Notes from Maine - 2023/07/16

It was quite a busy week here. The dogs had their checkups/vaccinations, I had my annual doctor’s appointment, and the furnace was serviced. All four of us are doing fine. I also called to schedule appointments for the horses, but that date is not nailed down yet. We usually do that in the fall.

Honestly, I’m still a little uneasy with my new doctor. A few years ago, my old doctor was absorbed by a bigger practice. They were already a part of a group—at least six doctors in the same building—which I kinda like. If you have something that’s between routine and emergency, it’s nice to know that someone will be able to see you in a reasonable amount of time. For example, about ten years ago when my insides tried to pop through to the outside (hernia), I was able to see someone a day or so later. We have tons of urgent care places around now, sure, but I like the idea of going to my regular doctor for something like that. Maybe it’s just me, but it felt less anonymous than going to an urgent care.

So that was Dr. Inger, who I saw for about twenty years. When that practice was absorbed into the larger group, Inger decided to go to another conglomerate. I decided to stay, knowing that I would be picked up by a new doctor. It felt like a reasonable thing to do—Inger was about my age, or maybe a bit older. I figured it might make sense to pick up with someone with a longer career ahead of them. I’ve witnessed doctors who grew weary and maybe a little fatalistic towards the end of their practice. So, I stayed with the big place and resolved to negotiate a relationship with a new doctor.

Before my appointment, I logged into the “patient portal,” and saw that they didn’t have any records in there before last December. There were no surgeries listed. They didn’t have the results of previous blood tests. They didn’t even have the results of one procedure I had done this year. My record was a clean slate. I can’t even fathom that. The nurse who came in for the preliminary examination said that the system had information that, “wasn’t posted,” but then proceeded to ask me about my complete medical history, typing the entire time. I never got the sense that they had any idea who I was, and they should have records for the last twenty years (at least) in there. 

The actual doctor remembered me at least. My last visit was for an injury and, apparently, it was memorable. We didn’t get off on the best foot last year, but that’s okay. The appointment was a little argumentative. I told myself that it’s good to be challenged on my approach and assumptions. If my decisions can’t hold up to scrutiny, they should be reevaluated. 

One point of contention was about the horses. Let’s say, for example, I was injured while riding or doing chores. The doctor said that I should be completely transparent with them about how I was injured. I asked if they were going to write my response in their file. 

“Of course,” the doctor said.

“And the insurance company gets a copy of that record?” I asked.

“We share that information as needed for claims.”

There’s the problem. The doctor was unaware of circumstances where the activity that caused the injury would dictate the amount of coverage I received. In fact, the doctor was giving me a sideways glance that suggested that maybe I was a little bit of a conspiracy nut—claims are paid based on the need and care provided, regardless of how the injury was sustained, right?

I’m not certain about that, and I wouldn’t trust a doctor to be completely up to date. Here’s one article that I found: “Surprise! Your sport is too risky to be insured.” (https://www.ocregister.com/2007/06/18/surprise-your-sport-is-too-risky-to-be-insured/)

The article says at one point, “For instance, if you break a bone tripping over little Johnny’s scooter, the medical bills are covered. If the same bone is broken in a skiing wipeout, coverage may be denied.”

I want to be open with my doctor—it should be a very honest relationship, right?—but regardless of how I’m injured in the future I think it might be best to say, “I don’t recall,” or, “I’d rather not say,” when asked how I sustained the injury. There are some examples that are obvious. If you get struck by a car, one expects the driver’s insurance to pay the medical bills. If a light falls and hits you in the head in a restaurant, they pay for it, right? But who wants to fight someone else’s insurance company to get them to pay your medical bills. My horses don’t even have insurance. 

Anyway, when talking to my doctor I just let the subject drop. They challenged my assertion and I went home and looked it up. The article above is from 2007, so the information could be completely out of date. There are ACA provisions for pre-existing conditions. Maybe there’s something in there about not denying coverage for injuries sustained doing “extreme” sports? I doubt it. 

Maybe its a good thing that my records were all blank this time.

The nurse asked how I was injured last year. 

I said, “I’d rather not say,” and they moved to the next question quickly. In fact the nurse seemed a little embarrassed about my response. That’s fine with me.