Red spots on baby's skin

I have had both HMO's, regular insurance, and
now a PPO and still have not had any issues at all with treating several
problems in one visit.

Me neither, fortunately, it's also not a medically sensible thing to do,
I mean a broken foot and a UTI are almost certainly unrelated, but so
many things are when you dig deeper and looking at all the symptoms
occurring can help diagnose a global condition.

Cheers
Anne

I don't have an issue either. What they wouldn't do is schedule Hunter and
Luke's well visit back to back. They gave me some reason (I think she only
schedules one a day) but I was miffed.

Yikes, how maddening, what I would do in this situation is talk to the
doctor when you next see them, explain that it's preferable for you to
do this, chances are is that they will agree to do it, then get them to
put a note in your file to say it's ok to do that. I've done variations
on this multiple times, the scheduler probably doesn't have the
authorisation to make this kind of decision. It was most frustrating for
me with the latest check ups that I had to wait 3months for the
appointment, but to get the two kids at the same time, it was only an
extra 3 days.

Cheers
Anne

On Jul 26, 4:19 am, enigma wrote:
"Aula" wrote :
"Jeff" wrote in message
news:yNRpi.7199$2c7.6039@trnddc06...
Your child should have his 1 year exam soon, if he hasn't
had it. You might be able to kill two birds with one stone
if he hasn't had it yet.

(Remember that if you go in for a well-child visit they
will not address illnesses due to billing issues with many
insurance companies, so schedule a sick child appointment
or, better yet, ask the scheduler if there is any issue
combining purposes. I know that when I was on an HMO, and
there were several, none of them would allow a combo visit
like that. You *had* to have two appointments to
accomplish those goals.)

the second is being able to address more than one issue at a
time. when i last had insurance, i happened to have a UTI
*and* a broken metatarsal at the same time. would they treat
both? oh no! can't do that! which did i want treated? i made
the mistake of going for the UTI, which they misdiagnosed (it
was actually a bladder infection), & gave me the wrong
medicines for twice, well, the first was entirely wrong the
second was a wrong dosage (nothing like dragging one of those
out). they couldn't manage to fit in the metatarsal injury for
another 2 weeks... at which point the bone is fused again
anyway.

OK, I'm stunned. I just finished 3 years of training with oft-
maligned Kaiser, and if someone walked into my office with multiple
problems that needed to be dealt with in a timely manner, we dealt
with them. I might run late for the next few hours, but that's life.
I've honestly never heard of this. Now if someone came in for a sick
visit and "by the way could you sign off on this sports form", that
might be a no-go -- can't sign the form without a full checkup and
can't necessarily squeeze that into a quick urgent care appointment.
That falls somewhat into the situation of "your failure to plan does
not constitute my emergency", because no matter how badly you want to
start practice tomorrow you won't get sick and die by waiting for your
checkup. But if acute issues came up in the well-check we dealt with
them. Sometimes we couldn't deal with them fully without another
appointment, but those were often the types of problems that need
multiple visits to sort things out anyway. Honestly the above example
makes no sense to me -- it's only a matter of time until someone has a
bad outcome from an unnecessary delay and sues that practice.

But then, we didn't have to worry about billing. Even so I know
enough about the billing world to know that you can bill for as many
diagnoses as you make in a visit, and you can bill for a simple short
visit or a complex long visit.

(Warning: political soapbox) My advice to my fellow Americans --
watch SiCKO, and push for single payer state or national health care.
Californians, support SB840 in the legislature now -- not universal
coverage that's about lining the pockets of insurance companies, but
about cutting out the 30% of your health care dollar wasted on paper
pushing and using it to provide care. (Off political soapbox)

Kate, ignorant foot soldier of the medical cartel (starting my new job
in the messy non-Kaiser world of public/private insurance tomorrow)
and the Bug, 4 years old

"Anne Rogers" wrote in message
. ..

