Mistakes, Aaaah, mistakes are a part of life. To err is human (to forgive “divine”?).*
Doctors, more than some healers, are famed — nay, can be infamous — for their pride, ego, hubris and mistakes. Doctors — and healers of all stripes — can do everything right, follow all of the rules, apply the science to an illness nearly exactly and still have bad things happen. They do. There is not always someone to blame.
These short writings on doctoring are not about the details. Lord knows there are so many subtle, complex nuances to quality, high-class medical care. But we may touch on the simpler mistakes here: medicine’s failing culture of common, daily mistakes. Things that many good doctors perhaps never used to do are important mistakes that we can still strive to avoid every day.
Factories: Doctors’ offices are not factory floors. Healing practices are not assembly lines. We do not produce widgets of people, with each person pounded into the same shape every five minutes to fit the same form of “care.” This is absurd. If you feel rushed, if you feel not heard, stop us right-here-right-now. Make us slow down. Make us stop and listen. This is our job.
Highways: Doctors’ decisions are not one-way highways, all speeding in one straight direction. And patients are not one-way streets who get all that they want the way they want it, either. There will be intersections, sudden stop signs, unexpected curves and oncoming traffic, you name it. And it is funny that the older I get here in West County, the more I now imagine seeing some patients committing more of this crime than even doctors do.
Dictatorships: Neither can one side dictate to the other what is wrong and what to do. Patients have all of their rights to self-care. And doctors have tons and tons of knowledge and experience, licenses, reputations and a real feeling of wanting to help do the “right” thing. Both doctor and patient have legitimate needs, even rights, to negotiate these dangerous, challenging rapids of life together in the same boat as a team. Their healing success comes from each side listening to the other and honestly meeting somewhere in between.
Thievery: Patients sometimes tell me stories that seem so unfair as to be right out of Robin Hood, all the way down to stand-ins for a “good,” if absent, King Richard physician and present yet “bad” nurses, colleagues, business offices, billing practices, scheduling, or you name it. A practice charged a patient $600 for five minutes of small talk and no exam simply to sign a predetermined referral form. $600 for what we can do for $60 with an exam? Such a clinician can be an accomplice to highway robbery. Did they know? Should they know?
Cheap Grace: Doctors can harm both their patients and their practices every day by overcharging for even the smallest services or by routinely writing off charges while still expecting to take home the same doctors’ salaries every week. A good businessperson may know that this is wrong on both ends. Both are taking more than giving. But which doctors today know what their practices do?
What can you do? You can sure presume that the medical bill you have is inflated. And mistakes, billing mistakes, do happen. In fact, when a patient comes to us concerned about a bill we start by believing we made a mistake. We look at it closely. Your own doctor’s office has to follow the rules to give you a clear and fair accounting of all that you are charged for and why.
Yes, overcharges are found in most parts of the health care system. Yes, you can ask to understand every line of your bill. Yes, there will be ridiculous charges that they are allowed to make. But no one pays full retail in health care, and cash is king. Doctors and hospitals should accept just as little from you as they accept from every other insurance company with bigger pockets. Why are they building their white castles on your back?
I feel these are some of the biggest mistakes in medicine today. It is not the rare malpractice which can even happen when nature and life are unpredictable no matter how well a doctor may do things right. The big medical mistakes are these daily mistakes doctors allow to happen when we choose to work hand-in-hand with for-profit businesses who pay themselves millions by profit-making off of everyday people’s pains and suffering.
What to do? Get a second opinion. Get a medical second opinion. And get a billing second opinion. You cannot go wrong with both.
*Alexander Pope’s 1711 “An Essay on Criticism also coined other literary gems, including something about a little knowledge being a dangerous thing and some fools rushing in where angels feared to tread.
Dr. Stefan Topolski is an academic physician and country doctor serving Franklin County. Dr. Topolski welcomes any questions you may have at public@cottagemed.org. His opinion is for educational and informational purposes and should not be used for diagnosing or treating any health problem without first consulting with a licensed physician. Never disregard or delay seeking professional medical care because of something that you read. The views expressed here are those of the writer, their research colleagues and no other organization.