For many years now, I have endured a mild skin disorder, rarely fatal. I usually am monitored by a fine doctor in Rancho Mirage. But I wanted a dermatologist near our home in Beverly Hills, so I asked around and got a reference for a Dr. Wang, as I will call him. (Not his real name.) This afternoon, I entered his tiny waiting room, introduced myself to the young women behind the counter and smiled.
The women asked me to fill out several forms, which I did and handed them back. The main receptionist, a woman of about 24, said to me, “Just have a seat, Benjamin.”
This really set me off. I don’t like total strangers calling me by my first name unless I ask them to. But I sat quietly for about 40 minutes while a large British man had a wild altercation on his cell phone, and then a middle aged woman with two truly snotty looking daughters came in and loudly made plans for a sleep over party.
Finally, another young staffer from behind the counter appeared and asked me to come into an examining room. “Right this way, Ben,” she said.
By this time I was seething. “May I ask how old you are?” I asked her.
“Twenty-five,” she said.
“Well, young madame, I am sixty-nine and I have done a fair amount in my life and I don’t like being called by a diminutive of my first name by someone forty-four years younger than I am.”
She looked totally stunned and said, “All right, I’ll call you Mister Stein.”
“That would be kind of you,” I said.
She gave me a paper gown and left the room. I put it on. A few minutes later, a very young looking doctor walked in and said, without offering his hand, “Hi, Ben, I’m Doctor Wang.”
“Wait a minute,” I said. “How come you call me by a little boy’s name and you call yourself by your professional name? Why don’t you call me Attorney Stein, or since I am a Doctor of Jurisprudence, and have many Honorary Doctorates, call me, ‘Doctor Stein’?”
He looked mystified but politely said, “I’m here to help.”
“Great,” I said. I showed him a few marks from my skin disorder. He looked at them for well under thirty seconds on one spot on my hip.
“What is that?” he asked me.
“It’s X,” said I. “It’s a skin disease.”
“Oooh,” he said. “We don’t treat that here. How have you been treating it?”
“With ultra violet has been the best way,” I answered.
“We don’t have those lamps here,” he said. “Maybe try UCLA Medical Center.”
“Doctor, I am here at a private doctor, ready to pay, just so I don’t have to go to a clinic.”
Meanwhile he was feverishly working a device that looked a lot like an iPad.
“I’ll try to find you a doctor who does treat X,” he said. “I’ll be right back. There is a first rate woman who handles X,” he said, “but she’s a bit far away.”
“Where is she?”
“That is a bit far away,” I said. (Maybe 300 miles.)
He went to look up doctors.
I’m a snoop, so while he was gone, I looked at his iPad-like device which he had left behind. It was a medical record keeping machine. It said my name (as “Benjamin,” not as “Ben” ) and then said that I had come in complaining of a rash and itching. It further said Dr. Wang has done a thorough full-scale examination of “all dermatological systems” or similar, had examined my whole body from ankles to scalp, especially my scalp. It also said I was to be charged as full exam, first time patient.
When, a minute later, Dr. Wang re-entered the room, I asked him, “I beg your pardon for snooping, but, sir, I would like to know why you said I had complained of an itchy rash. I don’t have an itchy rash and never did. I never complained about it. Why did you say you did a series of exams on me, not one of which you did? This is a medical record of things that did not happen. It is obviously a billing document.”
To his credit, Dr. Wang looked suitably embarrassed. “Oh, this is just boilerplate,” he said (or something similar). “At the end of the day I would have edited it to show I didn’t do anything much.”
“A full exam, first time patient billing under Medicare?”
“Oh, don’t mind that.” he said.
“Look at me,” I said to him. “Do I look familiar to you?”
“I think you do TV commercials,” he said with a wary smile.
“I do,” I said, “and I also talk on TV and write about public policy problems like health care billing.”
“There won’t be any bill for this,” he said somberly.
At the desk, his receptionists gave me the name and phone number of UCLA. Thanks a lot.
I went away angry. I am sure Dr. Wang is a fine fellow. Yes, very sure. But… There are hundreds of thousands of doctors in this country and millions of appointments with patients every day. How many of them involve billing for exams that never happened? How many of them serve only the purpose of ginning up revenue for the doctors? Mr. Obama wants to consider how to lower health care costs and he’s right. But what a staggering moral-ethical-criminal problem there is in medical care today. And with what sickening contempt these medical office personnel treat us patients. It was a maddening day.
I would add that most of the doctors I see treat me extremely well. Better than I deserve. But what about the doctors who see their license to heal as a license to steal? Who watches them?