I am comfortable only with doctors with a sense of humour - who can make you laugh about your condition by seeing the funny side of it. A friend even goes a bit further and declares that the most successful doctors are those with a sense of humour because in a profession where you deal with so much of suffering, you need it to cope and be successful. I am not so sure because I have come across doctors like the ones you see in films who look at you gravely, remove ther spectacles solemnly for effect and declare that you have Acute viral nasopharyngitis as if it is a terminal illness and you want to know how many days more you have to live.
My trips to hospitals take this to the extreme - I find each experience more hilarious than the other. Not too long ago, I shared this with you and had another of the kind yesterday and today. DIL has been complaining of a pain in the gluteal region and I assumed it was an allusion to her boss. It turned out that she had a huge abscess in that region and the quack she went to initially treated it like a pimple and gave her a couple of painkillers which did nothing to reduce the pain. For a couple of days we waited for it to burst on its own and it just grew worse. So finally we decided to go to one of the fancy hospitals closer to home.
We completed the registration formality and she was sent in to see the doctor while I waited in the waiting area. The doctor examined the affected area and explained that it was an abscess and asked her if she knew what that meant. She replied in the affirmative (Let me kiss the hands that created Google). Then he recommended an I and D procedure to drain the fluids and she said "ok." May be he expected her to panic or react a bit more. The unperturbed OK seemed to have confused him. So he again asked her if she knew what he meant. At this point she thought that probably there was more to it and she did not know what he meant and called me in. But the doctor was too busy initiating the admission procedure to notice my entry on the scene. After several phone calls to surgery, admissions, registrar and back to surgery, he finally noticed me and said "we are admitting her." I asked him why and he explained that the procedure was the only way she was going to be rid of the pain and there was no way the abscess would comply with our wishes and burst on its own. 'But surely there was a way to do it without admission?' I queried.
'Then you won't be able to claim insurance. I am assuming you have insurance?' he said.
"Ok. you go now and get admitted. Don't be fussy about your choice of room. Take whichever they give you. Then you can have it changed tomorrow."
All this seemed like a huge emergency - getting admitted even before we knew who the surgeon was. May be the surgeon was going to be paged to come and perform the procedure right away.
'So when will the procedure be?'
"oh the surgeon will be in tomorrow morning. Dr Bhat will do it."
But of course, Dr.Bhat for an abscess in the butt!
So we went to the admissions counter, still a bit unsure of why she needed to be admitted and what the huge hurry was if the surgeon was coming in only in the morning.
Counter no. 5 or 6 , we were told and we asked the young man the procedure for admission.
"you pay 10000 and get admitted and before surgery you pay 80% of the operation cost" and then he went on to elaborate on the forms required from the insurance guys.
My thoughts went: '10,000 for a boil - ok ok that is trivialising it a little. It is NOT a boil but an abscess but 10 k for an I n D procedure?'
"And can we have the type of room we want?" asked DIL sounding like she was booking rooms in a resort.
"No ma'm, we only have the general room that is shared by 3 people."
"And the bathrooms?" asked DIL probably hoping every bed had a bathroom attached.
"They are shared too."
That was the clincher. We did not want to go in with a boil and pick up more infections sharing rooms with people with other ailments. And certainly not share bathrooms with strangers.
So we decided to have a chat with the surgeon and take a call on the admission while making a booking for a separate room.
We went back this morning and the surgeon simply drained the fluid without so much as local anesthesia and neatly dressed the affected part and told her she could go back to her normal life. Total cost:consultation Rs.350+ RS. 320 toward lab charges for the Pus culture and Rs.303.21 toward cost of medicines.
We still do not know why we were being hurried into admitting her with an advance payment of 10 k. May be the first doctor missed the classes on the day they taught A for abscess. Or may be he gets his bonus based on the income to the hospital from his clients.
We do see a lot more cases of surgeries that people undergo these days - I wonder if the instances of surgeries have increased since the availability of insurance claim. At least there are a lot more cases of by-pass surgeries these days. Is surgery becoming the first option in most cases just to be on the safer side? And because insurance covers the costs anyway? What about the side effects of surgery etc?
