Doctor’s Musings As Insurance Call Makes Him Wait And Wait

Dr. Steven Schlozman

Dr. Steven Schlozman

Dr. Steven Schlozman is an assistant professor of psychiatry at Harvard Medical School and a staff child psychiatrist at Massachusetts General Hospital. He is also the Co-Director of Medical Student Education in Psychiatry. His first novel, “The Zombie Autopsies,” was published in 2011, and his affinity for zombies might explain his mind-numbing rage at being stuck on hold all the time. Readers, have you had muzak musings of your own lately? Please share in the comments below.

By Dr. Steven Schlozman
Guest contributor

I am a physician practicing in Boston. I do my best to get my work done as carefully and efficiently as possible.

I am writing to you right now, in real time, as I enter my…wait for it…38th minute on hold with Blue Cross/Blue Shield in my attempt to gain approval for a treatment that my patient absolutely needs. No one who knew the details of this case would argue otherwise; not politicians, or business specialists, or cost efficiency specialists, or medical school professors, or anyone really. Neither would anyone deny that the treatment that I am trying to procure for my patient is costly. Finally, no one would deny that it is legions more costly to not treat my patient with the treatment for which I am now sitting on hold and trying to procure.

Help. I love being a doctor. But this isn’t doctoring.

Still, here I sit. I sat initially for 26 minutes, at which point the very pleasant muzak stopped and a recorded and maddeningly soothing female voice told me that I would “have to call back later.” Then the line went dead.

So I called back later.

I called back exactly 12 seconds later, and that was now 42 minutes ago. I mean, 42 minutes, in real time, as I write this letter. I have patients in the waiting room who will understandably expect me to get to them soon. I also know that there are those who will tell me that this is what I signed up to do for a living.

But they’re wrong. I did not sign up to do this for a living. There are no courses in medical school about how to spend one’s time on hold while patients need your help.

Minute 58 just passed, by the way.

And yes, I am writing this letter here at my desk, when I could be doing other things.

Except I can’t. I’ve written all my notes, called back all my messages, and….I can’t listen to my messages or renew another patient’s prescriptions or reschedule a kid who can’t come see me because of Bar Mitzvah practice or a soccer game or call a school counselor or speak with another doctor or do all sorts things that could really help and make a difference for patients because I am still on hold and have to be, on the off chance that a living and sentient being will actually speak to me. .

I could have a nurse wait on hold, or perhaps an administrative assistant, but that means I will be interrupted in the middle of actually tending to a human being when a living person does happen to show up on the other end of the phone. That’s not good.

Wait! The same message just came on:

“We’re sorry…this call is being disconnected.”

They hung up.


I just called back. Clock starts now. Two minutes in so far. More muzak.

So, why would anyone do this? Why put up with this nonsense any longer than the time I’d give to filling up my hamster’s water bottle?

Well, it seems to me that the hamsters can be kept alive in about two seconds of care with relatively little bureaucratic oversight.

My human patient, though, now has endured two hang-ups from his insurer, and…


Irony – the muzak at….13 minutes… is a soothing and mind-numbing version of “You’ve got a friend.”

Some friend.

So, I am going to end this letter now. I’m still on hold, but if you bothered to read this you’ve probably finished your coffee or you need to pee or something. I need to pee also, by the way. But that will have to wait.

Help. I love being a doctor.

But this isn’t doctoring.

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  • Paul T

    This stupidity on the part of the insurance companies can probably be remedied by billing them for your wasted time. You can probably setup an automated wait time counter on your phone system. Print the record at the end of the month multiply by how much you charge an hour and send. Repeat this every month. After three billings and likely no response send them a delinquency bill and tell them you will stick a collection company on their behind if they do not respond. This method is frequently used by all sorts of companies and generally works. good luck

  • alexafleckensteinmd

    How come that a doctor needs to get a permission for a treatment that is generally accepted? Did the insurance people go to medical school? And if they did, are they the better doctors than the ones who work in the field??

    Alexa Fleckenstein M.D., physician, author.

  • Still Shaking My Head

    A heartfelt thank you to those physicians and other clinicians who still persevere through the self-serving barriers erected by the insurers as part of their unacknowledged rationing of necessary health care. Unfortunately, the factory business model seems to be spreading even more widely across all aspects of health care delivery and its management, leaving less time and less room for rational decision-making in the care of individuals. The concept of “effficiency” is extolled, but the markers selected for measuring “quality” are sadly lacking in relevance to what actually happens at the bedside. From what I have seen, as a clinician and as a patient, unless it relates directly to their own reimbursement, health care providers and organizations increasingly shift as much of this responsibility back to patients as they can, or simply select the less difficult path with a shrug: “I am sorry, it just isn’t covered. ” Until the medical profession as a whole, and the people of the US, recognize this and are impelled to raise their voices loudly against it to the highest corporate and governmental levels, it is only going to get worse. Until they get sick, members of the public tend to ignore the fact that the “market” approach to health care drains far too much money intended for patient care into other pots and pockets, and that it will have a negative impact upon them, too, someday.

  • Poppy

    As an ordinary citizen, I consider this an outrage. It is true that systems are in place within the insurance companies to encourage people to give up and go away, they will even tell you that. I am horrified that now physicians working for their patients’ health are treated similarly. Please stay angry; I am hoping that doctors as a group can bring some pressure here to change things, because individuals like myself have no power and are ignored categorically with impunity.

  • patient

    The insurance companies are ruling the medical system….they don’t want to give the doctors permissions because it will cost them money….I can’t tell you how long I’ve waited to get serviced by BC/BS and years ago it was better…my heart goes out to the doctors who have to put up with this crap…and the patients are the ones who suffer due to lack of time with their physicians.

  • Debbie Bourque

    As a former patient of their insurance, I wish I had a nickel for every time I had to call my doctor because his treatment or prescription was turned down by them. He’s an oncologist being questioned or rejected by this company. I found them to be very patient and doctor unfriendly which is why I switched.

  • Knottjustj

    As a social worker, I welcome you. Join us! It’s a mad(dening), mad(dening) world.

  • Steve

    This should be a major Boston Globe story. The Multiumillionaire BlueCross CEO should stand accountable to the patients and doctors who are abused by this common nightmare

  • Dr. John

    I am going to post this on Facebook. As an MD myself I am incensed at the expectation that my time is free for the wasting by insurance companies in the service of their avoiding expenditures for necessary care. The non-response of our professional academies to this absurd system is pathetic. There should be public education regarding the reason that docs don’t have quality time to listen to their patients. And there should be a CPT code for time spent on prior authorizations, so that insurance companies would have to decide if it was worth their paying for our time in order to deter patients from receiving care.

  • PCP

    Physicians are generally smart people….how did we as a group let ourselves get so marginalized in the big picture of heath care delivery?

  • PCP

    thank you for sharing this! I increasingly go through the same thing and I know my blood pressure increases every time…I find myself angry and at times like these and ask, “why did I ever listen to that 18 year old version of me who decided he wanted to go to medical school?” ….. There are moments of joy and satisfaction in the work we do as physicians, but they seem to be fewer and far between – taken up by these disheartening interruptions to real patient care.

  • Remy

    As a physician myself I totally empathize. The idea of many businesses is to reduce costs and they deliberately have systems in place to frustrate you so that you will (a) go away (b) come up with another plan that does not need prior approval. Incidentally, the former CEO of BC/BS made $4.5 million and got a severance of around $13 million approved. This is supposed to be a non-profit aggregator and they claim there is not enough money to care for patients. It imeant to enrich the 1% while ordinary people suffer. Believe me, no MD makes that kind of money!