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Old 10.09.2011, 10:54
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Re: Doctor's Practice problem

The interest in seeing me leave was about the canton/country, not about the practice. I thought that was obvious.

The problem with going to the insurance company to ask for a referral is that the insurance company is interested in the cheapest solution, not the best. There is a conflict of interest there.

Going to the "head of a department" is not an easy solution to find the supposed best. The head of a department is an established person, who at some point in the past, was the best at politics. This is no indication of expertise, and in fact may run contrary. Such people are not the best at keeping up with new developments. I had a conversation once with a doctor who was staying at my inn. He was there to be away from everything and spend days catching up on the literature of his profession. A monumental task in its own right. In fact, the head of a department was the one who failed me the worst. He was so steeped in ordinary cases he couldn't fathom mine. My private specialist made the difference, probably saving my life (or at least, avoiding a heart attack).

I think the problem is mainly the nurse/assistant at the practice is a bigoted bimbo who can't stand old/gay/fat/foreign people. Her English is horrible and her attitude is worse. And the doctor in uninterested in dealing with that problem. That and an interest in reducing the work load. Disgusting, really. But what do you expect in a place where supposedly educated physicians advertise that they use homoeopathy?
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Old 10.09.2011, 10:58
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Re: Doctor's Practice problem

I'm not sure I fully understand why you are upset..
Is it because of the medical diagnostic ?, the service at the doctor's office ? the doctor's attitiude ?

Not really clear, but.. wishing you best of luck
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Old 10.09.2011, 10:58
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Re: Doctor's Practice problem

I should add, the idea of changing cantons isn't too good. Insurance is by canton. To seek treatment outside Zug, I'd have to get special permission, or move (unless my private insurance would cover it, which is doubtful). Moving is a monumental notion, and unattractive. I've moved 5 times in the last 13 years.
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Old 10.09.2011, 11:11
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Re: Doctor's Practice problem

OP, I had similar concerns. Our ped used his assistant to filter off some "not justified" requests for seeing me and my child (mind you they were very attentive to our neighbors, same ped, but local neighbors, not foreigners and the same insurance plan and company, it was shocking to see how helpful they were with other clients). Her staff was just an administrative staff, too, not even a nurse. After a week of my 8mo old with serious dehydration issues and never ending diarhea, I started using ER since my ped didn't respond (which I always thought would be a nono if one has a regular doctor). Ped got bombarded with ER reports questioning why the hell ped can't see us when we have legit and worrisome reasons, it started to work somewhat.

I never want to just quit on docs since you give them credit for wanting to be good with you. So I waited and scenario repeated, with ear infections, a couple of misdiagnoses and wrong medication, and finally changed ped. Now we are super happy.

But the lesson is, some professionals will use their incompetent staff to fend off clients, even if the situations warrant immediate care. Consider also language issues, while I find docs perfect in English, usually (can't say the same for customer care of ethics of some, unfortunately), their staff might have issues with English and will be crabby or uncooperative.

I really think Sky hit the nail on the head here. You don't owe anything to anybody, if I was on blood thinners and bled, I would barge in any office, phone calls or not, manners or not. People sometimes do not see the function over the form and rules, square heads.

Just move on. Get a dif doc, ask for your file, first, transfer it yourself, to see if you have any personal comments made in your file about your behaviour, because that also happens.

Medical care is customer service domain, just like anything else. You pay your insurance, you are entitled to have a medical professional that is helpful and that you trust. Should you be unhappy with either unprofessional doc, or his staff, give your biz to somebody else.

Good luck.
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Old 10.09.2011, 11:35
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Re: Doctor's Practice problem

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The problem with going to the insurance company to ask for a referral is that the insurance company is interested in the cheapest solution, not the best. There is a conflict of interest there.
?
You might think that to be true, however the Dr at Sanacare is prescribing very expensive Statins for me, they are 10 times the cost of the ones that I would get in the UK on the NHS. I suspect that's why medical insurance is expensive here, nobody has any interest what things cost.
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Old 10.09.2011, 13:24
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Re: Doctor's Practice problem

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But what do you expect in a place where supposedly educated physicians advertise that they use homoeopathy?
To me, "homeopathy" doesn't necessarily indicate sugar water and convincing arguments but rather can also mean "natural remedies" such as being advised to take a syrup made of anise, "islandish moos" (special licorice tasting lichens from Iceland) and honey for my cough. (This cough syrup has worked wonders btw)

While you may be right, you may also be judging this based on what you think is meant rather than by what is actually meant.




Regardless of what is or isn't going on in your doctors office and with which members of the staff, end of, if you're not comfortable with and confident about the care you're receiving, go to a different doctor.

