When everyone else had already left thousands of dollars with doctors, I finally made it on my own with my cough and teeth, and here are my impressions.
1) Between client convenience and saving their money, the provider obviously chooses convenience, while the client has to care about saving by refusing some degrees of convenience. For example, any doctor automatically schedules you for a follow-up appointment if there’s any reason for it. If you don’t show up, they charge you for the visit automatically. You have to call and cancel.
2) If there’s a proper treatment (a) and a not quite proper but economical one (b), typically a yes/no question will be asked regarding option a, rather than offering options a and b. Prices, on the other hand, must be inquired about separately because it’s assumed that the client is familiar with them if they are silent.
3) Everything is insanely slow. Many people are involved in the process, each performing their part of the work, and the doctor appears somewhere quickly in the middle. Or not quickly. But you mostly pay for his time. Generally, the concept of a queue at a doctor’s is totally unseen here. You make appointments for all doctors, end up spending three times more time there than at a similar doctor in Russia, but there are no queues.
4) Being a professional doctor is about as important as being a pleasant conversationalist. So, someone like Dr. House here is the complete opposite of the typical doctor. The typical one knows less but is very nice.
5) If you need medications, they’ll tell you what they will be and ask for your pharmacy. It is assumed that you know what happens next. What happens is this: about 30 minutes later, you get a text message that they’ve started preparing your medications, and in about two hours, you can go pick them up. It is expected that if you are very surprised by the high price of the set, you should call and cancel when you get the text message, not at the pharmacy when receiving them. Prescription drugs are prepared personally for you. If you need to take antibiotics for five days, there are exactly five pills, not eight or ten.
5) With my cough, the doctor sent me to the hospital for an X-ray and blood test. Of course, there is no X-ray in the doctor’s office itself, even though it is called the Asthma and Pulmonary Center of Northern Virginia. The doctor receives the results on his phone immediately afterwards. The hospital gave me some kind of personal account where I’ll be able to see them in about a week.
6) The clinic sends the bill to the insurance, to which the insurance responds with its adjustments, to which the clinic can respond with its own (but usually it all stops at the second stage). If by the time the patient leaves the clinic, the final amount is not clear, the clinic does not take the money, but later sends the bill by mail. Generally, the patient can dispute the bill, but it’s quite rare/successfully rare. Moreover, it’s unclear who to dispute with – the insurance or the clinic. I had a bill for 250 dollars hanging, then under the threat of being turned over to collectors, I had to pay it, and after payment, I forgot what I wanted to argue about.
7) Some types of work are not fully paid or not paid at all by insurance. Meanwhile, the clinic itself may not know that the insurance has such strange conditions with the client. They just provide these services, and the customer deals with it. If a client is very budget-conscious, logically, they should think on their feet about which services could theoretically not be paid by insurance and ask the clinic to make a calculation for them. I did this at the dentist’s, and they brought me a calculation according to which I should pay 800 bucks after the visit. If I hadn’t asked for a calculation, I would have just received a bill, as seen in point 2.
8) In a typical clinic, there are few people, it’s insanely clean, and everything is highly automated. Just like in the best TV shows 🙂
They didn’t let me take a picture of the STRESS ROOM sign in the hospital. I wonder what it is? The room you can smash up with a baseball bat to unwind? It remains a mystery.
Hi, I'm Rauf Aliev. 