While I unerstand that I also understand that reason that has been
stated to me by the doc's receptionists: they need to be able to figure
out how long your appointment needs to be. A well-child checkup, for
example, usually takes under fifteen minutes. An exam of emerging
symptoms could potentially take longer.
[snip]

A while ago, I read about some research which was done into appointment
times. They found that if a patient was offered a choice of a 'long'
appointment or a 'short'appointment, the patient tended to be fairly
accurate about which they needed.

back in the UK, there was a notice somewhere telling you you could book a
double appointment if necessary, for other things, they basically relied
on the patient knowing that a procedure or medical or something would not
be a normal appointment and they kept a file by the desk with a list of
what did need to be booked in, so when I said I was booking for a coil
fitting, they looked up and found I should be booked for a double
appointment with the nurse and also with one of the doctors that was
trained to do it. I was never aware of any problems with people booking
the wrong thing, obviously the time varied and you weren't always seen on
time, but it was still better time keeping than either our pediatrician or
family practioner.
Quite often if I go for an appointment I will mention something else "while
I'm there". eg. needing a repeat prescription which is past its review date
or something small. One time I apologised for bringing 3-4 small extra stuff
(they took perhaps 2 minutes total) when I came for something more
important. The doctor said that he prefered it that way rather than me
making separate appointments every time something came up. He said in the
long run it saved him time. Usually the little extra things give me
reassurance in very little time, it is rare, if ever, these things have
become big issues that have had to take time.
Debbie

Anne Rogers wrote:

I agree. I do have to tell what sorts of things I
need an appointment for when booking the appointment, but
that seems eminently reasonable to me. How else are they
to know how long to book the appointment for? If I need
to address multiple issues or multiple kids, they'll just
book multiple appointment slots.

But do they really actually do that and book in for different lengths,

Yes, they do. The receptionist usually tells me how
long we're booked for, and I pipe up if the timing seems off
to me--for instance, a med check is usually short, but if I
have a lot of issues to discuss, I'll tell her and she'll book
a longer appointment (and probably code it differently).

Best wishes,
Ericka

"Anne Rogers" wrote in message
But do they really actually do that and book in for different lengths,

Yes they do. If it is a physical and/or sports exam, they take longer so you
need to specify generally what the appointment is for. If it is just a sick
visit, then they give you a slot accordingly. In the pediatrician's office,
they only take so many physical/well checks a day to accommodate the sick
visits. For our doctors, if DH needs a medication check up and/or a blood
pressure check, then we have to specify that because they are shorter visits
as opposed to his yearly check up, which is longer.
--
Sue

Yes, they do. The receptionist usually tells me how
long we're booked for, and I pipe up if the timing seems off
to me--for instance, a med check is usually short, but if I
have a lot of issues to discuss, I'll tell her and she'll book
a longer appointment (and probably code it differently).

It's possible that that may not normally be the case, obviously I can
only speak to the doctors that I've been to, which is one primary care
provider and multiple specialists, I've ALWAYS been asked what the
problem is and NEVER been told anything about the length of appointment
booked. I seems to me like it's just the way things are done, you tell
the scheduler what you are there for and you see a nurse first. I don't
think seeing a nurse first is a bad idea or anything, particularly with
the specialists I've seen, I'm yet to think it's particularly helpful in
primary care though at the paediatricians, the doctors don't seem to
read what the nurse has written and ask me all the same questions again
and my primary care provider I find it intrusive and instead of a
feeling of sympathy that I need to take those meds, the impression is
more how can you possibly need those meds, I really like my doctor, I
feel she has really worked with me in dealing with various conditions I
have and has found a combination of meds that have made a huge
difference to my quality of life, yet I feel I have to justify that
every time I see the nurse.

Cheers
Anne

Sue wrote:
"Anne Rogers" wrote in message
But do they really actually do that and book in for different lengths,

Yes they do. If it is a physical and/or sports exam, they take longer so you
need to specify generally what the appointment is for. If it is just a sick
visit, then they give you a slot accordingly. In the pediatrician's office,
they only take so many physical/well checks a day to accommodate the sick
visits. For our doctors, if DH needs a medication check up and/or a blood
pressure check, then we have to specify that because they are shorter visits
as opposed to his yearly check up, which is longer.

