Saturday, May 23, 2009

Those Nasty Gatekeepers

Well, it's that time of the year: the birds are singing, plants are flowering, trees are blossoming -- oh, and for me, it's doctor season.

This is that time of year when I have to put all my doctors in a row. On Tuesday, I see my oncologist. I believe I get a double whammy the following week, seeing my mastectomy and plastic surgeons. Luckily, I love my doctors, and I'm fortunate these are routine follow-ups.

However, some routines I can't stand. I really don't like going to doctors because it is so scary and I usually have to have a variety of activities to keep me from crumbling into one big fearball. (Curbing fear in a doctor's office will be discussed in a future blog.)

However, the routine I hate the most is making appointments with those nasty gatekeepers: you know them -- the dreaded receptionists and operators who were born just to make your life difficult. These people, given orders from somewhere to cut corners, or maybe because they enjoy making the patient's life miserable, try to give you an appointment with a nurse's assistant or a physician's assistant when it's clear you want and need to see the doctor. (Many receptionists and operators are nice and comply with your needs, but several are not, and these people are the ones I'm talking about.)

You have the right to see the doctor, not an assistant, if that is your will. And that means assertiveness and focus. After all, what is your insurance or your own pocket paying for?

I had such an incident just this week. I made an appointment with two of the three doctors with no problem. When it came to a final followup with the reconstructive surgeon, that was another matter. The gatekeeper figured it was a routine followup, so she could just send my case to some sort of "surgical assistant" I had never heard of or met. In the end, through my persistence and repetition, the gatekeeper complied with my request to see my doctor.

Here's how the dialogue went (the names have been changed to protect the innocent and the guilty):

Me: I want to see Dr. Reconstruction for my final routine exam.
Receptionist: Well, the doctor's schedule is limited, and he doesn't do these type of routine exams anymore, so we'd have to give you a surgical assistant.
Me: What? He did my last followup. No, I need to see him. What days is he available?
Receptionist: Well, he's in surgery a lot of Fridays.
Me: What about Monday through Thursday? Surely he must be available sometime. He told me specifically he wanted to see me at least one last time.
Receptionist: Well, our surgical assistant, Bambi, is very good and knows how to give an exam.
Me: Bambi might be very good, but I need to see the doctor, and the doctor only. I have had breast cancer and a complicated double mastectomy with reconstruction, and this is no time to mess around with someone unfamiliar with my case.
Receptionist: But Bambi --
Me: (Cutting her off): I will see the doctor. When is he available?
Her: (Begrudgingly): How about June 3 at 10 a.m.?
Me: I'm seeing the doctor?
Her: Yes, Dr. Reconstruction.
Me: (Summing it up): OK, so just to reiterate: I'm seeing Dr. Reconstruction June 3 at 10 a.m.
Her: Yes, see you then.
Me: Thank you very much.

I guess the key is, you must be persistent by plowing through all the nonsense that unfeeling or uncaring medical staff throw at you. It would've been easier to be complacent, but in the long run it would not have been the right choice for me.

Often the things we know are worth having -- like appointments with quality doctors -- are worth fighting for.

Beth L. Gainer is a professional writer and has published an essay on her breast cancer experience in the anthology Voices of Breast Cancer by LaChance Publishing. She teaches writing and literature at Robert Morris University in the Chicago area. She can be contacted at and



  1. I love my OB/GYN. He doesn't let ANYONE else see me from his office accept his associate. If I want ANYTHING, I have to talk to him. He does not communicate through nurses. It's great.

    He also has me meet with him in HIS OFFICE (yes, not in the exam room naked under a paper gown), where we talk about any concerns/issues/questions I might have. Then I go to the exam room (with soft, CLOTH gowns). Finally, I go back to his office for a follow-up discussion.

    All this for a pap! Once you get a good doc, ya gotta hold on to em.

    Now his office people over the years have annoyed me from time to time. THe most annoying incident a conversation like this:

    Her: Dr. Gyno. Will you hold?
    Me: Accounting please.
    Her: Will you hold?
    Me: Just need to be transfered to accounting.
    Her: I'll need you to hold first. I'm on the other line.

    Yes, in all the time she took to argue, she could have pressed hold and an extension and been done with me.

    It's called patient management.

    Another excellent blog.

  2. Thanks for your insights about the importance of a great doctor. The office staff can oftentimes be the major problem. Love your dialogue!!

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