iamboz:

Give me a bit…I’m working on this issue— designing the ideal health experience— right now as a matter of fact!

But the real issue here is that YOU are not the doctor’s customer. Customers are people who purchase goods and/or services. So if you used your insurance today to pay for…

I disagree. First of all, I’ve never had insurance that didn’t require a deductible and/or copay of some kind. Therefore, I’m still paying a chunk out of my own pocket everytime I go to the doctor, and usually when I first walk in the door. 

You seem so biased against insurance companies, yet when they were first conceived (as ways for people to protect themselves against expensive hospital bills and major accidents and surgery costs), they really were a good idea. HMO’s and the use of them for day in and day out “sick” care has really spun the system into something I don’t think it was intended to be. In my life I’ve had everything from being covered by Indian Health Services (which technically I always will be, I guess-not that they always have funding), to being able to use the clinic on the college campus for free, to refusing to use IHS and effectively having no insurance, to having “traditional” employer insurance, to having an Healthcare Savings Account combined with a major medical insurance plan (high deductible, but kicks in at 100% after that so serious accidents/injuries are covered-and our HSA helps pay the deductible costs). I have to say, the HSA combo has to be the cheapest for us and the company, the least paperwork ridden, pays any and all physicians/facilities we use the best rates, and all in all? We’re impressed. We can’t understand why more companies aren’t offering this option and helping people understand how it works. We also can’t understand why HSA’s aren’t being supported more by the new healthcare law. 

Finally, several years ago I worked for a hospital who was so aware of the need for customer service at all levels that they implemented a policy where all employees who had any contact with patients/family members/etc. had to take a training class in customer service skills. It was emphasized to us that people could go anywhere for care-they chose to come to us. While that’s not always true (in many specialties there may only be a few physicians providing care-true for the Infectious Disease doctors I worked for until just a month ago), the lesson was learned. A patient can always request that someone else take care of him/her, that I NOT be the nurse who draws their blood/takes their blood pressure. Everyone in the medical field needs to consider that: we are only there because they need us and want us-they can always go elsewhere (barring that it’s an emergency, of course).