Oh I realise they book different things when it's a specific thing like
an annual or something, my doctors in the UK relied on the patient to
tell them if it was anything special needing booking and it really did
seem to work, what I was more questioning is are they going to book a
different length of appointment if you say "I have a skin rash" versus
"I think I have a UTI". My doctor doesn't run anywhere near to schedule
(unfortunately - I really like her as a doctor, but the timing is
frustrating), so it would seem that whatever the scheduler is doing
isn't actually getting information that helps make the schedule work.

Cheers
Anne

Anne Rogers wrote:

Yes, they do. The receptionist usually tells me how
long we're booked for, and I pipe up if the timing seems off
to me--for instance, a med check is usually short, but if I
have a lot of issues to discuss, I'll tell her and she'll book
a longer appointment (and probably code it differently).

It's possible that that may not normally be the case, obviously I can
only speak to the doctors that I've been to, which is one primary care
provider and multiple specialists, I've ALWAYS been asked what the
problem is and NEVER been told anything about the length of appointment
booked. I seems to me like it's just the way things are done, you tell
the scheduler what you are there for and you see a nurse first. I don't
think seeing a nurse first is a bad idea or anything, particularly with
the specialists I've seen, I'm yet to think it's particularly helpful in
primary care though at the paediatricians, the doctors don't seem to
read what the nurse has written and ask me all the same questions again
and my primary care provider I find it intrusive and instead of a
feeling of sympathy that I need to take those meds, the impression is
more how can you possibly need those meds, I really like my doctor, I
feel she has really worked with me in dealing with various conditions I
have and has found a combination of meds that have made a huge
difference to my quality of life, yet I feel I have to justify that
every time I see the nurse.

Huh. We usually see a nurse first, but just to get
the usual weight/height/temperature/bp/etc. They may ask
some questions, but the usually seem to be of the sort to
give them a heads up about tests or equipment the doctor might
need.
I'm not sure that what you're experiencing is typical.

Best wishes,
Ericka

Anne Rogers wrote:
Sue wrote:
"Anne Rogers" wrote in message
But do they really actually do that and book in for different lengths,

Yes they do. If it is a physical and/or sports exam, they take longer
so you need to specify generally what the appointment is for. If it is
just a sick visit, then they give you a slot accordingly. In the
pediatrician's office, they only take so many physical/well checks a
day to accommodate the sick visits. For our doctors, if DH needs a
medication check up and/or a blood pressure check, then we have to
specify that because they are shorter visits as opposed to his yearly
check up, which is longer.

Oh I realise they book different things when it's a specific thing like
an annual or something, my doctors in the UK relied on the patient to
tell them if it was anything special needing booking and it really did
seem to work, what I was more questioning is are they going to book a
different length of appointment if you say "I have a skin rash" versus
"I think I have a UTI". My doctor doesn't run anywhere near to schedule
(unfortunately - I really like her as a doctor, but the timing is
frustrating), so it would seem that whatever the scheduler is doing
isn't actually getting information that helps make the schedule work.

The two aren't incompatible. The issue determines what
they can bill for. What they can bill for is related to the
length of appointment (if they want to be reimbursed for their
time). That said, just because insurance is only willing to
reimburse for a short visit for something doesn't mean that
the doctor can take care of you in that amount of time, which
is why they run late. They've booked the amount of time insurance
will reimburse for (so it's working in that sense), but may
not be able to get the job done in that amount of time. I.e.,
the scheduling isn't necessarily based on keeping the doctor
on his or her schedule.
From that perspective, most doctors would like to
hear if you have multiple issues to deal with (worth writing
them down before you make the call so you don't freeze up on
the receptionist). If you've got enough issues they can bill
for to justify a longer appointment, they'll schedule a longer
appointment. You also don't have to be specific with the
receptionist. You can say you need a med check, but you don't
have to go into great detail about which meds and why you need
them. If you're not sure how to characterize the appointment,
ask your doctor next time for the right words.

Best wishes,
Ericka