I do know a lot of people who prefer to get admitted rather than be treated as Outpatients even for simple procedures - so that it is covered by insurance. Otherwise they would have to pay it out of their pocket. No wonder there is such a demand for beds.
And what about cases that really need surgery but where people cannot come up with 10k+ 80% of the cost of operation immediately? It could be a Saturday and banks do not open till Monday or one of those many bank-strike days or festival holidays - what happens then? We could get away laughing about the hilarious encounter but I am not sure it is so funny for many people who go to these hospitals.
My trips to hospitals take this to the extreme - I find each experience more hilarious than the other. Not too long ago, I shared this with you and had another of the kind yesterday and today. DIL has been complaining of a pain in the gluteal region and I assumed it was an allusion to her boss. It turned out that she had a huge abscess in that region and the quack she went to initially treated it like a pimple and gave her a couple of painkillers which did nothing to reduce the pain. For a couple of days we waited for it to burst on its own and it just grew worse. So finally we decided to go to one of the fancy hospitals closer to home.
We completed the registration formality and she was sent in to see the doctor while I waited in the waiting area. The doctor examined the affected area and explained that it was an abscess and asked her if she knew what that meant. She replied in the affirmative (Let me kiss the hands that created Google). Then he recommended an I and D procedure to drain the fluids and she said "ok." May be he expected her to panic or react a bit more. The unperturbed OK seemed to have confused him. So he again asked her if she knew what he meant. At this point she thought that probably there was more to it and she did not know what he meant and called me in. But the doctor was too busy initiating the admission procedure to notice my entry on the scene. After several phone calls to surgery, admissions, registrar and back to surgery, he finally noticed me and said "we are admitting her." I asked him why and he explained that the procedure was the only way she was going to be rid of the pain and there was no way the abscess would comply with our wishes and burst on its own. 'But surely there was a way to do it without admission?' I queried.
'Then you won't be able to claim insurance. I am assuming you have insurance?' he said.
"Ok. you go now and get admitted. Don't be fussy about your choice of room. Take whichever they give you. Then you can have it changed tomorrow."
All this seemed like a huge emergency - getting admitted even before we knew who the surgeon was. May be the surgeon was going to be paged to come and perform the procedure right away.
'So when will the procedure be?'
"oh the surgeon will be in tomorrow morning. Dr Bhat will do it."
But of course, Dr.Bhat for an abscess in the butt!
So we went to the admissions counter, still a bit unsure of why she needed to be admitted and what the huge hurry was if the surgeon was coming in only in the morning.
Counter no. 5 or 6 , we were told and we asked the young man the procedure for admission.
"you pay 10000 and get admitted and before surgery you pay 80% of the operation cost" and then he went on to elaborate on the forms required from the insurance guys.
My thoughts went: '10,000 for a boil - ok ok that is trivialising it a little. It is NOT a boil but an abscess but 10 k for an I n D procedure?'
"And can we have the type of room we want?" asked DIL sounding like she was booking rooms in a resort.
"No ma'm, we only have the general room that is shared by 3 people."
"And the bathrooms?" asked DIL probably hoping every bed had a bathroom attached.
"They are shared too."
That was the clincher. We did not want to go in with a boil and pick up more infections sharing rooms with people with other ailments. And certainly not share bathrooms with strangers.
So we decided to have a chat with the surgeon and take a call on the admission while making a booking for a separate room.
We went back this morning and the surgeon simply drained the fluid without so much as local anesthesia and neatly dressed the affected part and told her she could go back to her normal life. Total cost:consultation Rs.350+ RS. 320 toward lab charges for the Pus culture and Rs.303.21 toward cost of medicines.
We still do not know why we were being hurried into admitting her with an advance payment of 10 k. May be the first doctor missed the classes on the day they taught A for abscess. Or may be he gets his bonus based on the income to the hospital from his clients.
