The last time I went in for a physical, I mentioned to the doctor that I had some bumps on my arms that I would like to get looked at. I’m 58, do a lot of outdoor activity so I get a lot of sun exposure, and forty years ago went on a canoe trip that resulted in sheets of irradiated skin peeling off for weeks afterward.

So. My usual doctor (“UD”) recommends I call a local dermatologist. I call and leave a message. A week later I get a call that they aren’t taking new patients, but they can recommend someone a town over. I call them, and they tell me that in order to even make an appointment, they need (a) my insurance information and (b) a referral FAXed(!) from my UD.

I hate this. In the first place, neither the dermatologist nor my UD will deal with email because—they say—HIPAA won’t allow it. I’ve read the regulations, and of course HIPAA allows it, but let that go. I’m going to have to spend an hour or two getting UD to FAX the dermatologist my information, and then I have to FAX them my insurance card. I feel like I’ve been dropped back into the 20th century.

And then...

Until I moved to New England, I had spent my life in HMO systems. There, I would go in, see the doctor, and, if he felt I needed lab work or a specialist, I was sent down a floor or up to the lab. No more paperwork. They had multiple folks in each department, so it wasn’t a matter of booking at a distance. If there was a copay, it was done on intake and it covered all other appointments that visit. No muss, no fuss.


THAT, my friends, was healthcare. THIS is a system that actively discourages people from seeing doctors. I’m halfway tempted to skip this whole craziness and just see what happens, but I have Spouse and family so I likely won’t do that.

And I know I’m more fortunate than a lot of folks who don’t get this level of coverage, that this is a First World Whine. But I’m pissed at the built-in inefficiencies of this so-called system.


OK. Rant (mostly) over for the day.