Monday, August 22, 2005

"Long Distance Runaround"

August is the month for annual visits for Pantrygirl. With my laser eye surgery scheduled, it's time to visit my primary care physician.   

For me, picking a primary care physician isn’t an easy feat.  Like most on an HMO, it all starts with picking the appropriate insurance carrier.  My company offers a handful of plans, each with different prices.  Do I pick the cheapest insurance carrier my company offers and pray that I’ll be able to cover 20% of any of my accrued bills or go for broke and pick the 100% coverage?  Once I pick my plan, I have to wait for ‘the book’.  

In a city filled with major medical centers, the book of physicians that arrives in the mail looks like a JCPenney’s catalog but without the non-descript kids in corduroys.  
Since these directories don’t include ‘user reviews’, I spend a lot of time researching and doing a lot of trial and error.  Trial and error?  Yes, if I don’t feel comfortable with the doctor and his office, I transfer PCPs.  I figure, if this person is going to be monitoring my health and he/she will be probing me in very vulnerable regions, he/she better have a good bedside manner.  You can say that picking a physician is like a job interview for me.  After I pick out the best candidates, the make or break point is their interview, aka the visit.

There are a few criteria I use to narrow down my choices; the first two are not medically based.  First, the proximity to his/her medical office.  I’m not going to subject myself to endless transfers and crosstown buses when deathly ill.  So more or less, I’m relegated to the West Side of Manhattan.
Next, and this is pretty sad but I ask myself, can I pronounce his/her name?  I need to know that in an emergency, I will be able to pronounce my physician’s name as well as spell it no matter how muddled my mind is.  

From this list, I review affiliations, age and several other items found in the state physician profile.

The rest is based on customer service and the physician’s bedside manner.
Yes, I know that I’m a little obsessive compulsive about this but, you should know that about me by now.

So you can imagine my despair when my relationship ceases.  This has happened to me once so far and it was devastating.  After three years with my physician, I was finally settling into that comfort zone in the relationship when she sent me a Dear Jane note.  Ok, it really was an “I’m no longer affiliated with your HMO” note but it stung just the same.  I spent weeks asking “Why?”  It seemed so impersonal and cold.  I even called her office.  Maybe it was sent in error.  The abandonment gone, Thanks to a pint of Haagen Daz; I set out in the world, newly single and looking for my Trapper John, M.D.

I went through many a rebound relationship.  Finally I found him.
He was a little older than I had hoped but I was optimistic.  During my first visit, he sat with me before and after the exam.  He put me at ease and asked me what I looked for in a physician.  Ah, the classic interviewee turnaround.  Nice.
His secretary and nurse called me by name from the first visit.  They returned calls in a timely fashion.  I don’t know how they did it but they made you feel at home in the cold sterile medical offices.

Then I got the call.  At least it was a call this time.  “Hey Hon.  It’s Joan.  The rent was too high so we lost our lease and have moved.  Can you make it to the Upper East Side for your appointment?”

Ok, for those who don’t know Manhattan, there is a giant park in the center of the island.  It separates the Upper East Side and the Upper West Side.  Please do not ask me the name of this park. Its name is apropos.  In order for you to get crosstown (West to East or vice versa), you need to take a bus or travel down to midtown, transfer to a crosstown train and take an uptown train.  Since crosstown buses are notoriously slower than trains, I essentially have to take a bevy of trains to get to the UES.  Under most circumstances the quickest route is a straight line.  In Manhattan, the quickest route is most likely shaped like a ‘U’.

Even though he broke one of my cardinal rules, I didn't want the long distance to be the reason for our breakup, so I set off for my appointment Friday with Harry Potter to keep me company.  4 trains and 40 mins later, I make it to his office, sweaty, tired and hungry.  “I tried calling you but I guess you were underground.  The doc is stuck in surgery and won’t make it back to the office.  Can you come back next week?”

“You’re kidding, right?  It took me nearly an hour to get here.”

I left dejected.  I’m rescheduled for the end of the month but I’m not sure if this is going to work out.  This looks like the beginning of the end of our affair.   Doc, we'll always have Central Park West.  If anyone has a good PCP in the West Side, let me know.