The view from the health care consumer’s side

Over the past few months, we’ve had several industry professionals share their stories of struggling to navigate the health care system. Each just affirms what we all know: health care pricing is completely nonsensical, and transparency is easier said than done.

To these stories, I’d like to add my own, highlighting yet another barrier to health care consumerism.

Recently, I went to see a specialist about a worsening case of carpal tunnel in my wrist. As I expected, he ordered a nerve conduction study to determine the extent of the damage and the need for surgery. His nurse gave me a form with their “preferred” imaging provider, who she said had locations in Aurora (where I live) and Lone Tree, about 20 miles away.

Related: The path to health care redemption

Unfortunately, when I called, the scheduler informed me that they no longer do appointments in Aurora and I would have to drive to their main facility in Lone Tree.

Now, I know, only having to drive 20 miles would be considered a blessing for people in some communities. But CU’s Anschutz Medical Campus sits a mere mile from my house in one direction, and the Medical Center of Aurora in the other. Expanding the radius another mile or two adds countless more medical services. Surely, somewhere in that mix was an imaging facility that provided what I assumed was a rather common neurological test and accepted my insurance?

I’ve read and written enough about shopping for health care services, so I thought it was time to actually give it a try. My bar was low: I wasn’t out to find the lowest price or best value, just the most convenient location.

First call, logically (I thought), was to the doctor’s office that had ordered the test. This was their “preferred” provider, yes, but were there any other imaging providers they knew of that I could try? The woman I spoke with was just a scheduler and couldn’t answer it; she’d have to pass the message along to a nurse, who would call me back.

Okay, no problem. The nurse actually did call back within just a couple of hours to say they were not aware of any other imaging providers, but if I did find a closer facility, I could let them know and they’d send over a request for the testing.

On to Plan B: my insurance company’s provider search tool. I’d used this a fair bit in the past, but it’s clunky, slow and frustrating. This time was no different. There are separate search options for providers, procedures and facilities. I was looking for a specific procedure–an EMG, to be done at an imaging facility. Unfortunately, searching for this results in a list of neurologists (and variations thereof). I already had a doctor–I just wanted the test.

But where there’s a neurologist, there’s probably also some diagnostic services, right? So I took to Google to look up these providers and see where they practice. Many are listed in one area or another of UC Anschutz. At such a big place, of course there’s going to be an imaging department, but how to get a hold of them? The closest I could find was a site for the radiology department listing numbers to call for CT, mammogram, MRI or ultrasound appointments.

Overwhelmed, I returned to my provider/Google search. I found a couple of more defined practices. One was a sports medicine clinic, another a general imaging facility, both of which clearly listed EMG testing on their websites. This was a good sign.

I called the first one. And waited.

(I should mention that I was making all of these calls from the office, for the specific reason that I could put the phone on speaker and keep working while I listened to alternations of staticky hold music and a recording instructing me to go to the company’s website for more information or help. Read: we really don’t want to talk to you.)

Eventually, I reached a receptionist. I explained what I was looking for: An EMG on my wrist for carpal tunnel. Did they do that?

She, too, didn’t have any idea. She transferred me to the surgical department, for reasons I don’t completely understand. The phone rang and rang, and eventually I gave up.

On to the next place on my list, the imaging facility. Surely this would have been my best bet to begin with, right?

The phone rang, and rang again. After a few more rings, I hung up, doubled check the hours on their website (yes, they were open), and then waited a half an hour or so to try again.

Same (non)response. I waited as long as any reasonable person would before hanging up.

I get it–I’ve stood in enough long checkout lines lately with just one register open and a “We’re hiring!” sign in the window. Everyone’s short-staffed.

At this point, I gave up. Had I exhausted my options? Of course not. But I’d now spent more time trying to find an alternate facility than it will probably take me to drive the 20 miles to Lone Tree.

The first lesson learned is one that I’m seeing bubble up more and more as the people like myself take a closer look at their medical choices: the health care industry is just not customer-friendly. Schedulers, until now, haven’t had to know where to send a patient for care or be able to list all of the services offered at their facility.

The tools we have to shop for health care services are piecemeal at best. Health care concierge services and advocates are helping, to an extent, but to create a truly empowered health care consumer is going to take some significant push for change on the administrative side.

And here’s lesson #2: Shopping for health care services takes a lot of time, time that many people don’t necessarily have. Not that I wouldn’t be willing to put in the same time and effort to shop for a health service as I would a new appliance or mechanic, but I also expect to be able to search for—and find answers—via the same means I would for these goods and services.