Posts from — May 2009

About a month ago, on the advice of my primary-care physician (yes, I finally got me one of those), I went to see a dermatologist due to the moderate number of nevi that are part of my genetic inheritence. My thought going into the office was that the doc would take a look, maybe take some pics, and then we’d track my skin over the next few years to see if there was anything of concern.

So I was a bit surprised, after stripping down to my shorts and getting examined, when he told me (not asked, told) that he wanted to take off a couple of spots he didn’t like the looks of. Now, again, he’s a doctor, I’m a nearly naked patient, so I wasn’t really feeling like I was in a position to question his judgment. He said that the thing on my back was a different color than my other moles, a bit reddish, which made him suspicious, and the other had “rough edges.” So not 10 minutes later, I had a slice wound on my leg and a few stitches in my back and was out the door.

I went back a few weeks ago to get the stitches out and got the results of the biopsies — the mole on my leg was just that, a mole, no big deal. But the now-removed thing on my back was nothing but folliculitis, or, you guessed it, a pimple.

I was a bit surprised that the dermatologist couldn’t tell the difference between a minor skin irritation and a mole, but I joked to myself that at least it wasn’t cancer and that that’s what they should tell people, that they removed a precancerous lesion ’cause that would at least give me a small sigh of relief.

Until I got the bill. Between the piece of the “surgery” that the insurance doesn’t pay and the lab bills for the biopsies, I’m now out (or will be once I pay it) over $600. Now, it would still be a small price to pay if it had been something cancerous, of course, but since it wasn’t, man, that just bites.

And the thing that gets me is that if the doc, who had just met me and seen my body for the first time, had simply said, “yeah, you know, there are a couple things I’m suspicious of, so maybe let’s make an appointment for me to see you again in a month or two to check those out,” then most likely the pimple would be gone, my mole would not have changed, and not only would I not be out 600 bucks, but I wouldn’t have been overtreated. Oh, and I’d maybe trust this doctor, who I’m now supposed to see every year or so for tracking purposes, but now am hesitant to ever see again.

And even if he still felt the need to take off the mole on my leg, at least I would understand why that was happening and have had some input into the process instead of feeling like I was, in some small way, taken advantage of just to line the doctor’s pocket. Obviously, since one turned out to be benign and the other wasn’t even a mole, neither needed to desperately come off at that precise moment in time.

Just the other day, the NYTimes had an article in it about referrals and how patients are treated as commodities, and that’s exactly how I feel. The dermatologist wasn’t in the room for more than 10 minutes before he — without asking anything about my insurance, my general health, etc (and in that “etc” is, of course, the mountain of medical payment stuff that goes along with having Archer, like the 600-buck-plus cardiologist bill sitting on my desk)  — decided unilaterally to cut off some of my skin.

Why is it that when you walk out of a doctor’s office, you have no idea what whatever you just went through might cost? How is that not, in our super crappy insurance system, part of the deal, an upfront cost? If I go to the mechanic, they at least give me an estimate and I can tell them to stop before they hit a certain amount. And hell, if they do something wrong, I certainly don’t get charged for it. Not that our health system should work like this, but sadly, it does.

So anyway, besides my muttering, this is just another expensive lesson that after 19 months of parenthood, I’m pissed off that I have to relearn: always make medical people stop and explain why they’re doing what they’re doing, ask if what they want to do is really necessary to do now, and find out what your other options might be. Even if you have to do it wearing nothing more than your underwear.