Context is everything, so you’re going to have to endure some history here.

Twenty or so years ago, some dimwitted employee of my soon-to-be-former health care provider stapled both copies of my “abnormal mammogram” report into my patient record rather than sending my copy to me. It took more than a year for the error to surface. Once that happened, it made for several very scary days while we waited for a needle biopsy appointment and eventually for the results–which were benign, by the way. Yay!

In the meantime, Bill, my husband, remembered reading a recent Wall Street Journal article about a guy from Seattle named Garrison Bliss who, fed up with fighting insurance companies’ billing practices, was in the process of starting a concierge medical practice, one that worked on a fee for service only with no insurance involvement at all. It turns out that years earlier, Garrison Bliss had been one of my clients back in my life insurance days. (If he had bought more insurance, maybe I wouldn’t have needed to become a writer!)

So, even though I wasn’t one of Garrison’s patients at the time, I called his office, and poured out my tale of woe. After being told he was on vacation in Hawaii, I left a message. He called me back. Immediately. That very day. And when those initial biopsy results came back, he offered to send them to someone else for a second opinion. Needless to say, we signed up with his practice a short time later.

That first practice was a Cadillac medical experience. You called and got an appointment–t day. If we were on a book tour in Georgia and needed meds fast, the call got made to a pharmacy near us. And when I mistakenly gave Bill my meds for the day along with my knock-out dosage of blood thinners, we heard back from the triage nurse in a hurry. (By the way, that would have made for a terrific 48 Hours Mystery: Mystery writer’s husband poisoned by an overdose of blood thinners. I’m the one who sorts the pills. My fingerprints were the only ones that would have been present on the remaining pills.) In case you’re interested, the treatment involved a prescription of Vitamin K and the administration of a Costco sized-package of fresh spinach.

But back to Garrison Bliss. He’s a funny, fun, and caring guy who happens to be a brilliant diagnostician. I went in for an annual physical one time and burst into tears because I thought my mother was developing Alzheimer’s. He asked several probing questions about my mother and about her having seen “all those cute little calves” in the yard next door. When I finished, he suggested that it was more likely she was hallucinating due to some kind of adverse prescription interaction. (Remember what happened to Diana Ladd in Queen of the Night? Garrison suggested that someone take all my mother’s meds to her pharmacist. When my sister did that and the meds were adjusted, those pesky calves disappeared completely. In other words, Garrison fixed my mother from 1800 miles away and without having ever met her.

But he’s also a visionary. Wanting to bring the same kind of hassle-free Cadillac medical care to the masses, he left that original practice and launched a new medical enterprise called Qliance. When we followed him there, Qliance was a one clinic proposition. Now it has clinics scattered throughout the Seattle/Tacoma/Eastside area.

Qliance is affordable. As “senior citizens,” Bill and I pay $1700 a piece on an annual basis. This covers all of our basic care–annual physicals, X-rays as necessary, same day service, flu shots, consults as needed. But when complications arise that call for some further, insurance-covered treatments, Qliance gets you in to see top-drawer specialists immediately. DVTs anyone? When Garrison suspected there was a blood-clot in my lower calf, (not related to the ones my mother saw) we were out to see the vascular specialists and back in Garrison’s office with someone teaching Bill how to give injections of Lovenox so fast it made my head spin. When Bill needed knee replacement surgery, he got sent to the best guy (in MY opinion) at Swedish–Dr. Merritt Auld. (By the way, in case you’re wondering, he’s the same guy who did Beau’s knee replacements.)

As Senior Citizens, Bill and I pay for Medicare Advantage through a company whose name starts with an H. but which, for the purposes of this blog, will remain anonymous. We pay a lot more for that than we pay for Dr. Bliss, even though we use his services far more often than we do anyone else’s. Qliance is where we went for a steroid shot for my bursitis. It’s where Bill’s sudden case of deafness was miraculously cured by having an astounding amount of wax removed from his ears. We walked in, had the work done, and walked out again. There was no paperwork to sign. No co-insurance to pay. No waiting around for an appointment. We simply got it done.

I am not a fan of Obamacare. I’m offended by the I.R.S. (of the missing e-mails) being involved in whether or not I have insurance and fining me if I don’t. And if there was a comic book sent out explaining all this, I didn’t read it.

My first personal intimation of trouble concerning Obamacare happened a year or so ago when a young woman called me from a doctor’s office in Kirkland–a doctor I had never heard of, by the way–telling me that he was my new personal physician and when did I want to come in for my annual physical. EXCUSE ME??? It turns out that H. had assigned me to him based on my ZIP-code proximity. I told the young woman that I had a perfectly good doctor and had already had my annual physical. But it turns out that since, Qliance “doesn’t do insurance,” H. has decreed that Garrison Bliss doesn’t exist.

Great. Are the words, “If you like your doctor, you can keep your doctor,” getting any traction here?

Those of you who follow this blog, know that I had another needle biopsy a few weeks ago. Again the results were benign, but this past week I received a call from H.–a robocall–which was supposedly all about my recent medical experience. After first making sure this was Judith Janice (Computer-generated voices don’t generally do pronunciation very well!) she launched off into a full round of questioning under the guise of conducting a survey: Had I been able to get an appointment to see my doctor immediately? The allowable answers were yes or no. The answer was “YES,” but not because my doctor was one of H’s approved doctors. When I arrived at the appointment, did I have to wait 15 minutes or more? No, but my appointment wasn’t at the doctor’s office in Kirkland. I have no idea how long THAT would have taken, but I can tell you straight out that I have never waited longer than fifteen minutes for an appointment at Qliance.

As the questioning continued, it was clear that the computer had no idea that I had gone in for a needle biopsy. She asked if I had fallen recently. I lied and told her NO. My amazing flying human act in Venice was NONE of her business! Then she asked me if my doctor had discussed the dangers of falling. After a biopsy? Really???? And then she asked if my doctor had discussed bladder control. For a needle biopsy! You’ve got to be kidding!!! Don’t waste my TIME!!!

That’s when I hung up. Fortunately none of the grandchildren were within hearing distance at the time. With all the steam coming out of my ears, even Bella was a bit concerned as the air turned blue around her.

So here’s what I’m asking. Does this kind of bladder-control indignity happen to everyone “of a certain age” who goes in for any kind of medical treatment? If so, I guess I’ll be booking my deck chair on the nearest ice floe sometime soon.

And the next time I get a phone call from H., I won’t be answering.

Let’s just call it doing my part to reduce the dangers of global warming.
PS: I passed this post by Garrison for general accuracy. If you’re in the Seattle area and interested in knowing more about Qliance, this is what he said:

Qliance offers many of the same services offered by other doctors and nurse practitioners to the public for $59-$99 per month (priced by age, not by sickliness) for access 7 days a week to office visits and 24/7/365 by phone to a physician with access to your record even if your provider is not currently available. We also are now working with large numbers of Medicaid patients and in the exchanges to improve the access and quality of care while reducing the cost of care for all of our patients, even those with few or no resources of their own.