. The one time I was in the hospital for a week I saw my
> personal physician there early in the morning and late at night every
> single day. I had been put there by a specialist surgeon but the
> family doctor still came by every day making his "rounds".
>
> The field keeps getting more complicated with more medication and
> methods of treatment. Not like it was even 50 years ago when open
> heart surgery was an experimental thing. And 70 years ago there was
> not much a doctor could do about most illnesses. Pneumonia was most
> often fatal, polio was a horrible epidemic, all children usually had
> measles, chicken pox, whooping cough, etc.
>
> My question is how much can we expect from doctors under present
> conditions? Free enterprise results in more and more new innovations
> and cures. Socialized medicine seems to stagnate the treatments.
> Under it you get what is available as long as there is not a cheaper
> alternative. It seems to me that most countries have their free
> enterprise physicians that will give the newest treatment for a price
> whereas the public gets what is "good enough" and they wage
> complaints that they don't get the "good" stuff for free.
>
> I am "rambling".

Rich...you are not rambling. I understand and agree with what you are
saying. I live in the U.S. which does not have socialized medicine (for
other non U.S. readers in the ng), and that can be just as bad (I'm not
saying socialized medicine is bad, but there are certainly pros and cons for
each). Doctors will drop your insurance in the U.S. if the ins company's
allowed rates are too low, and it becomes a damn vicious game that the
patient gets caught it in the middle, like I said. And then there are the
dreaded lawyers with the malpractice suits.

My over all complaint is that there are too many doctors (except for our Dr.
Sancha of course) that don't give a damn about the patient, and we are just
a chart, and they don't have any personalities and won't call you by your
first name (which they don't know anyway), and make you feel more
comfortable when you are talking to them. They give you 10 minutes (that's
becoming the standard appointment time these days), and start walking away
from you before you're finished asking your questions, so they can see the
next patient (incidentally patient scheduling should never be less than 15
minutes IMO - and I usually take longer than that).

My old pulmo at my last residence used to schedule half hour appts. (he was
a good person and a good doctor). Boy those days are gone. And there is no
way you can talk to doctor on the phone anymore, with *very* rare
exceptions, and then you get caught up in the miscommunication link between
the receptionist and the nurse (who usually won't get on the phone either)
and the doctor, and then back on down again (usually the nurse calls you on
the way back down). You have read some of my bitches about doc's before.

I know doctor's are busy people, but if they become so busy they lose sight
of what is going on with the patient (or they don't care enough), then we
are in trouble. Doctor's tend to gloss over stuff real quick and IMO miss
stuff (did you ever watch how they scan through your chart while you are
talking to them (kind of in a daze), like they are trying to figure out who
you are. I don't believe they can be listening to you and scan your chart
at the same time (I'm sure some people in the world can do that, but I don't
think too many).

Did you ever try getting all your records from a doctor (you should, or at
least get copies of your lab tests and scan reports and procedure notes -
most people don't care enough and are not into researching their conditions
(like some of us), and they may have more straightforward problems that are
easily solved. You would be amazed at all the things you will see in your
records that are not things you said (they could have been misinterpreted of
course) and all the mistakes the transcriptionist made in typing dosages and
dosage instructions because she didn't interpret the dictation correctly
(especially for "sound alike words"), or the doc dictated them wrong. I
went to a bad pulmo previously for my sarcoidosis, and he kept blindly hand
writing (no dictation) that my pulse/respiration were 72/18 (i.e. normal)
each office visit, and I have tachycardia and my pulse is always over 100,
especially in the doctor's office. In most cases the doc probably scans the
transcriptionist's typing quickly, initials it, and in your dreaded chart it
goes.

I have seen statements in my records from my current uro's (both the PA and
the surgeon) that made reference to doing an exam (e.g., abdominal exam is
benign, no CVA tenderness, liver and spleen non palpable, etc.) when none
was done (other than my digital massages from the PA). I confronted the PA
on this very diplomatically and basically told him they never touched me
except for my digital massages, and I thought I was going to lose them
(there were also several misstatements about things I never said). We had a
nice talk and the PA kind of weaseled out of the stuff. Perhaps they were
mixing up my dictations with other patients - who knows - but it happened on
three or four visits. You don't want to know about my misread catscans.
I'm sorry, but I believe the docs are going to fast, and god knows how many
surgeries may have turned out better if the surgeon might have taken a
little more time (although I understand being quick is very important in
many critical procedures, where time is of the essence).

Sorry...now I am rambling (once again)...Pete


.

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