Tag Archives: treatment guarantees

Doctor who?

18 Oct

After years of delaying, I recently decided to have my varicose veins treated. Years of summers in long pants and dresses, and mad dashes from the pool to the recliner to quickly grab a towel or sarong to cover the offending veins, were finally going to be over.  

I went about doing my (Google) research and found out that the doctor you’d go see for an operation to remove varicose veins is a vascular surgeon. These guys specialise in treatment of veins and arteries, and the lymphatic systems. Conditions treated by vascular surgeons include deep vein thrombosis, atherosclerosis and any other arterial diseases. I did searches like ‘worst varicose vein op ever’ and ‘worst vascular surgeon Johannesburg’. Not finding anything dramatic, I decided on a doctor who ran a vascular clinic in partnership with another surgeon, who had surgeries in two reputable hospitals. 

With all those very serious conditions being treated by vascular specialists, I was not entirely surprised to see that varicose vein procedures were rather at the bottom of the list in the world of vascular surgery. And from the word go, that was exactly the message I got from this particular practice.

First off, the doctor kept me waiting for an hour.  In that hour I saw him pass behind the battery of receptionists several times, munching on a sandwich. I kept wondering, did they schedule my appointment during his lunch hour, or had he decided to take his lunch hour during my appointment. Either way, I was annoyed by the time I finally got summoned to his office. 

I decided to keep calm, in order to get the best out of this appointment. So with a lot of deep breathing and counting to ten as I walked down the passage, by the time I entered his door, I was about eighty nine percent relaxed. We shook hands and sat across each other at his desk. That’s when I noticed warning sign two. 

A big fat ginormous booger was dangling from his left nostril. I should have just called it quits right then. I should have stood up and walked out of his office and found another doctor. But, because a dangling booger can’t be considered as an indication of competence or lack thereof, I decided to continue with the appointment. We spoke about the options I had, and he did a scan of the leg. He suggested that I went for sclerotherapy, where a solution is injected into the veins. This solution causes scars and closes the veins, and after a few weeks, they should fade. Thanks to Google, I knew that it could be done with local anaesthesia, but he suggested that I have general anaesthesia. When I questioned him about why I would need the general knock-out potion, he changed his tune somewhat and said that local would do. That should have been Alarm Bell Three.

I left his office with an appointment booked, and some paperwork to read through. The general gist was that payment up front was required for all varicose vein treatments. This message was relayed in bold, capital letters in font size 18 in about four different locations in my document pack. I am on an international medical aid, and they give treatment guarantees once they receive paperwork the doctor is required to fill in. As soon as I had the guarantee from the medical aid, I would pay into the doctor’s account.

And here is where warning sign four came in to play. I e-mailed the forms to the receptionist four weeks before the treatment date. Three weeks later, I was calling their offices to ask when I would be receiving the completed forms. The reams of paperwork required by medical aids are laborious at the best of times. They want all sorts of information not relevant to them at all, like whether it was full moon on the date of first onset of symptoms. I know for a fact that any forms from medical aid companies that need filling in are a pain in the ass for doctors – they keep telling me so. But the doctors know that if they want to keep shop open, they need to do the paperwork. 

I accidentally phoned the practice at the other hospital and the bossy-boots over there told me that my problem was that I’d sent the forms to the wrong person to be completed. Not entirely worried, because we still had time to get the forms sent in and the guarantee confirmed so I could pay, I sent the forms to bossy-boots who assured me that they would be completed.

  Four days of phone-tag, e-mail relays and a lot of passing the buck, the forms were ready. We somehow managed to push the medical aid guys to guarantee the payment by late evening the night before my treatment date. Fantastic, except I had no idea what time I had to be at the hospital, or whether I had to stop eating by a certain time. So I e-mailed the doctor asking for information. 

The response that came from his bossy-boots receptionist on the morning of the operation was a chastisement for contacting the doctor directly. This was followed up with a phone call where I was told that since I hadn’t paid any money into the doctor’s account, there was no chance of getting the procedure done that morning. 

My efforts to explain that it was her office’s fault that payment guarantee was only confirmed the night before were being ignored. For fifteen minutes her mantra was: “No payment, no treatment.” I persistently chipped away at her obstinance, repeating my own mantra of “no guarantee, no payment”. 

The idea that her offices might have been the reason why everything was delayed eventually started to take root. She was even slowly getting used to the idea that I, as the client, might have needed her offices to act quickly so that I had the guarantees I needed before paying the doctor. I was trying, despite all the signs telling me otherwise, to still get this doctor to perform the operation that morning. Once she told me that understood that they were responsible for the delay and the lack of payment, and not me, she hit me with this whammy:

“Well anyway, Doctor was working till very late last night and he’s too tired to perform your operation now. So we are canceling it.”

I took the phone away from my ear and looked at it. A queasy knot of unease settled in my stomach. I felt like someone who puts her name on the order list for a Birkin bag and gets told, just as it’s her turn to get one, that she’s not good enough to buy the bag. This is the strangest kind of inadequacy to feel because it’s not based on anything of substance. To this doctor, and his practice, I was just an account number and an amount of money that had to be in his account. Whether my needs were being met as a consumer was not this practice’s concern. Suddenly I was happy that my Internet was down the night before, preventing me from doing the transfer.

“I feel very uncomfortable now,” I said, more to myself than to bossy-boots. 

“You can make the payment and phone the other office to reschedule your procedure for next week,” she spoke as if she hadn’t heard me.

“I don’t want to do the procedure with Dr M anymore,” I declared. “If this is how his patients are treated before he’s even performed an operation, I don’t want him touching me. Particularly not with a scalpel.”

The insensitivity shown by his staff surely came from the top down, and I was not convinced that I’d be well taken care of by him. 

After more research I found another doctor, at another good hospital, whose receptionist filled in and processed the treatment guarantee application during consultation. He performed the procedure without insisting on payment from me first. I asked him about it in our first appointment, and his response was, “once we have the guarantee, the medical aid always pays out in the end.” The treatment was a success, and the medical aid paid without fuss.

So what could be learnt from this situation?

For the consumer:

Stop trying to force something that repeatedly shows symptoms of being ‘not meant to be’.

For the service provider:

Treating potential clients as if they are non-paying cretins right from the get-go, without knowing anything about them, means that they will look to more customer-friendly practices for the services they need. In this instance, the staff had been drilled to be so adamant about payment first, that they forgot that their clients had prerequisites that needed to be met too.

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