My husband wasn't helping me find a GP (I'd asked him if there was some "accepted" list of doctors for our insurance, he kept putting me off), so I went looking for one myself. I have no idea what this meant in terms of how my insurance coverage works because of this BUT I can tell you this - I made an appointment with the doctor and interviewed him before settling on going with him. If he had "failed" that interview, I would have continued my search.

So, I advise you do to the same. There have been websites posted here with ability to select doctors based on specialties and location, usually with some indication of languages they speak. Search for likely candidates and interview them. Explain the problems you've had before both health wise and with your actual care needs and expectations. If they won't suit, it will show and continue your search until you find one with whom you've got reasonable expectation of being satisfied with their care and services.

The problem with doing it this way is that your insurance may (or may not, I honestly don't know how it works) pay different percentages for "premium" doctors vs others. I suspect as mine is in a group practice with a lot of their own equipment (ability to do lab work, x-rays, stress and breathing tests, etc), we probably pay more for the care I get from his office BUT I am extremely pleased not only with my GP but also with the other doctors there I've seen AND the other staff I've encountered.


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I really think Sky hit the nail on the head here. You don't owe anything to anybody, if I was on blood thinners and bled, I would barge in any office, phone calls or not, manners or not. People sometimes do not see the function over the form and rules, square heads.
I will go back to what I said though... if you have a ROUTINE thing you need done, whether it is checking blood, sugar, skin, whatever, it really is the very best idea to have routinely scheduled appointments for this!

I can understand (and really would think doctor's assistants and nurses or whomever would as well) "barging in" when there is some sort of emergent situation BUT for routine testing, there's no reason not to have appointment, no matter how little time you think it will take.
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Old 10.09.2011, 14:15
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Re: Doctor's Practice problem

Homoeopathy has a specific meaning. In a way, I would be even less inclined to favor a physician who misused that term than one who actually was sincere about the magic water. That'd be like confusing penicillin with M&M's.
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Old 10.09.2011, 14:20
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Re: Doctor's Practice problem

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Homoeopathy has a specific meaning. In a way, I would be even less inclined to favor a physician who misused that term than one who actually was sincere about the magic water. That'd be like confusing penicillin with M&M's.
Read all about it...

I think the reason some doctors have it is because it's a money-spinner. As long as there is a market for it they'll have a piece of the action. Swiss docs are not unique in this, by the way.
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Old 10.09.2011, 15:20
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Re: Doctor's Practice problem

er... um... way more snarky than I'd intended so instead, I will just share a picture of this lovely cat:


Last edited by Peg A; 10.09.2011 at 15:42. Reason: not that mean, not today anyhow.
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Old 10.09.2011, 18:03
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Re: Doctor's Practice problem

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I will go back to what I said though... if you have a ROUTINE thing you need done, whether it is checking blood, sugar, skin, whatever, it really is the very best idea to have routinely scheduled appointments for this!
Bleeding does not sound like a routine reason to see a doc. I am not sure why you mention routine check up, when OP was talking about an emergency situation. But I might be not reading the thread too carefully, pardon me, seriously, since I am simultaneously trying to figure out why there are certain members from thousands of kms away interested in selling us some weird hair gels or iphones, or happy ends, haha.

It seemed to me that OP was peeved since staff was rude, despite him having an emergency situ. Nobody with a sane mind would just not schedule routine appointments here and treat their docs as a walk-in clinic. Bleeding while on blood thinners is a pretty good reason to want your GP seeing you immediately.

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I can understand (and really would think doctor's assistants and nurses or whomever would as well) "barging in" when there is some sort of emergent situation BUT for routine testing, there's no reason not to have appointment, no matter how little time you think it will take.
Yep. Bleeding does not sound routine. Unless OP is a girl. Oops.

Homeopathy....aaargh. I saw a school nurse for hearing tests since we now are dealing with the aftermath of ninccompoopy pediatrician and my child seemed to have decreased auditive function. With discussed shyness, etc. all the other things that poor little person compensates, socially, non functioningh physical stuff. And she, instead of offering auditive tests, wants me to go to kinesiologist. Jaysus. How far does the woodoo obsession go in here..

OP, if you are stuck with the doc, and really want him (maybe a hustle to go to another one, if it is in a different town, or something), you can really use ER after hours, chances are your doc still works short shifts, etc. Or, demand strongly, to speak directly to your doc, instead of the assistant. Avoid her. See if it takes you anywhere. Ask your doc for refferal to another one, since he seems to be pretty overloaded with an assistant having to pull these tricks on you. Or, before you get another doc, see a specialist, and ask him to call your GP to explain why you want to feel like you can rely on your GP's services. GPs are sometimes not educated or on top of the latest stuff and this particular GP might be treating you like one of the regular folks, despite your condition.

