Putting the Patient On Hold

JOHN R. LION

January 21, 1992|By JOHN R. LION

The other day I was ill, so I phoned my health care provider.These folks used to be called doctors, but doctors have long since abandoned the practice of medicine and now own chains of hospitals and MRI diagnostic centers. Instead of stethoscopes dangling from their white coats, Mont Blanc pens protrude from the pockets of their finely tailored suits.

''You have reached the main headquarters of the MegaCare Health Plan,'' the recorded voice oozed at me.

''And we are proud to be a new member of the Majestic Health Corporation of America. Serving you is our first priority. If you are calling from a touch tone telephone and feel a little ill, press one. If you feel seriously ill, go to the nearest emergency room. If you are calling about a claim or payment, press 68247913 six times, and then the number 83529476.''

I opted for number one.

''Thank you for calling the mildly ill hot line,'' the voice proclaimed. ''A health screening adviser will handle your call in sequence. Please stay on the line and have your telehealth access code ready for the operator.'' I was put on hold while a chorus sang the MegaCare health ditty:

We really care about you, you, you,

We really care, we really do,

At MegaCare it's you who's first,

We're gonna care until we burst.

After this, a rich baritone voice talked about the new MegaCare Frequent Illness Bonus Point program. If you have an illness which requires at least three laboratory diagnostic tests, you get one free visitation right to your health care provider.

I had a tough time listening to all of this attentively because I was drowsy from the antihistamines I had taken. I fiddled to open a new box of tissues and gargled with some salt water. Then I lay on the bed with the phone propped up against my ear. It took a long time.

''This is health care adviser Cathy,'' the voice said sweetly. ''How may I help you?''

''I feel wretched,'' I told her. ''I have a bad cold.''

''And have you called our hot line before?'' Cathy inquired.

''A few times,'' I coughed into the receiver.

''Let me bring your record up on the screen,'' Cathy said. ''Oh yes, here it is. You called us in July about a rash.''

''Poison ivy,'' I sneezed.

''And in August about your appendix.''

''I had to call you for preauthorization,'' I explained to her. ''The surgeon couldn't remove it until you OK'd the procedure. I called from the operating room.''

''We still count that as a call,'' Cathy replied sternly. ''And it also looks like you called us in November.''

''I had chest pain.''

''Oh dear,'' Cathy said.

''It turned out to only be indigestion,'' I hastily added.

''No, no,'' Cathy corrected, ''I was referring to the fact that you have used up your three annual calls.

''But I have the Extension Plan,'' I protested. ''It allows unlimited calls to the health care screening adviser.''

''I'm sorry,'' Cathy said. ''Our records show that you only have the Generous Allowance Advice Plan.''

''How can that be?'' I sat up straight on the bed. ''I paid the premium last month. Five thousand dollars.''

''I'm sorry, sir,'' Cathy cooed.

''But I just want to talk to someone.''

''I can refer you to the mental health screening adviser if you like,'' Cathy suggested. ''They come in on the first Monday of every month from 1 to 1:15 in the afternoon.

''This isn't fair,'' I complained. ''All I want is some reassurance about this flu of mine and . . .''

''Thank you for choosing MegaCare Health Plan,'' Cathy was already saying and I found myself listening to a dial tone.

I vowed then and there to change health plans. I'm finding one with advisers who care. I heard there's a new one in town where the providers even see you in person. It sounds far-fetched, to be sure.

You have to be careful of all the quacks who want to physically examine you and sit and talk about your health. They're a dangerous bunch. They're just in it for the money.

Dr. John R. Lion is a psychiatric health care provider in Baltimore.

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