Visit to the Veterinarian

[Larry Frank]

I took my young dog to be spayed. She came through it fine. I noticed the bill, report and instructions that I recieved. The report provided a over view of her health, weight, and list of shots. The bill was a detailed breakdown of the costs. I occurred to me that I get a better report and instructions from the veternarian that I do from my own doctor. I am lucky to get a hand written receipt. I kind of would like to have a short report when I visit the doctor and specific instructions. If I am sick and seeing the doctor, I am not likely to accurately remember all of the verbal instructions.
The other part was the cost. It was very reasonable for a full surgery with anesthetic, recovery and pills to take home. In addition, my veternarian also price matches on any medicene or pills.
Lastly and more important, we are fortunate to live in a country where even our pets get a higher level of health care than those in most countries.

[Jeffrey Makiel]

I'm glad the pooch is doin' well.

I agree with your comments about the human medical side. I'm always dealing with denials from my family's health care insurance provider. I honestly believe initial denial is their policy. Unfortunately, there are only two providers in NJ that write independent policies, and they are both about the same. Why the State's Attorney General's office doesn't pursue this as fraud makes me raise my eyebrow.

Also, when trying to clear up a billing issue, no information is provided. The billing is all in code, or uses extraneous terminology. Since the billings were denied by the insurance company, and are then forwarded to the family, why is it kept ambiguous? Do they expect to get paid in 8 years after a patient finished medical school so they can decifer the bill?

As far as inadequate communication by doctors, again, I agree. It seems you get more service and information from the local Dunkin' Donuts. Death, injury and costs as a result of poor communication/information are staggering in the US to the point that even Congress took notice.

Again, I'm glad the pooch is fine. When you see the vet again, ask him or her if they would be willing to work on me. I'll even wear a fur coat to make them more comfortable. :)

-Jeff :)

[Caspar Hauser]

Hmmmm. I wonder where this will lead.

[Peter Stahl]

I'm glad the pooch is doin' well.

I agree with your comments about the human medical side. I'm always dealing with denials from my family's health care insurance provider. I honestly believe initial denial is their policy. Unfortunately, there are only two providers in NJ that write independent policies, and they are both about the same. Why the State's Attorney General's office doesn't pursue this as fraud makes me raise my eyebrow.

Also, when trying to clear up a billing issue, no information is provided. The billing is all in code, or uses extraneous terminology. Since the billings were denied by the insurance company, and are then forwarded to the family, why is it kept ambiguous? Do they expect to get paid in 8 years after a patient finished medical school so they can decifer the bill?

As far as inadequate communication by doctors, again, I agree. It seems you get more service and information from the local Dunkin' Donuts. Death, injury and costs as a result of poor communication/information are staggering in the US to the point that even Congress took notice.

Again, I'm glad the pooch is fine. When you see the vet again, ask him or her if they would be willing to work on me. I'll even wear a fur coat to make them more comfortable. :)

-Jeff :)

My wife does billing for a Doctors office and you're right, if the code isn't right it doesn't go through. Take it back to the doctors office and ask them to resubmit it. I think she said Horizon was the worst, which one do you have?

[Matt Meiser]

If the coding isn't right its not the insurance company's fault and they shouldn't pay until its fixed. The coding tells the insurance company the diagnosis and treatment. I once got a rejection because the coding said I got an MRI on my elbow for an ankle injury.

But I agree on the lack of detail. I just got an $8000+ statement from the surgery center where I had eye surgery last week--for "surgery" or something like that. Hopefully they gave my insurance company a little more detail. :) When I need more detail I've not found it hard to get it though except in one case where they switched billing systems and only forwarded the patient balances. We knew why we owed, but needed documentation to turn in to our flex spending account. After lengthy discussions they rejected my suggestion to just type me up an invoice in Excel and wrote it off.

Should you choose to go to the vet, I hear if you are a good patient you might get a treat! Of course, watch out if you get old and sickly!

[Jeffrey Makiel]

Peter...my family has Horizon. We just saw our annual policy jump from $14K to $16K last week. In that same week, we also received a denial for having a suspicious mole removed which was billed as $3K for 20 minutes of outpatient service.

It's broken.

-Jeff :)

[Rod Sheridan]

Mentioning the doctor and veterinarian reminded me of a conversation with my doctor years ago.

He said that vets were far better at diagnosis than your avrage GP because the vet couldn't ask questions of the patient.

