Just exactly how much of what was I saving?

Yesterday I went to the doctor for my annual exam.  It’s not an especially fun event, but I do have a really nice doctor that I like, I never have to wait more than five minutes in her waiting or exam rooms, she’s a Christian, and the massive medical system she’s a part of still allows her to give me a 30% discount because I’m a self-pay (uninsured) patient.

There are always four components to an annual exam:

1.  The nurse weighs me (down 10 pounds from last year!), checks my blood pressure (122/70!), counts my respirations (I do breathe regularly), and records my pulse/ox.  She then goes through the whole list of my meds and asks which ones I’m still taking.

2.  The doctor comes in and asks me a few questions and I tell her which prescriptions I need refilled.

3.  Like the Peach, the doctor exits the scene, I garb myself in one of those woefully inadequate hospital gowns, and the she returns and does three exams:

~ the eyes, ears, nose, throat, heart, lungs stuff

~ the breast exam

~ the pelvic exam and pap smear

4.  I then ask the doctor any questions I have and she answers them.  (I always dress before paying and departing the premises.)

This time, when we got to #2, Doctor Gordin said, “When was your last pap?”

“Last year.”

“Well, since it was normal, you can go to every two years now.”

HOORAY!!!  (That must be one of aging’s fringe benefits.)  So, it was a happy day.  I only had to endure half of the usual undressing and none of the pesky poking and prodding.  And the fact that I was out of there by 8:50 AM was an added bonus.

My annual exam is pricey.  The doctor’s fee (set by Mercy Clinics) is $214 this year.  The lab work usually runs close to $300, and then there’s the mammogram with its multiple fees.  I think that one pushes $400 or so, all together.  As I said, Mercy lets Dr. Gordin discount my doctor’s fee, so I paid about $150 for that, but there are no discounts on lab work through Mercy.

A few years ago, our AWESOME family doctor, Dr. Kym, and her husband (internal medicine doc, Dr. Chris), who had been in practice with Mercy (then St. John’s) here in Branson for nine years, got so fed of with Mercy and their system that they resigned and ended up moving to Florida, where they have subsequently set up a cash pay office.  I’m not sure how they do it, but they take NO insurance of any kind, and they see patients for a flat $50 fee, no matter what.  I have admired their gumption.

Now, with all the government and insurance and big medicine mess, some entrepreneurial types have come up with a similar provision for lab work.  There exists in the U.S. (or at least in parts of it) a franchise of cash-pay labs called AnyLabTestNow, and one of those labs is in Springfield.  Dr. Gordin has been giving her self-pay patients the option of having their lab work done at the Mercy Clinc for Mercy’s price, or at AnyLabTestNow for about 40% of Mercy’s price.

I am no fool.  I said I’d go to AnyLab.

I have to be fasting for my bloodwork, and my usual ritual is to go to the doctor, have the exam, step into the next room for the blood-letting, and then drive myself directly to McDonald’s for an Egg McMuffin.  Yes, I know what an Egg McMuffin does to one’s cholesterol, but I like to celebrate after an annual exam and blood draw, and and Egg McMuffin (or sometimes two!) is a spiffy way to celebrate when one is ravenously hungry.

So I had this all figured out.  8:50 AM. . . ten minutes to get to AnyLab. . . maybe they wouldn’t be too crowded (it’s walk-in; they don’t take appointments). . . I COULD conceivably be home before 10:30 AM!  That would be great, because we had a lunch meeting with our pastor at our house at 11:45, and it would be helpful to be there to make lunch.

I pulled up to AnyLab at 8:59 and there were no other patients there.  This was clearly going to be my lucky (well, blessed) day!  The guy at the desk was polite, friendly, and talkative.  He gave me a very small amount of paperwork to fill out and while I was doing that, we learned that we both were Christians, we both had kids in colleges in Virginia (his daughter pre-med at Liberty), and when he asked which school our kids were at and I told him it was a very small school that no one had ever heard of called Patrick Henry College, he said, “Oh, I’ve heard of Patrick Henry, and it’s right near Leesburg!”  Small world, for sure.  I was feeling pretty good overall – other than being fairly hungry.

I hadn’t seen any nurses around, or even any other staff at all, for that matter, so I asked (half jokingly), “So, are you the phlebotomist, too?”

“Yes, and the office manager and the janitor and the owner!”

That was slightly unsettling, but I figured as long as he washed his hands between his janitorial and phlebotomical duties, all would be well.  I paid my $129 and sat down.

Before he could take me back to the chair and do the deed, the phone rang, and he was just as chipper with whoever was on the phone as he was with me.  It rang again.  And again.  And two people walked in.  And the phone rang again.  And another person walked in.  I wasn’t going to be out of there by 9:30.

