Monday, December 5, 2022

Who Wants To Know?

 I had my 'medicare appointment' today. I mean, I thought I was going there to get my prescriptions for another year, but they informed me that it was my medicare appointment. 

I am still learning my way around the medicare system, so I just took them at their word. It was my medicare appointment.

I went there with my book, but there was no time to read it. They had four pages that I needed to fill out because this was my 'medicare appointment'. 

It started out innocuously enough, but by the second page, the questions wanted to know whether I needed a walker, a cane, a wheelchair to get around. What adaptive equipment did I need in my home. I was a little surprised to see that I was being asked about my ADLs. Could I do my own housework independently? Cook for myself? Do my own laundry? Could I make phone calls by myself? Could I toilet myself? Shower myself? Stuff like that. 

WTH?!!! Of course I can do those things. 

I drew an impatient line and wrote N/A. This is my family doctor, for heaven's sake, and there would be no reason for her to have any questions about whether I could do these things or not. 

I continued on, and it moved into my mental state. How often did I socialize?  I stopped ticking boxes and read ahead. Eventually, I got to 'Did I feel that everyone would be better off without me?' 

You know, about 12 years ago, or so, my mother was hospitalized. The doctor sat us all down and explained that my mother was going to die and that nothing could be done about that unfortunate fact. She was sent from the hospital to a nursing home while her home care situation was being figured out. 

She had to fill out a form too, a lengthy thing, and part of it was a self assessment of her mental health. One of the questions was 'Do you think about death a lot?' My mother answered yes. After all, she was still processing the news that she had a terminal illness. 

The nursing home's response to that was to put her under a suicide watch. Let me tell you she. Was. Livid. If anyone had bothered to talk to her, they'd have figured out that she was grappling with her own mortality for the soundest of reasons: she was dying. But no one bothered to talk to her. 

Now, all these years later, I sat there staring at the same questions. I don't go to the doctor often, but when I do, we always chat cordially. We always find something that strikes us as hilarious. She's never had a reason to ask questions about my mental state or what adaptive equipment I need, or whether I can still dial the phone and carry on a conversation. 

So what was up with this form? This was my 'medicare appointment'. So who was asking me the questions, because it sure wasn't my doctor. 

I drew a big line across the rest of the questions and wrote, "I can assess my own mental state." 

I took the clip boord back to the window and politely said, "I am not filling this out. I turned 65 but this is simply the worst case stereotyping. Very little of this applies to me. Lyndsey would never have a reason to ask these questions, so who is asking them?"

She said, "It's okay. Don't worry about it."

I'm still curious why a 65 year old woman, just retired, walking into the office on her own two legs (slight limp: arthritic knee), carrying on a perfectly appropriate conversation, arriving 15 minutes early for her 2PM appointment would warrant that questionare? Did I mention it was four freaking pages?  


40 comments:

  1. one gets that form every year...

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  2. Bureaucracies suck when it comes to treating people as individuals.

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    1. Bit my question is 'who is the beaurocracy here', because it is not my doctor.

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  3. Did you get to see a Dr in the end? Or was that form doing the "doctoring" for them? I can quite understand your mother being so angry at such an assessment when she was having to come to terms with her mortality.

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    1. Oh, I got to see the doctor just like always. The paper was asking questions that she doesn't ask, and never would have a reason to ask.

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  4. The simple answer is that the questionnaire is to reduce future lawsuits. If doctors misdiagnose something, they get sued. Those lawsuits take time and money to resolve. If you were to go home and shoot yourself tomorrow and your kids sued the doctor for not diagnosing a mental issue, they can simply hand the form back as evidence showing that you refused to answer the questions. Likewise, when your mom's form came back saying she was thinking about death, it required a suicide watch for the same reason.

    My wife is due in court perhaps next year over a lawsuit about a missed diagnosis. This isn't the first time. Until we stop our litigious behavior, these sorts of questionnaires are only going to get longer and with more consequences.

    Do I wish doctors had correctly diagnosed my mom's headaches sooner before her cancer became incurable? I surely do. But I don't blame the doctor and I have never sued him. Others don't think the same way as I do on the matter unfortunately.

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    1. That answer gave me quite a bit to chew on. In the end, I think your points are valid. The good news is I am not planning to shoot myself, so we are all good.

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  5. That is interesting in what Ed says. Doctors wary of being sued, we also are beginning to see the same in the NHS as well.

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    1. We are a very litigious bunch over here. The lawyers advertise for malpractice on tv, making claims of how much money they can get for you...and that it will cost you nothing unless you win. The courts are being played like the lottery.

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  6. I too was very interested in Ed's comment and hope this doesn't become the norm over here.

