A friend of mine recently shared a pretty disappointing experience she recently had with her primary care practice when she sought treatment for a painful, infected spider bite.  Or, perhaps I should say, an experience she had with her former primary care practice, since the practice refused to see her — stating that she was no longer a patient because she hadn’t been in for a visit for three years, and therefore “couldn’t be seen” until she scheduled a new patient wellness exam.

My friend was told that this was the policy of the IPA that the practice was part of — and that she had “no choice but to go to urgent care.”  In this context, urgent care was presented to my friend almost as sort of a downgrade — like, “go wait in line at urgent care.” It felt to my friend — who was already a bit nervous about her injury — like the practice really didn’t care about her at all.

Luckily, the urgent care center they recommended was friendly and appealing, and a doctor saw her quickly and treated her infection (which turned out to be spreading alarmingly fast) carefully and attentively.  Not surprisingly, the doctor at the urgent care center was happy to let her know that he could also act as her PCP — and, my friend is considering making the switch, even though she had been with her prior practice for nearly 20 years!

Why did the PCP risk losing such a valuable patient?  (Besides being a long-term patient herself, my friend has two teenaged children who will soon need to graduate from their pediatricians.  So, that’s three patients potentially sacrificed for lack of a recent wellness visit.  Moreover, my friend is the ideal patient for primary care: pays her bills at time-of-service and is always diligently compliant with advice.)

One guess is that the IPA doesn’t want to miss out on the chance to bill for a new patient wellness visit at a higher rate.  (The practice may not even realize this is an underlying motivation.)  But, is that $50 or so really worth risking losing a valuable patient for good?

Of course, there’s an even more obvious question: how does my friend go more than three years without a reminder for a wellness visit — especially since a periodic visit is required to remain a patient of the practice?  Like many women, my friend also has a gynecologist she sees annually, and so was not aware of any need to see her PCP — but, if she’d received even one reminder to do so, she’d surely have booked an appointment.  And, the practice would have gained more revenue by reminding my friend to come in regularly for a check-up.  Now, they’ll likely lose a valuable patient and the opportunity to bring her two children into the practice over the next couple of years.  (And, if my friend were the online-griping sort of person, she’d surely be sharing her disappointment that her trusted physician’s office failed to consider the seriousness of her injury before refusing to see her!  Lucky for the practice, she’s not inclined to do that sort of thing.  But, plenty of other patients would have headed immediately to Yelp or RateMDs to share this experience and give the doctor low marks.)

My friend noted that the practice is always very busy — and that she suspects that’s why they “don’t really care” that they’re losing a patient.  But — as we’ve said again and again — all patients are not equal.  Poor service — which really came across as a lack of caring to my friend — cost this practice a patient of the type no practice can afford to lose.

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