April 17, 2013
Yesterday, my son left school early complaining of itchiness and blurred vision in his right eye. I immediately suspected conjunctivitis (commonly known as “pink eye”) since his mother had just recovered days earlier from the highly contagious infection.
I phoned our health care provider, Kaiser Permanente, before noon to inquire about setting an appointment for our primary care physician (or another doctor) to see my son that afternoon at our local clinic in order to diagnose his illness and prescribe a remedy. The Kaiser representative I spoke with said that for suspected cases of pink eye (being that it’s highly contagious), “a nurse will phone you to conduct triage over the phone.”
My initial reaction was that Kaiser’s process made a lot of sense. With something as common and observable as pink eye, it was prudent to allocate treatment over the phone and, with a physician’s consent, prescribe antibiotic eye drops to eliminate the infection.
About an hour later, I received a call from the nurse who asked a series of questions about the condition of my son’s right eye:
Does it itch? Yes.
Is it swollen? Yes.
Is it pink? Yes.
Is there discharge? Yes.
During our conversation, I happened to mention that my son had removed his contact lenses and was now wearing his eyeglass frames. To my surprise, the nurse said, “If he wears contacts, then he’ll need to see someone at the Kaiser eye care facility in Highlands Ranch.”
I said, “The Highlands Ranch facility is 35 minutes away. His primary care physician is less than 10 minutes from my house. Why can’t we go there instead?”
The nurse reiterated that I must take him to a Kaiser eye care facility because he wears contact lenses. So I asked her, “If Coleton wore eyeglass frames rather than contact lenses, would we still have to drive all the way to Highlands Ranch for him to receive treatment?”
Sensing my irritation, she repeated Kaiser’s policy of referring patients wearing contact lenses to one of its eye care facilities to diagnose conjunctivitis. She then offered the next available appointment time of 4:15pm. (For those readers who are unfamiliar with Denver, the only thing worse than a 45-mile round-trip commute from SE Aurora to Highlands Ranch, is doing so during weekday rush hour.) I accepted the appointment time, hung up, and then left immediately with my son for the OnPoint Urgent Care facility located about three miles from my house.
There, after a 5-minute wait in a very comfortable, non-clinical “waiting room” (see photo above) and after a brief examination, (for the cost of a $25 co-pay) the physician assistant diagnosed that Coleton had indeed contracted pink eye and prescribed Ofloxacin antibiotic eye drops. Prescription in hand, we stopped by our local Walgreens pharmacy on the way home, paid $11.24 for the medication (perhaps $1.24 more than Kaiser would have charged under our medical plan), and began treating Coleton’s infection by 3:15pm.
At that point, I phoned Kaiser and canceled our 4:15pm appointment in Highlands Ranch.
When I looked at the receipts, I saw that only 48 minutes had elapsed between the time I paid the copay at OnPoint Urgent Care and the time I paid for the prescription at Walgreens. That’s less than the drive time from the Highlands Ranch Kaiser eye care facility to my house in SE Aurora in rush hour traffic.
My wife and I have been with Kaiser since relocating to Colorado in 1998. In that time, we’ve had four children and our healthcare costs have quadrupled. Although we have a choice to change providers during annual enrollment each year, we continue to choose Kaiser Permanente. We like our primary care physician, his support staff, and the employees we come in contact with at the pharmacy.
What we don’t appreciate is an absurd policy that requires an ophthalmologist (who’s located 22 miles away and is not available until 4:15pm) to diagnose an eye infection that a physician assistant (who’s located 3 miles away and is available right now) can diagnose after a 2-minute exam.
Health Maintenance Organizations (HMOs) like Kaiser Permanente are often criticized for their bureaucracy, escalating fees, and mediocre patient service—which is often demonstrated by their insensitivity to the needs and realities of patients. As a result, nimble urgent care centers like OnPoint Urgent Care are carving out a niche by providing better patient service (more comfort, convenience, and responsiveness) than HMOs like Kaiser Permanente.
Don’t settle for ordinary. Choose extraordinary. (It’s always a choice.) Pre-order Delight Your Customers: 7 Simple Ways to Raise Your Customer Service from Ordinary to Extraordinary by Steve Curtin (AMACOM Books, June 11, 2013)