But don't let it be, I am now running around to try to fix hearing problem we didn't have to have if I listened to my guts and if I ignored the "don't make waves in the new country" bull.

Good luck.
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  #31  
Old 10.09.2011, 23:15
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Re: Doctor's Practice problem

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Bleeding does not sound like a routine reason to see a doc. I am not sure why you mention routine check up, when OP was talking about an emergency situation.
I kept mentioning the routine thing because there were two occasions.

Occasion 1 was the bleeding (and I agree, shouldn't need an appointment for that) 2nd occasion was for a (seemingly, going by OP's description) "routine" blood draw for testing.

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This time, she had "no time" to take blood samples. It was 9:30, no one else was visible in the office, and she was doing paperwork. She insisted I needed an appointment for blood drawing. I find that completely unusual and weird, and so does every Swiss person I've asked. I mean, it's 5 minutes to draw blood! I'm SUPPOSED to be monitored for problems due to the drugs they have me taking. Apparently, her convenience is more important than my heath care.
It doesn't make any sense to me that this would not turn into routinely made (and kept) appointments for monitoring.
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Old 10.09.2011, 23:33
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Re: Doctor's Practice problem

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I kept mentioning the routine thing because there were two occasions.

Occasion 1 was the bleeding (and I agree, shouldn't need an appointment for that) 2nd occasion was for a (seemingly, going by OP's description) "routine" blood draw for testing.

It doesn't make any sense to me that this would not turn into routinely made (and kept) appointments for monitoring.
Hmmm, I would bet my shoes she does not know he was supposed to be monitored, nor his particular diagnoses. We don't know what routine means for this particular patient. Whatever it seems to us, blood drawing does not have to be routine. Blood drawing can be because a patient experiences particular/new/unusual symptoms. In that case, if he is supposed to be monitored, docs should welcome him showing up anytime something unusual happens. That means a patient is educated, observant and responsible. Even if a patient panics, considering his sickness, a professional attitude would not be to shoo him away with some cranky unpleasantness. It's all about being helpful and communicative. Which I think isn't really happening for this person.
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  #33  
Old 10.09.2011, 23:46
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Re: Doctor's Practice problem

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I kept mentioning the routine thing because there were two occasions.

Occasion 1 was the bleeding (and I agree, shouldn't need an appointment for that) 2nd occasion was for a (seemingly, going by OP's description) "routine" blood draw for testing.
In my opinion you should always call ahead, even if it is an emergency. That is the way it is done Switzerland (at least in rural areas).

I think it would be important, too, to know how severe the bleeding wound was looking. Maybe the assistant was just fed up with people, who do not care to call ahead, just stepping into the practice having only minor injuries. Add to this that maybe her English was not good enough to realize that the OP was on blood thinner.

If the OP had called the GP before stepping into the practice. S/he would certainly have got an appointment to see the doctor as fast as possible (that is at least my experience with emergency visits to a GP). By just walking into the practice s/he probably was perceived as rude by the staff (in rural areas calling ahead even in emergencies (if possible) is certainly the norm), which resulted in the perceived behaviour of the staff. Today when everybody is carrying a mobile phone, calling ahead shouldn’t really be much of a problem.
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Old 11.09.2011, 01:01
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Re: Doctor's Practice problem

The whole matter of the OP has several aspects. Without knowing all the relevant details, all I can say is this:

The practice of a GP often sees patients that just walk in, sometimes with minor problem that, of course, are not minor at all from their own point of view. Plus there are many phone callers that urgently want to talk to the doctor himself, even saying it's private, personal etc., and when he interrupts his work on a patient and answers the phone, all he gets is a question concerning the invoice for the last consultation (which he never saw, because it was the receptionist who wrote it) or one of those stubborn guys who want to talk him into some great business opportunity on the futures market ("you don't need much money, a quarter million will do").

It's the receptionist who has to separate the chaff from the wheat. If that is not done, a doctor will spend more time on the phone or having other patients with major problems wait because of a scratch than doing real work. BUT, of course, the receptionist must be able to do the screening in a decent way. There are front desk dragons who may be great for the doctor but not for the patients.

A GP's practice, in my opinion, should be able to handle such situations. It just needs a bit of flexibility and good organization. Of course, there is the possibility that five such "special" cases drop in within an hour, which strains even extreme flexibilty to the breaking point. But even then, there should be a way to handle the situation in a decent manner.