His comment was that humans come in, give biased or mis leading answers to questions that make diagnosis more difficult.

There must be some truth to that..........Regards, Rod.

[Belinda Barfield]

It occurred to me that I get a better report and instructions from the veternarian that I do from my own doctor. I am lucky to get a hand written receipt. I kind of would like to have a short report when I visit the doctor and specific instructions. If I am sick and seeing the doctor, I am not likely to accurately remember all of the verbal instructions.

Larry, find a new doc. If your doc isn't willing to take the time to make sure you understand you health issues and treatment, or have someone on staff who will, you're receiving inadequate care.

I worked for years for a opthalmologist. We had racks and racks of patient education material, both in the waiting room and in the exam rooms. Once a patient was diagnosed with, for example, a cataract part of my job was to sit down with them, give them the written material, verbally review the written material with them, and answer any questions. This was also true for the treatment plan. There are some patients who don't want that much detail, and some who will never understand regardless of how much time you spend, but I did feel that when our patients walked out the door we had done our best to educate them.

One issue with today's physicians is that many of them work for a large groups that are hospital owned. These physicians are basically forced to see more patients than they should see, therefore they cannot spend adequate time with each patient. It is not uncommon for a physician to have a patient scheduled every 15 minutes, sometimes every ten minutes.

This is not meant in any way as criticism of physicians. Their job is very difficult and can be both mentally and emotionally exhausting. They are under tremendous pressure to make the best diagnosis in the least time, and try to render the best treatment while factoring in variables such as patient noncompliance, a patient intentionally or unintentionally providing inadequate or incorrect information, and a patient's lack of understanding of his/her disease.

[Bruce Volden]

Well since we've moved on to MD's billing why is it that I see 1 doctor at his clinic but get SEVERAL bills?? Lab, X-ray, radiologist, supplies,......come on, it would sure be nice to write 1 check :eek:

Bruce

[Steve Rozmiarek]

Well since we've moved on to MD's billing why is it that I see 1 doctor at his clinic but get SEVERAL bills?? Lab, X-ray, radiologist, supplies,......come on, it would sure be nice to write 1 check :eek:

Bruce

I AGREE!

Vets insurance is probably a huge amount cheaper. Never heard of a malpractice suit involving a vet. I just became more familiar than I hoped to ever be with my local vet, and I have to admit, I'm impressed by his general approach. Seems much clearer than the usual MD's.

[Belinda Barfield]

I AGREE!

Vets insurance is probably a huge amount cheaper. Never heard of a malpractice suit involving a vet. I just became more familiar than I hoped to ever be with my local vet, and I have to admit, I'm impressed by his general approach. Seems much clearer than the usual MD's.

I have a friend who is suing her previous vet for misdiagnosing her dog. The dog ended up having surgery at the University of Georgia on Thanksgiving Day for some issue with his spine.

[Mike Henderson]

I AGREE!

Vets insurance is probably a huge amount cheaper. Never heard of a malpractice suit involving a vet. I just became more familiar than I hoped to ever be with my local vet, and I have to admit, I'm impressed by his general approach. Seems much clearer than the usual MD's.
If I remember correctly, an animal is considered a possession under the law, same as a tool or a sack of feed. So if the vet harms the animal, your only recovery is the value of the animal. There's no such thing a pain and suffering or loss of companionship. And if there's long term care required, you won't recover any of it beyond the value of the animal. The response in the law is to put the animal down, rather than provide care beyond the value of the animal.

So the vet doesn't need much malpractice insurance.

Mike

[Ken Garlock]

The individual is ultimately responsible for their own health. If you don't understand something ask the doctor. If you get a test, ask for a copy of the results. If the doctor seems insulted by your request, get a new doctor.

These days many people think they are entitled to this or that. The only thing you are entitled to is the opportunity to get of your can a get a job. :mad: This carries over into the professions, especially doctors. They have the mistaken idea that because they CHOSE to go into medicine they are the anointed ones. Guess what, when they get up in the morning, they put on their pants the same as your do, one leg at a time.:( I doubt than you can find a doctor anywhere that had a gun held to his head forcing him to enter medical school.

With that in mind, I am not against the medical profession, but I am against the arrogant ones that think you are in their office for his entertainment. Specifically, there is no reason for having a room full of patients waiting for over an hour to see his/her highness. All it does is pi.. off the patient and make next month payment on the Benz. These salesmen of medical care need a lesson in customer service. They are first and foremost in the customer service business, and their product is medical services.

