Last week I received a form letter from a pediatrician; loosely it said that we could not be patients of that office, if we did not pay a fee of several hundred dollars per family, per year.  I pondered this.  I looked at my insurance claims and made a rough calculation of how much income was required to run his office and whether insurance payments alone could support the business.  Against my own instincts of self-preservation and natural born avarice, I decided that the man had a point and I would pony up.

I had been fond of this particular doctor because he is open minded enough to support the right to choose which vaccinations are administered, he makes strides toward sustainability with his choices in furniture, and toward holistic medicine through his choice of staff and he also offers supplements/herbs for sale onsite. My children have seen him for a wide array of treatments from biofeedback, to extensive lab testing, to Chinese medicine, to Reiki.

One of my children has not seen him as much as the others, and as it turns out, there is a high price to pay for not being sick with enough frequency.

In the past the office staff was frequently overwhelmed, and it was nearly impossible to speak with a nurse or doctor real-time.  A patient portal existed online to facilitate communication. Unfortunately this portal was afflicted by many glitches and the staff had no inkling as to how to make it work.  Phoning was not an option, voice mails take days to be returned and as I found out in CAPs reply, e-mailing was viscerally frowned upon, as the patient portal was the only official communication device for patient issues.  You see the vicious circle.  Luckily there was priority for sick children and though you cannot make an appointment a day in advance even if your child has a rampant fever, you can, on the morning of, call in and beg to be seen (not ever the night before – just the morning of).

Rebel with a cause I emailed my frustration about the patient portal on the night before. This morning I righteously and promptly called the office as I had two children with acute illness who needed to be seen by a doctor. I was told that an administrative decision had been made a couple months ago. One of my three children had been deemed inactive because he has not been to the office since November 2012. I explained the fever of 103, that the siblings had been assiduously coming in, and that the third child was simply not ill recently.  The unsympathetic (while flustered) voice on the other side of the line said I could take one of my sick children in for a sick visit, but not the other. Was this Sophie’s choice? Was it the judgment of Salomon? No, this was a moronic administrative decision made to enhance a bottom line that apparently this doctor does not know is fueled by humans. 

On several occasions this pediatrician offered in his own words that the quandaries we presented him were above his pay grade.  He, as most primary care doctors, outsourced 80% of symptoms to other physicians, who through specialized education have been assigned specific body parts. That said it appears he has given away the business of one child who had often been ill but he could not help, and he refused the business of the other who had not been sick often enough. So the holistic not only turned out to be not so holistic, but the business acumen turned out to be not so shrewd.

It boggles my mind why in an environment where the first tenet is to do no harm, a physician of this repute and tenure would not be in tune to how this perceived indifference affects clients (lets not call them patients), and in the end, will affect his bottom line and possibly his soul, quite adversly.