We do see a lot more cases of surgeries that people undergo these days - I wonder if the instances of surgeries have increased since the availability of insurance claim. At least there are a lot more cases of by-pass surgeries these days. Is surgery becoming the first option in most cases just to be on the safer side? And because insurance covers the costs anyway? What about the side effects of surgery etc?
I do know a lot of people who prefer to get admitted rather than be treated as Outpatients even for simple procedures - so that it is covered by insurance. Otherwise they would have to pay it out of their pocket. No wonder there is such a demand for beds.
And what about cases that really need surgery but where people cannot come up with 10k+ 80% of the cost of operation immediately? It could be a Saturday and banks do not open till Monday or one of those many bank-strike days or festival holidays - what happens then? We could get away laughing about the hilarious encounter but I am not sure it is so funny for many people who go to these hospitals.
assumed it was an allusion to her boss
Could not resist an LOL here!
I had to stay in an AC room with a balcony,TV,refrigerator etc because I had insurance!No questions asked, this is what is available kinda attitude!Better take it types.And this was for diarrhea!
-Nikhil
Whoa! I remember a very long time ago when I had an abscess on my hand, our friendly neighbourhood GP did the I n D right in his clinic in Gandhi Bazar(needless to say, I gave him a decent dose of run-around, before his compounder could tie me to the chair, but that is a different story for a different day :P) and sent me home with a victorious bandage wrapped around my hand like a war-hero and a liberal dosage of antibiotics to stop infection.
And in this day and age, they con people into admitting themselves to a hospital for this? Sheesh.
aha, the insurance companies and the medical fraud. After so many years of letting money go, the US govt is finally clamping down on fraud waste and abuse. I know ;)
There's so many bad elements within the system, it's a bad maze alright! :)
Interesting experience. LOL on Bhat and Butt. I cannot believe they make a business out of one's ailment. Kali muthi pochu!
painful experience! hope you DIL is doibg better now. Aren't insurance companies more vigilant? I mean no company would pay up 10K for something that is essentially a 1K affair, no?
when I was younger we used to go to a family practitioner who had comics all on his walls and his ceilings, and he was always smiling. He was the third gen of doctors in his family. To this day I still look for a doctor as good as that. Laughter really is underrated.
Also, it sounds like you have such a sensible DIL. If one of my sisters found out they had a cist they would be talking about it for months. My mother would be crooning about the procedure they had to go through... you get the point. It must be so nice to have a smart and intelligent Daughter-in-law.
phew! oh well i didnt get my insurance when i dislocated my elbow because i wasnt adnitted overnight! just for the day even though i was given anathesia to knock it back into place etc!
anyhoo! hopsitals do charge a lot more because insurance is avlbl. esp in case of maternity benefits which are offered by companies. if both are working, both can claim it with per person limit being 50k! so you can go to these fancy "birthing suites" and "cherish" the experience! :D
its become such a business. while i understand that docs need to make money too, but i hope they are doing their share of chritable work for the poor too.
hope DIL is doing good now!
cheers!
abha
This piece brought back very too painful memories for I well know all about the pain in the arse. I'm an absyss expert if you may call it that. I once had a smart alec doctor smirk and laugh as he pulled down my jeans and gave an injection right at the spot. I asked him whether it was the size of my rear that made him laugh. He said, 'no, the pain it has taken to lodge itself between your flanks'. Aiyooo! the shame and pain of it all.All sympathies.
Talk about a pain in the rear- the hospital, I mean. How's DIL doing now?
Sounds like a scary hospital.
Never had to go through such an experience, touch wood. Half of my family in India consists of doctors of different specialities. One of them is a no-nonsense type with a wicked sense of humour. He gets really irritated when patients insist on getting admitted or trying to make a big deal out of it when all they need to be treated as out patients with a treatment costing a thousand bucks at the most! Its really funny to watch how he deals with those types.
Hope your DIL is doing better now!
Its a lucrative business my dear . I liked the bit about the DIL checking out the room as if it was in a resort . That's what some of these places are . Read last week's The Week and you'll know what I mean .