Fortunately I have only encountered a couple of these anointed ones over the years. I the past 6 months I have visited my GP, and two specialists. Each one is has run a timely practice. I waited no more than 15 minutes to be be seen by a medical assistant, and then another 5 minutes for the doctor. In each case the doctor was busy, but he did take time to answer my questions and explain what was going on and why. In the case of my GP I always get a copy of my lab report from my annual inspection, oil change and grease job.

Even as much as we, including myself, like to complain about the medical profession, it is still the best in the world. Like all professions their people who are in it if or money and those that really lilke their jobs. The job for you and me is to find the ones that really like their jobs. :)

As a foot note, I saw a panel discussion of 50 doctors on TV last month regarding the socialization of US health care. One thing that stuck in my mind was that a young female doctor just starting her practice had to pay $200,000 per year for malpractice insurance. Yes folks, that is 200 with 3 zeros following. Just think what the heart, and neurosurgeons pay. Tort reform must be addressed, and without the assistance of ambulance chasers.

[Scott T Smith]

If I remember correctly, an animal is considered a possession under the law, same as a tool or a sack of feed. So if the vet harms the animal, your only recovery is the value of the animal. There's no such thing a pain and suffering or loss of companionship. And if there's long term care required, you won't recover any of it beyond the value of the animal. The response in the law is to put the animal down, rather than provide care beyond the value of the animal.

So the vet doesn't need much malpractice insurance.

Mike


Mike, you're pretty much right on target. My wife is a Vet and her malpractice insurance is less than what most folks pay for their car insurance.

There is another dimension too though... there is no national "Legal determination" of the "value" of a companion animal. This tends to discourage attorneys from bringing malpractice suits againsts vets, as they know that there is a small liklihood of a big recovery. If anything, this benefits us all by keeping the malpractice premiums low, it helps to keep the vet bill low too.

Three years ago my wife received an award that was presented at the Harvard Law School by the Animal Legal Defense Fund. One of the topics that was discussed was the desire by a number of prominent national attorneys to have the AVMA agree to a "value" for companion animals, in order to incent attorneys to bring more suits forth. Although their stated desire was to be able to use this in animal cruelty cases, the reality is that it could also have a profound impact on the entire veterinary discipline. Fortunately, AVMA wasn't supportive...

[Mike Henderson]

The individual is ultimately responsible for their own health. If you don't understand something ask the doctor. If you get a test, ask for a copy of the results. If the doctor seems insulted by your request, get a new doctor.

These days many people think they are entitled to this or that. The only thing you are entitled to is the opportunity to get of your can a get a job. :mad: This carries over into the professions, especially doctors. They have the mistaken idea that because they CHOSE to go into medicine they are the anointed ones. Guess what, when they get up in the morning, they put on their pants the same as your do, one leg at a time.:( I doubt than you can find a doctor anywhere that had a gun held to his head forcing him to enter medical school.

With that in mind, I am not against the medical profession, but I am against the arrogant ones that think you are in their office for his entertainment. Specifically, there is no reason for having a room full of patients waiting for over an hour to see his/her highness. All it does is pi.. off the patient and make next month payment on the Benz. These salesmen of medical care need a lesson in customer service. They are first and foremost in the customer service business, and their product is medical services.

Fortunately I have only encountered a couple of these anointed ones over the years. I the past 6 months I have visited my GP, and two specialists. Each one is has run a timely practice. I waited no more than 15 minutes to be be seen by a medical assistant, and then another 5 minutes for the doctor. In each case the doctor was busy, but he did take time to answer my questions and explain what was going on and why. In the case of my GP I always get a copy of my lab report from my annual inspection, oil change and grease job.

Even as much as we, including myself, like to complain about the medical profession, it is still the best in the world. Like all professions their people who are in it if or money and those that really lilke their jobs. The job for you and me is to find the ones that really like their jobs. :)

As a foot note, I saw a panel discussion of 50 doctors on TV last month regarding the socialization of US health care. One thing that stuck in my mind was that a young female doctor just starting her practice had to pay $200,000 per year for malpractice insurance. Yes folks, that is 200 with 3 zeros following. Just think what the heart, and neurosurgeons pay. Tort reform must be addressed, and without the assistance of ambulance chasers.
If you're reasonably healthy and can wait to see another doctor you can try what I've done many times. After waiting about 15 minutes past my appointment time, I go to the office clerk and say that I want to re-schedule my appointment because it's obvious that the doctor is running behind. By taking me out of the schedule, it will allow him/her to get back on schedule and better serve his/her patients.

