Battle of the Ask-a-Nurses

The battle of the Ask-a-Nurses. Or: Insurance companies are fighting back.

When I lived in ND, the big hospital & clinic conglomerate, Meritcare (for which, by the way, I have the greatest respect in terms of quality of health care) had a free ask-a-nurse line. You could phone a toll-free number, night or day, 365 days a year, and speak to a nurse if you had a health question. The problem was that the answer to your question was nearly always to advise you to come in and see a doctor. Sometimes a very narrowly-focused and carefully worded question could get you a useful answer, but most often they just told you to see a doctor.

It recently came to my attention that here in WA, my health insurance company (Lifewise) also has an ask-a-nurse line, and when I phoned to ask for advice regarding some discomfort in my throat when swallowing, I actually got useful information: after determining that I had no fever and the symptom was less than a day old, the nurse advised me to wait, as a doctor would most likely just send me home. She told me to see a doctor if it persisted for 48 hours or I developed a fever or other symptoms.

Here's my take. Maybe this is obvious:

The nurses working for the hospital were instructed to tell everyone to see a doctor, because the hospital makes money when you make an office visit. The nurses working for the insurance company were willing to tell you when your symptom did not warrant an office call, because the insurance company makes money when you refrain from seeing a doctor.

It's nice to have some balance. And for a hypochondriac like me, it's useful to be able to get advice other than just "Come right in."

 

I don't actually know where the nurses are located, or what if any priorities they have. I just thought it interesting that the Meritcare nurses always advised me to come in, regardless of my complaint, and the Lifewise nurse advised me not to.

When I have a question that I feel requires a more specific knowledge of my situation, I call my doctor's clinic and ask to speak to his nurse, who relays my question to him and then calls me back. But that process often takes a day or two: She may or may not return my call the same day I call her, and it's usually another day before she gets back to me with an answer.

I was half-joking in my original post. But only half. My experience of doctors is that they want to provide the best care they can. But hospitals are usually businesses that want to generate revenue. And insurance companies also want to make money. Hospitals make money by getting people in; insurance companies make money by keeping people out.

 

I have had surgery three times. I have the highest regard and respect for the nurses who tended me after my surgeries. They were, without exception, wonderful, caring, and extremely competent people. But then both Fargo and Spokane have that small-town quality where people care about each other, and I was at expensive hospitals.

Nurses are, without a doubt, the best people on the planet.