Usha, someone I know alarmingly fainting while sitting in a queue in out institute hospital OPD, and was promptly referred and sent of to a nearby swanky hospital where they put him in the ICU. He recovered, from the medical problem. But is still recovering from the 2.5 lakh bill (for 2 days) he was presented with. (And u cant be with the patient in the ICU at all times; but a lakh a day for sleeping with tubes and stuff and a bunch of specialist visits? Boggles the mind, and many other things ....)
You know, after I had my first ceasarian, these were the very thoughts that I had. Could I have had a normal delivery? Was the doc only interested in the monies? But at that point in time, I simply wanted my baby safe. So, I just thanked God and moved on.
But, good to know you saved a lot of the hard-earned money.
...and yes, I guess maybe we should google before going to a doc ;)
Oh that sure is an experience. Abcess are usually painful and they don't go without an I&D. It is good to get it off soon before it spreads any further. How is the DIL doing now?
Is this the "W" hospital ????
Nikhil: Oh wow - this really looks like a resort vacation - all expenses paid. was the food good?
Altoid:She was in a lot of pain and we almost admitted her until they told us about the sharing arrangement etc.
cesmots:Ya, this was all a huge revelation.
Dinesh: I am surprised that insurance companies haven't objected to this practice.
Dotthoughts: See with surgery and room costs the bill may have come to over 10 k. The whole point is that the surgery itself was not required.
Havah: Fortunately all the doctors I go to have a good sense of humor.
She is sensible and she was in such a pain she was willing to put herself through the I n d right away without any anaesthesia.
Mama-mia: Exactly what the first doctor said. better get admitted and claim insurance. So i guesss we must ask for the estimate of the expenses involved and the take a call on whether to get admitted or not. Silly rules.
Maami:didn't you slap that doctor? I admire your patience.
Dipali: Really the whole experience was a huge pain in the rear. She is doing well, thank you.
Hillgmom: They are all like that. There isn't much of a choice any longer.
2 b's mom:It is always good to have a few doctors in the family. At least you are sure of what you need to do.
She is much better thanks.
Eve's lungs: I hope they serve good food too.
WIAN: I have heard several cases of c-sec too where people were never sure if they should have waited.
We saved quite a bit of money and what about the pain of staying in hospitals.
Sumana: She is doing well, thanks.
Praveen: Yes this is the W one while my earlier experience was with the A one.
Ugich: Terrible, terrible.
"allusion to her boss" - absolutely funny. Thoroughly enjoyed reading the post and sentencing you to be bookmarked. Keep up the rational posts
Ageless,
First time here. Your blogs are sensible and honest.
When I was very young,my abscess was treated by a local Rs.10 doctor, whose pills were distinctively colored ,based on the ailment.:-). He broke it without even giving me a local anesthetic.
Cost of transport: 0
Cost of the fix: Rs.10
The aftermath: Well, it should have been painful , as I remember it till now..:-)
Why would anyone admit a person for something as simple as this? I have seen varieties of docs in India ..been there, done that..
Satish: Thank you.
Survivor:I feel so lost in these big hospitals. I prefer to deal with my doctor in his private clinic. Things are always simpler.
As Insurance picks up only hospital admission bills, Many a times, treatments which could have been done as OPD, are given after admission as patients in the hospital. As the hospital authorities know that the bills are picked up by insurance, they are a little liberal in charging for their services. Sir Northcote Parkinson said :
" Work expands so as to fill up the time available for its completion". Tests in hospitals expand till the insurance limit or paying capacity of the patients are exhausted.
Those who do not have insurance are not milch cows and therefore are slaughtered in the normal course and are sent out with a semblance of treatment, if the hospital aurhoties choose to be a little charitable.
I really had a good laugh by the time I finished reading the post. These hospitals and their fees are going attrociously funny day by day! Asking a 10K+ for cleaning the abscess which finally costed you not even 500 is just really really funny :)
The best thing to do is not fall sick. Ever.
Trust hospitals to treat you for an altogether different condition than the original one, just because it would fetch them more money.
In the US, hospitals make their fortunes out of optimizing (maximizing) the charges they can extract out of the insurance company. Luckily most people here have insurance, so things dont get as out of hand as in India.