Monday, September 01, 2008

A Bloody Nose

Carilion, our health care behemoth, received a bloody nose from a Wall Street Journal article last week.

I have watched over the years as what used to be health care in the Roanoke Valley has degenerated to the point where it's more like a massive "make you sick" effort. While I know that the minions of nurses and even the lower-level doctors are doing their best to make the citizens of the valley healthy and happy, it is obvious to anyone with half a brain that their efforts are completely and totally undermined from the top down.

From the minute you pick up the phone to make an appointment until the time you finally write the last check for the bill, dealing with Carilion is, frankly, hell.

Trying to get an appointment at the local clinic is like navigating 36 feet ocean swells in the middle of Hurricane Gustav. You just can't do it well unless you're quite the expert captain, and not many of us reach that level when it comes to health system navigation.

Once you have an appointment, then you have to deal first with the support staff, some of whom I have had - honestly and truly - simply fall apart at the face of yet one more patient whom they couldn't deal with that day. Then you have a harried nurse who can't take your blood pressure without subjecting you to this horrid machine that pinches the crap out of your arm and leaves bruises.

Then in comes a doctor who's lack of attention is second only to the aloofness of the neighbor's cat. And for your three hours of time and your $40 copay you might get a prescription unless you need an antibiotic, in which case they will make you wait another five days and come back in because they fear they are over prescribing Z-packs these days. So that will cost you another $40 copay plus the copay on tests if you can convince them to actually check your white cell count. Not to mention another visit to hell.

I thought the scariest part of that article was the zeal with which Carilion goes after people who owe them money. They place judgements against 4,000 people ANNUALLY. And that's just in Roanoke City. That doesn't count Roanoke County, Salem, Botetourt, Bedford, Franklin - all of the surrounding communities. I daresay Carilion has a judgment against 10 percent of the area population at any given time.

I know from experience that they'll turn you over to a collection agency without blinking twice. My husband went to the ER two years ago with severe hives. He got them while he was at work and his superior insisted he go.

Seven months later, I received a nasty call from a bill collector saying we owed Carilion money. I had paid bill after bill for that particular visit - first the doctor, then some blood work, some other tests, the hospital itself, etc. etc., I think I made out a check to everyone except the laundry for the cleaning of the sheet on the bed my husband probably sat upon.

To make a long story short, somehow Carilion in its magnificence had managed to get our address right on everything but this one $40 charge, which somehow still had a rural route as the address. Of course we haven't had a rural route for about 20 years, so go figure where this came from.

For this, their error, they deemed it necessary to damage my credit and have me accosted by a bill collector when a phone call (or maybe a records check by someone with a brain in the office) could have cleared this up without the surliness.

I know Carilion saves lives. Many people would not be walking the streets, saddled with debt to the facility, were it not for their heroics. But to that I say, that is what they are supposed to be doing. That is their job.

And with the CEO making $2.7 million annually, I'd say they get paid for it fairly well, at least at the top.

So I say good for WSJ for giving Carilion a bloody nose. And to Dr. Murphy, who whines that Carilion can't take the blame for the country's broken health care system, I say to you, Sir, You are indeed the very reason it is broken.


  1. I, too, noticed the front page, not terribly affirmative article on the WSJ the other day, and found it humorous, nay, frightening, to read the spin the RT gave that article on a FULL PAGE. Sometimes we will have to compare C-notes, as my husband acquired a MRSA infection in his sternum after open-heart surgery at C. and subsequently several other hospital acquired deadly infections, leading to a 2 week medically induced coma, near death, and months of threatening phone calls by people suggesting that if the entire several hundred thousand dollar bill was not paid in full within 60 days we would experience serious financial repercussions. Frightening. I felt so sorry for all the patients who do not have the experience, education or grit to be able to stand up for themselves. But I guess I better leave it at that! It would take too long to air my grievances here!!! I am so grateful to the staff, the nurses who work so hard, the doctors, but they are not the ones writing policy. They have no clue what the hospital is charging for that pill and bedpan.

  2. I have to say my experience is like gingerhillery's above. The actual people taking care of me have done a good job, though most of them seem harried more often than not (overload), but the billing and financial people have routinely messed up bills, and then pushed to get the messed up billing paid before it gets straightened up. I've often wondered how many people who don't check their bills carefully (and it's hard to do in some cases) ended up paying a great deal more than they needed to. Odd thing, while I have had numerous mistakes on billings, I've never had one in my favor. Odd, huh?

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