Medical Bait and Switch

Just a few weeks ago, I used my medical group's walk-in service because of a nasty bout of bronchitis.

Little did I know the appointment would feel like a rollercoaster derailing, thanks to medical staff's unwillingness inability to communicate to their patients effectively.

As I was checking in, a receptionist said coldly and matter-of-factly, "Oh, and here's a sheet to read while you're waiting."

I simply couldn't believe my eyes.

The letter started off, "We are sorry to inform you that XYZ Partners has decided to terminate its contract with our physicians...You will end up being assigned to a new (different) [primary care] physician." The letter went on to say all I had to do was to contact my HMO and change my group number, and I would continue to have my primary care physician lickety split.

Oh, and I would also be assigned to a new hospital. Which means -- with the exception of my primary care physician -- all new doctors. All new specialists.

Now if I were a run-of-the-mill person with excellent health, I might not have had too much of a problem with this. But all I could think of was this: I would have to make a horrible choice: Get a new primary care physician and keep my gazillion terrific specialists, including my oncologist, or keep my wonderful PCP and venture out to a new hospital and all new specialists.

So I did the only thing I could do at that moment.

I panicked.

When I questioned an unhappy-looking staffmember -- who was not at all concerned about my interests, of course -- she raised her shrill unpleasant voice to me, telling me that it was not the office's fault that my hospital was dropping my medical group as a provider.

And then I raised my voice, blaming the medical office's staff for breaking the news this impersonal way. 

In a shaky voice, I then poured out my heart. I told them that I have had breast cancer and I couldn't just go pick another medical group, thereby ditching my specialists and interrupting my continuation of care. And the meanie plus her medical cronies looked at each other, then at me, and the unhappy staffmember had the nerve to say:

"We understand this is an inconvenience and continuation of care is important, but if you select the new group 123, you will have the same primary care physician."

An inconvenience?

And I continued, "What about my oncologist, my breast surgeon, my gynecologist? Do I get to keep them!?"

The staffmembers all said, no, but if I selected the new group 123, I would be so lucky to keep the same primary care physician and get a new hospital to boot. 

I could see the writing on the wall: I would have to make a choice between my primary care physician, who took great care of me for 14 years, or my terrific oncologist, gynecologist, et al.

So while I sat in the examination room stunned as a fly who had just been swatted, in comes a physician I didn't know. The first thing he said to me was, "Looks like you're sick of being sick." Yes, I was sick, alright -- but my bronchitis was the furthest thing from my mind.

He started examining me and -- I've never had this happen to me before -- he said, "Ooops, I am not sure if I am supposed to be examining you because we are changing hospitals. You might have to pay a lot of money for this exam. Let me check."

And with that, he exited the examining room and then came back saying the office manager was allowing me to just pay the co-payment due to my unique circumstances. He could proceed with the examination.

Oh lucky me.

That exam being done and prescriptions being filled, I sobbed on the way to my car. I already made the tough decision: I will have to say goodbye to my primary care physician and keep my wide array of specialists and my hospital. I cried with anger that nobody told me about this change in person or via phone. Instead, I felt as if I were regarded as an afterthought with that impersonal letter.

A few days later....

To add insult to injury, I received the same "Dear John" letter in the mail.

A few days later....

I got a letter now saying that my primary care physician "resigned" from the medical group.

A week later....

I made an appointment to see my primary care physician just to achieve closure. I wanted to tell her -- without crying -- how much she meant to me. I wanted to tell her -- without crying -- how I didn't want another primary care physician and start over with a general doctor who didn't know me. I wanted to see her one last time -- without crying.

Well, I didn't cry, but I told her all those things and how very upset I was with the situation. She said she was upset about it, too. She said, "You know, I consider myself a pretty good physician. But you have many specialists, such as your oncologist, and it is easier to replace a primary care physician than it is an oncologist. You have specialized needs, so if I were you, I would search for a new PCP."

I didn't have the heart to tell her that was what I decided to do -- even before our appointment. In fact, I felt better because I was able to lie to convince myself that she made the decision for me.

Now that I'm no longer reeling from the shock of it all, I will call my oncologist and ask for a recommendation for a stellar PCP. It is difficult to start over with any doctor, but that's life. Change is inevitable. Doctors retire, move to other parts of the country, are also victims of changing healthcare policies, and they pass away.

They are human like everyone else.

Achieving closure with my PCP was one of the best things I could've done. I had an excellent doctor, and speaking with her in person about my concerns and fears was a great move.

I can go forward. I am still scared of the prospects of a new doctor, but I am going forward.

I'm writing a book titled Calling the Shots: Coaching Your Way Through the Medical System. Please feel free to subscribe to this blog by clicking the orange subscribe button. I am a professional writer and have published numerous academic and magazine articles, as well as an essay on my breast cancer experience in the anthology Voices of Breast Cancer by LaChance Publishing. I can be contacted at bethlgainer@gmail.com and gainercallingtheshots@gmail.com.