July 23, 2021

But, Doctor, fair is fair, right?

By John Guy LaPlante

I’m getting set for my appointment with a new M.D. and planning to make an unusual demand.

One unnheard of.  I’ll bet he’ll think it awful, preposterous, insulting .  So  be it. I’m tired of the way doctors are running  their business. Hear me out and  you’ll feel the same way.

Yes, I’m a new patient. And so his office has told me to bring in my Medicare card plus the card of my secondary insurer if any, plus my list of meds and if possible the actual meds, plus my co-pay. I’m familiar with this. No problem.

I’ll be handed a questionnaire. I will write in my name, address, phone number, email address, date of birth, gender, race, next of kin and contact info, and my complaint(s). No problem.

I’ll be told that if his service is not fully covered, payment  will be expected immediately. Otherwise other arrangements must be made. Also that if my insurer declines payment, I will be responsible.

I’ll be confronted with many questions and I’ll be expected to answer them. Past medical complaints, surgeries, hospitalizations, etc.  Including potentially embarrassing ones – HIV, addictions, psychiatric problems, and for womenfolk, I wouldn’t be surprised, abortions,.

No surprise in this. I will reply fully. I understand all this is important, even essential.

(By the way, I’ve read in the New York Times that some doctors are now asking your sexuality–straight, gay, lesbian, bisexual, or trans-gender. News to you?)

Then, my turn! I will submit a questionnaire of my own! This will be my standard operating procedure from now on for Sir or Madame Doctor to fill out. As we know, more and more physicians are women.  My request will be met with surprise. Maybe indignation. Not laughter, I’m sure. Maybe shock. I’ll shrug this off. What I’m asking for is reasonable. And in fact overdue.

Here is my questionnaire..

Attending M.D.’s Professional Profile

Name _____________________   Place of birth __________  Age ___

Years of Practice as M.D. ____  As specialist ____

Medical School _________________  Location __________ Year of graduation  ______

      Internship   _________________________    When _____

      Residency   __________________________  When _____

      Post-doc      __________________________  When _____

Are you licensed to practice in any other state, or have been?  No ___ Yes ___

Hospitals where you have attending privileges:




     Specialty Certifications beyond the M.D.




Are all of these current?   Yes ____     No  ____

If no, why not?  ___________________________

Are you self-employed?   Yes ____    No _____

If no, who is your employer? _______________________

Do you have Malpractice Insurance?  No  ___   Yes __

 Provider(s) of your Malpractice Insurance

       ____________________    Address ________________________

       _____________________   Address ________________________

Has any Insurer ever canceled you?   No ____     Yes __

If yes, why?  ___________________________


Upon request, do you supply a list of your standard fees for your various services, especially for the non-insured?  __________

Do you have different prices for insured and non-insured patients?  _________

Do you sometimes provide charity (free) services?   ________

Do you own in whole or in part any treatment center, laboratory, pharmacy, diagnosis center (for CAT Scans or other), physical therapy center, eye vision center, or other complementary or supportive service?  No ___   Yes ___

If yes, name  ­­­­_______________  Address   ______________________       

            Name _______________  Address _____________________

Have you ever accepted money or a gift in any form, including a trip or stay or vacation, in appreciation for a patient referral?  No ___   Yes ____

Or for prescribing certain medications?   No ____   Yes ___

Has a patient ever filed a complaint to a hospital in which you have  treated him or her?  

No ___    Yes ___ How many times _____

If yes, what was its or their disposition?

     Absolved  Yes   ____

     Warning   Yes ____

      Fine  Yes __

      Suspension Yes   ____

(Note: For the following, if necessary list your replies on a separate sheet)

Have you ever been sued?  No ___    Yes ___    How many times ____

If yes, disposition ____________________________


Has a complaint ever been filed to any other entity, such as your State Registry of Physicians and Surgeons?  No ___  Yes __

Where ____________________________

Have your privileges ever been suspended?   No __    Yes ___

If yes, please explain  ______________________________________________

Have you ever been treated for substance abuse or a psychiatric diagnosis? No ___    Yes ___

If yes, institution ______________________________

Any treatment / program currently underway?   No ___   Yes ___

Where __________________________________

In any surgeries or other procedures of any kind in which you are the principal, do you complete them from start to finish or get assistance from another professional, to “start” or “close” or do whatever? 

No ___    Yes ____

Of course, your candor is expected. If falsehood is discovered, be aware you risk a legal suit.

This questionnaire is respectfully submitted to you because my health and even my life may be at stake. A favorable report from you will be re-assuring.

In this way you, through the questionnaire I have filled out, and I, through this questionnaire you will now fill out, will know one another better and will be prepared to move forward confidently.

And Doctor, fair is fair, right?

Take three days to process this if necessary.  You may email it to me at johnguylaplante@yahoo.com.  Or johnguylaplante@gmail.com  

Thank you.Oh, one more question.  Does your waiting room supply magazines beyond WebMed and the AARP magazine? And do you automatically cull the older ones after the three latest issues? ___________________

Do you make the daily newspaper available?  _________________

Your signature __ ______________________  Date ____

~ ~ ~ ~

Dear reader, your suggestions for additional pertinent questions are welcome.

Truth is, I’m nervous about this. I’d feel better if some of you did the same with your doctors.  As we know, there is strength in numbers.

What do you think of starting up a new group to push this — the American Association of Progressive Patients?  The AAPP. Hey, sounds good, don’t you think?

 ~ ~ ~~





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