Without questioning the situations described in the OP, it's just one side of the story. Audiatur et altera pars (Latin: Let's hear the other side too), obviously not possible in this instance. This is no excuse for the rude behavior. Not even asking the patient for the reason for dropping in is pretty bad, and screaming at a patient should be a reason for a pink slip. On the other hand, I don't quite understand where the notion comes from that the doctor is more interested in his assistant than in his patients. That sounds a bit biased, which, after those incidents, is understandable to a certain extent, but it doesn't sound very objective.

Then there is the question if the front desk person is authorized to take blood samples. The OP says she's a nurse. Really? Could it be that she is just a secretary? The doctor and his medical staff may be too busy indeed. I wouldn't like to have my blood taken by a secretary, unless she's a seasoned morphine addict (ok, just joking). Needless to say, it would be illegal anyway.

In short, I agree, the behavior, as described in the OP, is not acceptable, and it definitely is not normal. It smacks of a lack of social skills. Very poor communication. But we would need to know more to assess the degree of what went wrong and what could have been done. I'd aske around to find another GP.
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  #35  
Old 11.09.2011, 10:40
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Bleeding does not sound like a routine reason to see a doc.
That's correct but wouldn't it make more sense to present at the hospital, especially when the patient is on medication that could possibly make him bleed uncontrollably, where they will have bags of blood on standby should he need it?

Knocking on the door of my doctor wouldn't be my first port of call in that situation. In fact, the doctors I have seen in the past (especially specialists) are often out of their office for much of the week either operating or lecturing or on the golf course.

For example, if I had a gynaecological emergency I know it would be pointless rocking up to her practice on a Wed/Thur/Fri because she's simply not there.
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Old 12.09.2011, 00:07
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Re: Doctor's Practice problem

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That's correct but wouldn't it make more sense to present at the hospital, especially when the patient is on medication that could possibly make him bleed uncontrollably...
It depends on each patient and location. I would, for example, not truck myself to a hospital, on my own, if I bled and was on blood thinners. I would get myself asap to any nearest medical facility and ask them to at least accompany me, make the calls, supervise the transport, or supervise me waiting for it. If GP was the one to arrange these things, so be it. But trucking yourself on your own to hosp and unsupervised while you bleed might not be in certain circumstances the wisest thing to do. Phone calls or not, sometimes people do not feel so strong with the knowledge of their local lingo for phonecalls, and, trust their medical professional to be able to manage the situation in person (hoping the doc will react quickly seeing the wound, or so, instead of battling and trying to get through an unhelpful assistant). If both GP and assistant aren't helpful, then ER might be the only option until OP finds a GP replacement.
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Old 12.09.2011, 10:19
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Re: Doctor's Practice problem

My experience* has been that some (maybe more than some) receptionists and practice assistants see their primary role as 'gatekeeper'. Getting through can be difficult, and one does indeed need to follow protocol.

Call ahead and you will likely be seen that day. Not calling ahead may get one labeled as a problem patient, and one's concerns may not be taken seriously.

Whether it should be like this is a moot point - this is the way things work 'round these parts, one needs to use the system as it is if one is to get the treatment one needs.

So call ahead, even if that means calling from the vestibule.

Yes, the local doctors have an emergency after-hours coverage rota, but the small one-man-band GP practices in my area are not set up to handle anything other than routine appointments. They have neither the staff nor the diagnostic equipment needed to handle an emergency or complicated illness. For anything other than dispensing antibiotics, flu shots, or measuring blood pressure one is referred to a specialist. (The quality of GP care is a whole 'nuther discussion, though...)

For concerns that are not life-threatening but nonetheless need to be treated in a timely fashion I go into the Permanence clinic at the ZH HB, although it is an hour away. Life threatening emergencies straight to the local hospital ER. These two facilities are set up to handle walk-ins, have the staff and equipment to handle whatever might arise.

It's frustrating I know, and I sympathize with the OP. When you are new here it isn't always easy to figure out how things work.


* Simply my experience, living in the boondocks. Perhaps a GP in a larger town or city might provide a broader range of care as standard.
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Old 12.09.2011, 10:32
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It depends on each patient and location. I would, for example, not truck myself to a hospital, on my own, if I bled and was on blood thinners. I would get myself asap to any nearest medical facility and ask them to at least accompany me, make the calls, supervise the transport, or supervise me waiting for it. If GP was the one to arrange these things, so be it. But trucking yourself on your own to hosp and unsupervised while you bleed might not be in certain circumstances the wisest thing to do.
Just better make sure you bleed during office hours, in that case.

Otherwise, I think the advice should be Teatowel, Telephone, Taxi.

Job done.
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