Details, details

Yesterday I had a pre-operation appointment with Dr. Smith, the surgeon. I'm not certain what the purpose of this meeting was. Smith and I had already discussed this surgery in detail.

At this time I handed in a two-page "medical history" form. This form is unique to this doctor, but is roughly identical in content to the medical history forms I will give the primary care physician today and the anesthesiologist on Monday. None of these forms is in a condition to be scanned into a computer.

The surgeon's staff person took my blood pressure and verified that I have a pulse, and the surgeon reviewed the X-rays and glanced at the medical history form.

It strikes me that we are duplicating a lot of effort here. One medical history, preferably the lengthy and detailed one in my chart at my primary care doctor's office, should be sufficient, especially since so far as I can tell the three forms I am handing in now will not be compared with each other, or read carefully even. Furthermore, the anesthesiologist is a highly paid, highly qualified, board-certified specialist who surely has better things to do with his/her time than "meet with" someone whom he/she intends to anesthetize. What would anyone hope to learn from this meeting?

The real reason is probably the profit motive which runs all through this system. The anesthesiologist will bill me separately. This meeting may form some of the "justification" for this separate bill. I imagine that I am supposed to form some kind of bond with this person.

In other news, the primary care physician's office sent me a form requiring me to figure out whether or not the examination today is covered by my insurance. (Wouldn't it be the business of the doctor's office and/or the insurance company to figure this out?) In the course of exploring this I found out that the insurance company could not find the pre-authorization for this surgery in my file. I called the surgeon, talked to the ever-competent administrator in that office, Nevada (not her real name), got the authorization number, and called Blue Cross back. They had coded the date of surgery improperly.

I probably just saved us a lot of hassle later, since there is a "penalty" for not pre-authorizing surgery.