We went back to the “lab” section, which was just behind a partial wall beyond the front desk, and I told him what I have told every person who has attempted to draw my blood in the past 15 years.  “I’ve been told I’m a hard stick.  I have drunk so much water this morning that I’m about to float away.  You can go anywhere in either arm, but what usually happens is they try different places and then end up with a butterfly in the hand.  I don’t care how many times you try, but my one rule is that you MAY NOT DIG.”  Following that speech, most people go straight for the butterfly, get in on the first try, fill the two (or sometimes three) tubes in about 30 seconds, get out, and I go home.  No big deal.  The lady at Dr. Gordin’s office is especially good at her job; she doesn’t even hurt!

“Mark” agreed that a butterfly in the hand would be the way to go, and he chose my left hand, which was fine with me.  However, he didn’t do any of the usual apply the tourniquet, make a fist, slap the hand song and dance routine.  He just put on the tourniquet and felt the hand.  While he finally did the deed I turned my head to the right and closely studied all the variously-colored collection vials.  There were a lot of them, in many colors.  They all had detailed labels, and I had plenty of time to study them.  He wasn’t hurting me, but I did feel pressure on my hand, as if he were pressing on the vein.  I’m not too bright, but I thought to myself, “doesn’t applying pressure tend to stop bleeding?”

He asked me if I was OK and I said I was.  A little while later he asked me again.  My hand was somewhat sore, but nothing really bad.  Mostly, I just wanted to have him get the blood and be done.  He asked me if he was hurting me.  “No.  If you were hurting me, I’d make a noise.  It wouldn’t be a terribly loud noise, ’cause that wouldn’t be good for business, but you’d know it.”  (There was no door between us and the folks sitting 20 feet away in the waiting area.)

I asked him if he was getting anything.  “We’re almost done.”  That was encouraging!  It had been three or four minutes, and that’s a LONG time for a blood draw.  Finally, I said the things I REALLY did NOT want to say.  I still hadn’t looked, but it must’ve been running awfully slowly to take that long.  I sighed.  “If you want to come out and try the other hand, I’m OK with that.”  He stayed with it another 30 seconds or so; then, finally, he was finished.  I was relieved.  I held the gauze on my hand while he held up the vial.  I could not believe what I saw.  There was less than 1/2″ of blood in the bottom of it!!!  All of 27 drops!!!

This was not good.

My bladder had kicked into overdrive, so I excused myself briefly while we both took a deep breath and prepared to go at it again.  In the bathroom, I could hear the phone ring, and when I got back to the chair, it was another round of put the gloves on – go answer the phone – welcome a couple new arrivals – answer the phone – label the tubes – answer the phone – apply the tourniquet – welcome another patient – answer the phone – swab the hand.  Etc.

I figured my right had would be happier.  I mean, I was well-hydrated; how hard could it be?  “Mark” told me he would let the answering machine get the phone and cheerfully pressed forward on the task at hand.  (nice pun, huh?)  I won’t bore readers with the details, but while the phone rang and the door chimed and I breathed slowly and deeply and studied a super-enlarged photo of a red blood cell on the left-hand wall, “Mark” spend several minutes not getting any blood from my right hand.

I was beginning to be concerned.  He already had my money.  My hands are the easiest places to draw blood.  The arms rarely perform well, and I do have my limits.  I was NOT going head or feet! What to do?!?

“Mark” asked me how much time I had today.  There were several sarcastic replies that could have been made, but I am proud to say I passed all those by.  “Well, I can’t leave and come back.  I live too far away.”  “Well, do you have 20 minutes?”  “Sure.  I can wait 20 minutes.”  “OK.  Let me take care of some of these others and then we’ll do you.”  I went back to my seat in the waiting area and took out a book.  Thus began one of the longest 20-minute time periods in recent memory.  I texted Scott and asked him to pray for us to be able to get the blood.  I read.  And read.  And read.

I also wondered if I should just forgo $149 and drive back to Dr. Gordin’s office, where her phlebotomist would get the blood in 30 seconds and Mercy would bill me $300+.  What would Scott say about that?  I was trying to save money, but my time, even though not worth any dollars or cents, had to be worth something, didn’t it?  I kept sitting and reading while “Mark” dealt deftly and seemingly without any problems at all with eight to ten other folks and an untold number of walk-in questions and phone calls.

Finally, when I was sure I had heard him give the answers and prices so many times that I could probably have been hired as a desperately-needed receptionist, he called me back.  It was right hand again (different vein) and it hurt quite a bit, but I bit my tongue and did not alarm the folks in the waiting area, nor did I kick “Mark.”  He did eventually get the two requisite vials, and I left at 11:09 AM.

So. . . I guess I saved us something like $150, but was it worth it?  I don’t think so.  And next year, where will I have my labs drawn?  Well, I’ll probably call AnyLabTestNow and find out WHO is doing their draws.  If it’s “Mark,” even though I like him, I appreciate his Christian stand, and I admire his independent go-get-’em approach to making money outside the system – and really want to give people like that my business – if he’s manning the needle, I think I’ll stick with Mercy’s sky-high prices.

At least today, I still the right to make that choice.



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