A Night in the life of a Physician and a “Patient Advocate”

September 25, 2013

What follows is a correspondence I sent this evening


George Paz

CEO of Medco, now a part of the Express Scripts family of pharmacies

100 Parsons Pond Drive

Franklin Lakes, NJ


Dear Mr. Paz:

I will begin this correspondence by stating that you and your organization are the problem and not the solution for our nation’s healthcare crisis. Once you read this correspondence in its entirety, I expect you will agree with me that the onus is on you to prove otherwise.

I have thus far spent 25 minutes dutifully following the automated prompts on your phone system in order to provide your organization with my patient’s demographic information as well as my own, only to be put on hold to wait for the “next available patient care advocate”. If my patient’s advocate ever comes on the line, I will have to tell them, all over again, my patient’s ID#, name, date of birth home telephone number, my name, NPI#, office phone number and office secure fax line all of which is already provided on a document faxed to me by the local pharmacy where my patient has her prescriptions filled. The primary reason for this fax was to communicate to me that I am required to call a patient care advocate at your organization to approve the medication that I prescribed for my patient.

Only after I, Mitchell Weisberg, MD, the patient’s personal physician for fifteen years, provides the patient care advocate, who incidentally has never met the patient in question nor requires a high school education to perform their duties, the above information will the patient care advocate fax me a form on which I will, for the fourth time (count them), give the same information.

It has now been 32 minutes and I am currently listening to a barely audible recording of a Jazz Trio while I am on hold. This is a good time to point out that without the medication for which I am navigating your maze, she is unable to function. That means she is not performing her job, she is not spending any meaningful time with her twenty year old autistic son and she is most certainly not joining in on the fun of girls night out. Therefore the oath I took to become this woman’s physician as well as my personal ethics obligates me to wait on hold as long as necessary to speak with my patient’s “advocate” to assure my patient receives her vital medication.

I apologize for this delay, but I must interrupt the flow of this correspondence to tell you that after my being on hold for 39 minutes, Dafney my patient’s advocate came on the line. She apologized several times for the delay, but this did not prevent Dafney from asking me to repeat my name three different times, and the name of the medication about which I am calling twice. I finally spelled it for her. It is now 53 minutes and Dafney placed me on hold.

Are you still reading this? It is now 58 minutes and I am still on hold. Please stand by.

Dafney and I have accomplished our mission and she promised me she is faxing me the form I need to complete to get my patient her medication; and it only took 1 hour 6 minutes and 30 seconds. However, I am on hold and I am not hanging up until the supervisor gets on the line. Dafney assured me a supervisor will be taking my call shortly. The purpose of my speaking to a supervisor is so I can get your name and address so I can send you this correspondence. I asked my patient’s advocate, Dafney for this information but she did not know it. I will let you know as soon as the supervisor comes on the line. I will even address you by name. Please be patient, whatever your name is, while I wait. I appreciate your patience and I apologize for the delay.

Hello Mr. Paz, Charlotte L. (she is not allowed to disclose her last name) was kind enough to give me your name and your contact information. Mr. Paz, George (you can call me, Mitch); from one CEO to another, I have two questions to ask you. First, how is your organization making the American health care system work better? Second, and more importantly, how is your organization helping my patient remain healthy and well?

George, I expect and deserve your written response to my questions. In case you disagree, please consider the fact that I just spent more than an hour of my precious time complying with your organizations protocol for prescribing medication to my patient. I realize it is not possible for you to give me back my hour or to compensate me for it. However, I am requesting that you educate me about the purpose your organization serves. Forgive me, but somehow, in spite of my eight years of post-graduate education and 23 years of practicing medicine I am unable to figure it out.


Mitchell R. Weisberg, MD

Founder and CEO

Optimal Performance MD


2 Responses to “A Night in the life of a Physician and a “Patient Advocate””

  1. val0525 said

    I’ll be anxious to see if you receive a reply!!

  2. Howard felix said

    Nice post. The healthcare system in this country is so rattled with inefficiency it is truly scary. Perhaps some political or corporate
    honcho will take a bullet and yell and scream. I doubt it. Keep . your voice louder and louder. Just don’t get laryngitis because you may not be able to get appropriate medication

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