Imagine you call a heating and air conditioning contractor because you wake up in the morning and your furnace isn't working- and they take you through the following process:
1. The technician shows up at your house, and before they even touch your furnace they have you fill out a form:
-do you have furnace insurance?
-how will you be paying for your furnace repair?
-please give the phone number of someone to call in case they blow up your house while working on your furnace...
2. Have you sit alone in a room (naked?) for 20 minutes while they look at someone else's furnce during your turn
3. have the helper turn on your furnace, ask you questions about how you use it, and then turn it back off again
4. finally the master HVAC mechanic comes in, turns your furnace back on, taps on the ductwork, and then schedules you with another HVAC contractor "specialist" to determine through testing that it is in fact the furnace. (your mechanic is a furnace repair guy- but not this particular model.)
5. schedule you for a procedure based on the specialist's recommendation, where they tear out furnace, send to lab for testing, tell you to come back in a month.
6. meet with you for a paid consult to talk about the results of the test for your broken furnace
7. schedule replacement (1-2 months out)
8. charge you for the furnace, the 4-5 people who help me load it, ship it, install it, and turn it on (each segment of the process requires a specialist.)
9. sequester your house for 2-3 days for observation.
10. release your house and place it on "light duty" for 3-6 weeks
11. schedule you for a follow-up consultation
12. be sure to let you know that this isn't going to fix everything, you still can only use your furnace 50% of the time- so you have to decide whether to be cold at night or during the day.
10.On a future visit, realize that it wasn't the furnace in the first place, and place you on a routine schedule for tests, "furnace therapy" and "maintenance" You may never have 100% use of your furnace ever again.
13. schedule more testing of all of your electrical systems, plumbing, and other appliances just in case...
I know this is obviously ridiculous, but it points out how lax doctors have gotten about ordering tests and referring specialists at a thousand dollars a clip. My wife recently tried to turn down a bank of tests during a prenatal visit and they told her she had to do it. I just think medical costs would go down if more people questioned the validity and the actual need for some of the procedures and charges they incur- and I wonder if universal healthcare will just make it easier for doctors to be lazy with diagnosis and specialist referrals.
I mean, we have a popular TV show with a rather formulaic premise- the doctor orders a bank of expensive tests, and then we're expected to believe he's a genius when he has an epiphany while jogging...
I obviously don't think that fixing a furnace is anywhere near what it takes to perform open heart surgery- but I do believe that basic troubleshooting procedures are universal. The only thing that changes is the complexity of the flow chart. It's just that every once in a while, I perform service on a highly complicated piece of equipment, and sometimes I have a difficult time figuring out what is wrong. I get this look on my face when I'm not sure what I'm doing.It amazes me how often doctors get the same look on their face when I see them at work.
I've actually had to give back money, or not charge for services when I find that my original diagnosis was wrong. My conscience always bugs me- I picture myself on Dateline, or on some other hidden camera show. "This contractor told us that x part needed to be replaced, and then tried to charge us additional money when he discovered that it was actually y part that needed to be replaced."
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