I lay awake last night going over and over in my mind all the unpleasant hurdles I was going to have to navigate in order to get the new UTI treated. First: do I make an appointment, or do I try to get the doctor to call in a prescription? I'd prefer the latter, but it means dealing with attitude from the receptionist; and should I give her attitude back? what KIND of attitude would be most effective? (Effective = makes her burn with shame at the way she was treating a patient, followed by making her eager to appease me by helping me---as opposed to riling her up and making her accidentally drop my message into the wrong pile and/or into the trash.) Let's rehearse all the attitude-giving options here, in my mind, in the dark, at 1:00 in the morning.
Then, if the doctor is willing to call in the prescription with no appointment, there is often a many-hour wait before he or she DOES SO (once it was 2:00 in the afternoon, when I'd called at 8:30), so that in the past I've decided I might as well just make the appointment because it's FASTER.
But if I get an appointment, they will rebuke me for taking the Azo painkiller, which dyes the pee so they have to diagnose me through traditional methods (i.e., letting me describe my Absolutely Classic UTI Symptoms) instead of by dipping a strip of paper my insurance will charge me $20 for.
Then I will have to be firm about them NOT sending the pee away for $450 worth of lab work, which my insurance charges me $140 for---and even when I have been firm in the past, I have lost. So I will have to be firm far beyond the natural limits of my temperament type, which will make me cry.
The whole thing will end unpleasantly no matter what, and I'll be exhausted from having to struggle so hard for a treatment plan I consider reasonable, over a treatment plan I consider an excellent example of why heath care costs are so crazy. It COULD be a bladder/kidney issue instead of a UTI, I realize, and it COULD be a UTI that's resistant to the antibiotic they prescribe---but I am youngish and healthyish, and I have had these many times before, and they can FULLY COUNT ON ME to call back if I don't feel better or if I get scary lower back pain or ANYTHING.
(Perhaps you are even now scrolling down to the comment form to suggest I switch practices or doctors. If so, I think you are overestimating the size of my town and underestimating my ability to think of easy solutions.)
By this morning I had decided on the following things:
1. I would make an appointment.
2. I would not take Azo, despite the suffering, so that they could do their strip-dip.
3. I would not, however, pay for lab work. I would continue to say, "No, I'm sorry, but I can't pay for that" as many times as necessary. I would patiently endure their disapproval, and store it up to feel angry about later.
I called, and at first it felt as if things were going the most perfect way they possibly could: they didn't have any appointments today. They had me speak to the nurse, and they used the word "instead." I spoke to the nurse, who said she would speak to the doctor and see what they could do, and then call me back. I was going to get my prescription called in, without even having to fight with the receptionist first!
I was of course Theoretically Annoyed. Oh, I see, when _I_ ask for it to be called in, it's impossible and unreasonable and I'm trying to get away with something, but when THEY'RE busy and it would be more convenient for THEM, suddenly it's a good plan. But not VERY Theoretically Annoyed, because of being Actually Hugely Relieved. Plus, I could take Azo, so I did!
Then the nurse called back. The doctor there today is the one who previously insisted on sending away the pee sample for lab work despite my repeated protests, and assured me that insurance WOULD cover it. I was so thrown by this claim, and by the failure of my repeated protests to accomplish anything, that she won that round. And now, today, she declines to call in a prescription. She will need to see me, and she has no appointments until 2:00. Does anyone have anything earlier? No, that is the only appointment available in the entire day with any doctor.
I told the nurse that I had taken Azo, and she said that was fine because they could still send the pee for lab work and get a result that way. I said I would not have the lab work, because it was $140. We both said "Hmm" a few times. She said she'd run this new information by the doctor and call me back.
So not only am I waiting for a phone call (my THIRD in one morning), but I'm CHEESED OFF. I get these several times a year, and have for years and years. I have never been wrong about it, NEVER. A $450 set of tests is ridiculous for a routine UTI with no worrying symptoms. I wasn't trying to get out of needing an appointment, but I DON'T need their ONLY appointment of the day, if they won't be able to do the strip-dip OR the lab work, and if it's 5 hours from now.
If they think I'm getting too many of these (which they DON'T, despite me suggesting it seems like QUITE A FEW), or if they think there is something alarming that needs looking into, in THAT case I would be happy to cooperate with lab tests for further exploration of the problem. But $450 (plus the $20 strip-dip, plus the $130 appointment) to determine (1) that I have a UTI and (2) that it is not resistant to the prescribed antibiotic (test results back in 48 hours, by which time TRUST ME I WILL KNOW if it is not responding to the antibiotic) is WHAT IS WRONG WITH THE ENTIRE WORLD. Global warming? Due to unnecessary lab tests. Pollution? It's all the unnecessary lab tests. Crime and violence? PEOPLE ENRAGED BY UNNECESSARY LAB TESTS.
[Edited to add: I called my GYN, just to SEE. What I did was, I first made an appointment for an annual exam, because I'd rather go there anyway than to my primary. THEN I sprung my question. They only treat UTIs for women who are pregnant. So. Good to know, anyway.]
[Edited to add more: The doctor insisted on seeing me. I left with a prescription, and I refused to have the lab work done. She prescribed me an antibiotic my usual doctor says is not as effective; it would not surprise me to find that she is hoping I will be taught a lesson, since she kept mentioning that without the lab work she really couldn't make decisions for my care. So as usual, the whole thing ended up unpleasant no matter what: I'm glad to have successfully declined the lab work, but I'm upset and discouraged about everything else, and already greatly discouraged/upset in advance about the NEXT time this will happen, and about how very little control/choice patients have.]
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