God's Word for today

Tuesday, 23 September 2008

It's about the PEOPLE, stoopid...

You will see from previous posts that my wife was involved in a car accident the other day. I am most thankful to God that she is doing well, and is on the mend (notwithstanding a kaleidoscope of colours appearing on various parts of her body).

However, my experience at the hands of the so-called medical "profession" leaves a great deal to be desired.

Note that I refer to "my" experience, as Belinda couldn't complain too much about her side of things. She couldn't sing the praises of the paramedics highly enough. The doctors who treated her in ER were helpful and efficient. The hospital ward was reasonably comfortable (once she had been transferred from that zoo otherwhise known as High Care - anyone who has been there will understand). Even the hospital food was reasonably palatable.

However, my fun and games started first thing on Monday morning. I had arrived at my client, and had barely got my computer fired up when I received a 'phone call from the radiology department. A rather strident women exclaimed that, according to my medical aid, I had to pay a "co-payment" of R1500, and when can they expect the money?

Excuse me? Who are you? What X-rays and scans were done? How much is the total bill? Where is my invoice?

Now let me get one thing straight. God may be turning an accountant into a minister, but He hasn't erased the last 20 years from my brain. I don't care if you are the X-ray department, SARS, Thabo Mbeki, or the Pope - I don't just hand over money to people without seeing some sort of invoice first! In this case, once I have seen some sort of documentation confirming how much I owe, and once I have confirmed the matter of co-payment with my medical aid, only then will I be willing to pay over the money.

What really got my goat was the fact that this cretin 'phoned my home asking to speak to my wife (she was at that stage still in hospital, one floor above their offices), then asked to speak to me (I was at work), and then promptly blurted out to my mother the fact that they wanted this money, like, yesterday! Now I'm not one to have too many secrets, but I don't appreciate my confidentiality being breached in this manner.

Round 2 of the "fight of the century" took place that afternoon with the doctor who attended to my wife. My particular medical aid is contracted to use Lancet Laboratories as their preferred pathologists. These have been the rules for about 8 years. The hospital knows it, and their screens indicate this fact in big bold letters. In fact, this particular hospital has a Lancet office right on their premises.

95% of the doctors who treat patients at this hospital use Lancet. Guess who picked one of the 5% who uses other service providers?

Now here's the problem that I have with the whole system. My wife has just been dragged from a wrecked car which, according to a witness, "took off" as the car hit the storm drain. She is bruised all over. Her shorts have been ripped in three places from the impact, her T-shirt is covered in blood, and she suspects that her nose and a number of ribs are broken.

Now imagine being in that state, and having the presence of mind to say to your doctor, "Er ... excuse me, do you charge 'scale of benefits'? Blood tests? Which provider do you use? My medical aid only pays for Lancet". Not likely!

Now fair enough - emergency situation, and all that. But imagine if I had been tasked to prepare your tax return, and then suddenly you receive bills from Deloitte or Denys Reitz? When you query these bills, I indicate that I needed to "refer" your case to "specialists" - without consulting you first. You would in all likelihood roll these bills up into a ball, shove them up my left nostril, and hold me liable for payment. And rightfully so! Yet such practices are the accepted norm in the medical profession!

So here's the legal position as I see it. If my medical aid refuses to pay for these blood tests, I am technically not liable, since I did not authorise the use of the other service provider. The hospital maintains that they did not authorise the tests, either - of course, with the clear instruction from the medical aid, they would have to say that - anything else would be an admission of liability. Which leaves my wife, and I'm willing to bet that any court in the land would find that any authorisation that Belinda may have signed would have been obtained under duress.

Thankfully the medical aid has agreed to pay, since the situation was considered "emergency" and my wife was brought in over a weekend. So Dr X can relax, knowing that this month's instalment on his Merc will not be diverted to paying for my wife's blood tests! Because as sure as the good Lord made little apples, there was no way that I was prepared to accept liability if the medical aid had refused to pay.

What the "system" seems to have conveniently forgotten is that in between all the procedures, rules, protocols, terms, and conditions, medicine is actually about PEOPLE!

But there is a lesson in all of this for me. For as ministers, it is easy to fall into the trap of seeing our congregants not as individuals, but as "the confirmation class" or "the baptism class". The "I've done X number of baptisms / funerals / weddings / pastoral visits in the last year", rather than focusing on the individuals whom we have baptised / buried / married / visited.

I have to confess that I have also fallen into this trap. I do not know the names of many of the people who greet me on Sunday at church. At one point I was getting to the stage of "oh no, not another funeral", instead of seeing it as an opportunity to bring God's love and comfort to a family in need. I have become so "busy" that when I see a church-related e-mail, or my cellphone rings and I recognise the number as being someone from the church, I groan inwardly before replying or answering.

Oh Lord, please forgive me of this attitude. And thank You for showing me, through this hospital experience, how easy it is to forget that ministry, just like medicine, is about caring for people. Help me to follow Jesus' example, where He had little time for the hypocricy of the religious leaders, but always had time for the people.

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