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  7. I would have filled out the answers even with them all being "no", because the time would come when they might be "yes" and they could more easily assess how long it took me to get to that point and how much extra in home help I may or may not qualify for. and whether or not different medications might be required. Even now, in subsidised housing, I have a once yearly "home visit" where they ask if I am still capably managing. I am, but if they arrive for the visit and I'm clearly not managing but haven't realised, they can then take steps to help me. the form seems intrusive, but medicare is nationwide and it gives "them" some idea of how people in your age group are coping, or not, in different areas and why, and how that ratio can be improved for future generations.

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    1. I think the doctors notes would provide a timeline of decline.

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  8. About 5 years ago I had to have some regular hospital appointments ( in England) and the young nurse who first saw me had to ask If I could still dress myself etc etc. Like you, I had walked in and I assume I looked perfectly competent, but she had to ask to fill her form in. Not her fault, so I wasn't too stroppy!! But I was annoyed!
    Interesting points from River though.

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    1. I was"t mad at anyone. I just was curious....and still am...who was the information being for?

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  9. I think what I don't like is being stereotyped. I'm capable, living alone and liking it, doing stairs, all that, but medicare thinks I should be on my last legs by now!

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  10. N/A would have been my answer to most questions.

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  11. How dare you fight against the system and not comply with requirements. Ah, you have a history of doing the same.

    It is the same here, so much paperwork. But am learning so far as medical forms, as long as reception hand you the form and you say thank you, you put a little bit of ink on it and sign it, all is well when you hand it back with your signature. Reception staff don't really look at it and they say thank you.

    Social security form filling in has become so bad here, businesses have sprung up to do the paper work for you on an ongoing basis. It costs of course, so only the better off can afford the luxury. God help the poor. No one else does.

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  12. I wasn't fighting it. It simply made no sense. I obviously needed no mobility aids. I was physically sound, mentally appropriate in conversation. The questions were not applicable.

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  13. That is quite the event you had. I wonder who dreamed up this idea?!

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    1. I am so curious too. I like to understand how machinery works.

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  14. I have these Medicare wellness appointments twice a year. They ask me these sort of questions, check my blood pressure, and send me off to get my blood work done. That seems to be healthcare for the over 65 crowd now.

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  15. I read online that it is not mandatory to have the wellness visit so you can refuse it if you want. I think it is just checking in on people that are on Medicare and helping them to develop a medical history so their doctors know what is going on with them. Not everyone has a doctor that they see regularly.

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  16. Yes, good rant. It seems that every medical place you go to hands you that dreaded long form. Each time you go back you get it again for updates.

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  17. I no longer fill out those mental health questionnaires, they sound like some grad student project. And, I found out they were billing my health insurance about $70 for glancing at them.

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  18. I usually ask the office to send me the forms online and then I do not need to rush through and just mark out the unnecessary questions. Hit send and be finished with it.

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  19. Sorry you didn't like the forms. I haven't found a form I like. U.S. Medicare requires that those forms be done and noted in order to receive Medicare. My doc's office has an RN dedicated to just doing those blasted forms with patients. Yep, it's called the initial or yearly Medicare visit. It's not a doctor visit. They are not created to prevent lawsuits from injuring docs. Most every patient I admitted to a hospital has lots of similar questions. "Thinking a lot about death" in some units would be cause for concern, but not in units with lots of elderly patients. Unless more specific questions were answered, it's rare to actually be so concerned as to put a patient on "suicide watch," even amongst hospice patients. Medicare uses the forms to collect data. They weren't out to get you, or deny care now or in the future. It's just a baseline start of what your abilities and needs are for now. Please consider checking off the stuff next year. Heck, my Medicare RN was out for a couple of weeks, and we did the subsequent yearly forms by phone. Cheers for the crazy method! Linda in Kansas

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  20. Although I haven't filled out those forms and appear to be a competent and well-adjusted person, I'm happy when my doctor asks me about my mental health or any depression issues. Many people hide how they're doing or feeling and as a widow, living alone and sometimes lonely and depressed, I'm glad for any concern.

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  21. We have an online survey to fill out before any appointment - I doubt if the dr reviews it before seeing me, however, as she always asks "what are you here to see me about" even though I have stated in the pre-survey exactly what is needed.

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  22. I told my doctor years ago the providers, from the government down through the insurance company and the doctor are as interested in heirs and assigns as medicine. I do not answer that publication.

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  23. When we go to our military facility they have me fill out the same questionnaire every time, even though it's all in their computer system already. And the questions are stuff like where did you have your last mammogram? When was your last period? Where did you get your blankety blank immunization? Etc. I now put all that on my phone because I can't remember most of it.

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  24. I am 10 years older and have never had a questionnaire like that. Maybe they know that I am behind hope. 😀

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  25. Interesting. I bet it's a standard thing the Medicare people make everyone fill out, whether they're 65 or 85.

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  26. I just tell them everything is the same, just age and weight have changed, and both have gone up.

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  27. Doesn't sound like your 'medicare appointment' was a good time, Debby. Sorry. The cover your butt approach to medicine kind of sucks.

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