Every time, I get escorted to an examination room almost immediately.

The reason for this is that doctors HATE to have an empty appointment slot - it means lost revenue for them. I realize that unforeseen things can happen and the doc can get behind. Also that a patient may take more time than planned. But that has to be factored into the scheduling. I show up on time for my appointment and am willing to wait a short while, but I'm not willing to wait an hour. Keeping appointments goes both ways.

And if you look at the evaluation of doctors by patients, the primary factor in the evaluation is whether they get to see the doctor in a timely fashion.

And now for a defense of doctors. I know too many doctors and have way too much experience with them because of a family medical issue. Most of the ones I've encountered are dedicated, EXTREMELY hard working, and caring. But they cannot provide the kind of hand holding that some people seem to want. Realize that your doctor only thinks about you when you see him/her and a few times otherwise (unless you have some life threating problem or something really unusual). Respect his/her time. Use e-mail instead of the phone. With e-mail your doctor can answer your inquires when they have time and you'll get your answer about as fast as if you try to phone them. If your question involves something visible, send a picture.

Doctors do okay financially but it depends on the specialty and the size of the practice. And they've spent a lot of years getting to where they can practice and make money.

After having a lot of exposure to the practice of medicine I don't know if I'd want to be a physician.

Mike

[John Coloccia]

I've had some health issues over the past couple of years. All of it has been pretty minor but the symptoms were similar to other issues which could have been very serious (anyone with acid reflex knows EXACTLY what I'm talking about...it doesn't always present itself as simple heartburn).

Anyhow, I know that the doctor's seen me immediately, with no notice. I've taken other people's slots. Tough nuggies. At the time, I was more important than someone with a regular checkup or the sniffles because of the symptoms.

My doctor almost always sees me on time. Sometimes I have to wait a while...up to an hour just recently with the flu thing running around. When I'm in for a regular check up and there's 5 people in high risk groups that are being seen last minute for potentially life threatening or altering ailments, then I expect I'm going to wait. They're more important than I am at the moment. If I have somewhere to be, like Mike I'll just simply reschedule.

I'm glad that general practitioners see people like this. I don't want everyone crowding into an emergency room because their local doctor says they have to wait a week for an appointment.

I had an eye doctor that used to over book his appointments. I ALWAYS waited. I waited so long once that they had to dilate/anesthesize my eyes TWICE because the first time wore off. I simply dumped him and go elsewhere now.

[Chris Kennedy]

My issue with this is simply that every time I see a doctor, I always have to wait well beyond my appointment time. To me is that I have to rearrange my work schedule for the appointment, and the doctor doesn't have the same respect for the fact that I am at work as well. Yes, I know, they are working hard and other patients have pressing needs, but that is something that they need to build into their schedule. That is the nature of their job.

Cheers,

Chris

[Dan Friedrichs]

... and make next month payment on the Benz. These salesmen of medical care need a lesson in customer service. They are first and foremost in the customer service business, and their product is medical services.

That logic will seem ridiculous in 10 or 20 years when we have a critical shortage of physicians.

LOML is a medical student. She easily spends 80+ hrs/wk studying - we literally never do anything for entertainment - she honestly does not have time for it. Sleep, study, eat -for 4 years, at a tuition cost of $70k/yr, excluding living expenses. Then comes 4 years of residency, for almost no pay. Then what? Become a family physician to earn a salary of ~$100k (and also needing to pay for malpractice insurance)? Many family physicians are 20 years out of residency, and STILL paying off medical school debt.

My point is that most physicians go into medicine because they realize that they can provide some benefit to society. The financial incentives are almost non-existant for non-super-specialists. When we discuss heathcare, "overpaid doctors" is a argument only used by those who are grossly unfamiliar with the reality of the system.

[Mike Cruz]

I just don't want the doc to take my temp the same way my vet takes my dogs' temp! :eek:

[Peter Stahl]

Mike, My Doctors office double books a lot during the busy season espesially. Also one of the Doc's like to BS a lot. I don't think I was ever at a Doctor's office and got even into a room close to my appointment time.