Tue 4 Dec 2018
Deadly Bureaucracies
Posted by PJ under bureaucracy, drugs, it's curmudgeon time, medicine
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Bureaucracy, n., A system set up to help large institutions waste the time, resources, and lifespans of individuals.
—PJ’s Devilish Dictionary
One gets the impression sometimes that large medical institutions would be happier if we would all just die and stop bothering them. Certainly, their bureaucracies have little regard for our individual stories and needs. Some of these institutions train their employees well, to be completely professional in their ineptitude. Others can’t be arsed, but it all works out the same.
Or maybe that’s just an American thing.
And let me just state for the record: I know I am lucky to have medical and drug coverage at all, given that I am an American and our pay-for-play medical system is an abomination.
As of November 1, I transitioned all my medical coverage from two systems to two others, medical and drug (actually, three others but I won’t get into the horrorshow of that). It took hours on the phone, but mostly it seemed to go smoothly. Most of my prescriptions from my primary care physician got through to the new drug pushers and I received a new supply in a timely manner. Unfortunately, the most vital medication I take, the artificial thyroid hormone that keeps me alive, did not. My thyroid was removed some years back because I had cancer, so I literally cannot live without the synthetic hormone. I have been on the phone with UCLA countless times since November 1 trying to explain to them that the old prescription service they’ve been blithely sending my prescription to is no longer my service. I even explained this to my doctor on my last office visit on October 29 when he electronically sent the prescription off to my old service while I was in the office with him.
“I’m sorry, doctor, that won’t work. They’re no longer my provider.â€
“Oh? Well, call into the office with the new information and we’ll send it again. Next!â€
I’ve called several times in the last month, explained the situation patiently, been reassured that the next time the doctor is in the office, they will send the prescription off to the service. Fortunately, I had plenty of pills when this started. I’m now down to about a two-week supply and once the Rx is sent, it will take about a week for them to send me new pills. So, I called yesterday yet again and this time I seemed to have gotten someone who not only sounded professional but acted it. She told me that their records said the Rx had already been put in (but I’d just talked to my Rx provider and it had not). I explained yet again that it had been sent to my old Rx provider. She took extensive notes (like the others before her) and sent it on to the doctor’s assistant, putting an expedite on it because I was getting so short on meds. She said someone would call me back by 11 a.m. today to let me know how it was resolved.
I guess I don’t need to tell you that 11:30 rolled around and still no call. I called once more. This time I got another professional-sounding person who finally admitted that the doctor’s assistant had changed the information in the computer only yesterday. But now the doctor won’t be in until Thursday, so that’s the soonest this can be resolved.
I lost my shit. I usually don’t go that route because it’s counterproductive and because I really don’t like being that person. I try to remain reasonable even in the presence of dumberheads and I try not to swear and do other things that turn people hostile. But this is my life and they are being careless with it. I may have said something along the lines of, “This is what you’ve said every time I’ve called and nothing gets done. I’m tired of you all and if I get sick because of this I’m suing the shit out of UCLA.†(I probably won’t and they know it.)
It did not make me feel better. In fact, it just made me feel more impotent because, essentially, we both knew I was impotent in this situation (the other reason I don’t like to go there). The professional-sounding person on the other end of the line listened and said very professionally, “I’m sorry I can’t do anything more at this time. Is there anything else I can help you with?â€
Is there anything else I can help you with? is one of the more infuriating sentences in the world when you’ve been bashing your head against an intransigent wall. It is the last refuge of incompetent systems because they know there’s no reasonable reply to it except no. It is the professional equivalent of “Get off my phone and go fuck yourself.â€
I have to say that there is some fine medicine being done at UCLA, and they have trained their personnel to meticulously professional phone manners instead of the old “Yeah, whatever†you used to get at UCLA. It doesn’t mean that they’re doing the job any better, but hey, they sound good. And UCLA would rather sound good than be good, if you know what I mean (and if you understand ancient SNL references).
I like my doctor there quite well. We’ve been together years and he’s a pioneer in the field and he’s done quite well for me generally. But this was not his finest hour, and the bureaucracy at UCLA is getting worse, not better. I may have to find a new endrocrinologist. Who is not associated with UCLA.
