Over the 35 years I practiced medicine in Lake Zurich, I was lucky to work beside some of the most caring and talented people in the field. In many ways, we became a family. We worked together, ate together, laughed and cried together. We each had a role in caring for our patients, some behind the scene in the back office, others in direct patient care. I’ve been telling my story; but, realistically, my story would not have existed without my supporting staff.
My front desk was like the palace guard. They assessed patients from the minute they walked through the front door. They registered new patients and updated the established patient’s record every time a patient walked in. The demographic information they collected was important as, without it, I wouldn’t be able to contact you with critical findings that showed up the day after your appointment. The insurance information they collected told me what rule book we were following and kept the office in the black. Patients never understood the importance of the data the front desk collected. Some patients got downright pissy. The front desk took a lot of flak.
“I just gave you my insurance card last month! Why do I have to give it to you again? I just filled out those papers last month, why do I have to do it again? (At my last visit to my urologist, I told the nurse I was seen 6 months ago. It had been 3 years, Oops!). I’m sure my wife paid the bill. All you care about is money! I just want to ask doc a question, do I really have to register? It’s been 20 minutes; how much longer do I need to wait to see the doc?
The longer the wait, the pissier some patient became. Some actually got hostile. Some made the check-in staff cry. Thankfully, there were the Shirley and Mels of the world who, at every visit, made sure the staff felt appreciated. They became part of the family. Shirley and Mel had a fantastic garden and they would bring fresh vegetables for the staff. They were old with poor eyesight and arthritis and tended to let their cucumbers and squash stay on the vine too long. Their cucumbers were humongous and could have been used as a club to beat the pissy patients into submission (I actually thought of clubbing a patient who made Dawn cry).
The collections team got the most abuse. A medical practice needs money to pay the bills, payroll, buy supplies, etc. We carried hundreds of thousands of dollars on the books and too often, had to fight to get paid. The person responsible for collecting that money took a lot of crap form patients. What patients failed to understand was that sitting at that desk was a loving, caring individual who would bend over backwards to make accommodations for the patients she came into contact with. If a patient was broke, she would write off their bill or set up a payment plan for as little as $5 a month. She was also afraid of anything that crawled or flew. I had a lot of laughs at her expense. Once, we had a mouse in the lunchroom. I’ll never forget the look on her face as she stood on the chair as if the mouse was hunting for her. All the little creature wanted to do is pay its bill. I miss her!
The back office was the home of the coders. Dealing with insurers is like dealing with Satan, herself. Yes, the devil is a female. She was CEO of Blue Cross for a while. When the insurance companies took over my world, they did it with codes and fancy words. I became a “provider’ and my job was to distill everything I did down to a series of numbers. A short visit became a “99212”. There were numbers for everything. Getting those numbers rightwas a bitch. It was also expensive. Behind the scenes were the unsung heroes who coded and recoded each visit so we could get Satan to approve your test/procedure or to fork over what she owed us. It wasn’t easy. Coding demands are increasing and, in some reports, account for 40% of your doc’s time. What a pity!
Today, my point is that there is a lot more to a doc’s office than meets the eye. There are hardworking, caring individuals who keep the office open and functioning. They need to be treated with respect. They are there to make sure you have a place to go for medical care. They have rules, set by their employers, that they must follow. Please don’t take out your frustration with the medical system on them.
Be a Mel and Shirley, not a Pissy Patsy. You don’t have to bring them cucumbers (although they are always happy to be fed) to get good care. I don’t think I ever told them how much I really appreciated them. I truly appreciated them, and I miss them!
Tomorrow, I’ll write about the clinical staff and the role they played in our lives.
Here’s your music and a joke.
A man and his wife were sitting in the living room discussing a living will. “Just so you know, I never want to live in a vegetative state, dependent on some machine and fluids from a bottle. If that ever happens, just pull the plug,” the man says. His wife got up, unplugged the TV and threw out all the beer.
Really wonderful caring staff for all 30 years we were your patients!
Your article definitely feels my pain. I was in back office management for 2 mental health practices totaling 30+ years. Rewarding & VERY frustrating at the same time. Glad I’m now retired.
Elaine