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Duke hospital is excellent for many things but friends and family have had good and bad experiences there. Are you considering a doctor or practice at Duke Health as your primary care provider?
Mixed bag. They saved my daughters life, but (literally) made mistakes that almost killed her later.
My take, they are great in an urgent care situation, but the bureaucracy of a big hospital is an issue once it comes to maintaining and recovery. Pretty much the same in any hospital these days, due to the way our medical system is in the USA.
As for billing: One appointment might get five or more different insurance codes, so instead of paying the co-pay ($20, $50, what4ever), you end up paying a bunch of deductables. I get free preventative blood draws in my insurance, but if they do one draw at duke, it litterally costs me $500 or more, so I have them write the orders, and go somewhere else.
If I see a specialist, I pay my $50 to see him, but then a get a bill from the clinic, and another bill from the hospital. So my 20 minute visit usually costs several hundred dollars.
I've gotten collection calls from bills that were not even due yet.
I've gotten bills that were not settled with insurance, causing me to have to file for refunds.
As for daily care, after the emergency. Make sure you know EVERY medicine and procedure before it happens. Make sure you know why, and are convinced it's needed. (Example: They tried to give my 1-week old daughter the max dose of Morphine for pain management, but neglected to take into account that she was there for pulmonary issues. That much morphine might have killed her. I had a huge issue with the 3AM doctor. I stood my ground, and when the attending came in, he sided with me, reduced the dosage, and all was well.) I could give you a hundred examples like that, but rather than get upset, I just remained involved, asked a lot of questions, and considered them part of the same team I was on, with the goal of getting my daughter well. That was 18+ years ago, she is relatively healthy now.
Just stay involved, stay aware, and make dang sure the patient ALWAYS has someone from the family there to advocate for them.
Most of my experience is with Duke Eye Center and Duke Hospital (5th and 9th floors). I cant really speak about any of the individual clinics around the triangle because I imagine each of those would need to be evaluated essentially as separate units from the others.
I believe we've received top-rate care and I have very few complaints.
That said, when you go to one of the above sites on the main medical campus off Erwin Rd, prepare for:
1) Lots of nurses and interns and med students and residents asking you the same questions over and over again. It's a teaching hospital so you have to go through this drill often. My advice is just to get used to it and know that you are helping train the future. Take your patience pills before you go -- it will never be quick visit.
2) The medical staff is great, generally speaking. The dropoff occurs with the scheduling and billing folks.
My family's own experience has been good. I have heard many good anecdotes and a few bad ones. Like any large institution there is variability in quality and there is bureaucracy. Buyer beware.
Have generally had a good experience and love the computerized records plus ability to message a doctor.
Have had some ridiculous experiences with incorrect medical records, and one recent terrible experience with a PA who ordered a lab test that was not necessary, without my knowledge, determined by my insurance to be experimental and they rejected it twice. I refused to pay, and I guess Duke knew the PA was in error, because I no longer had to pay for it.
It's such a large system that I think communication among staff is not always what it needs to be. But the actual care I've gotten from providers (except the PA mentioned above) has been excellent.
If I see a specialist, I pay my $50 to see him, but then a get a bill from the clinic, and another bill from the hospital. So my 20 minute visit usually costs several hundred dollars.
Between DH and I (with a $5K deductible on my individual insurance), we've seen at least 12 different specialists in the last 5 years. Unless there was surgery, biopsies or tests involved, this has not happened to us EVER. The bill is for the doctor's time only.
DH has had major surgery 3X in those five years. All went very smoothly and with great results - but the food is ****-poor and the parking at the main hospital is awful.
ER rooms - three visits, two at Duke Raleigh Hospital Wake Forest, the other at Duke Main in Durham. The two at Duke Raleigh were pretty awful and I was totally unimpressed. The one at Duke Main was totally outstanding (except for the $4995 bill I received for 2.5 hours of care).
People should realize that different health care systems have different strengths and weaknesses. IMO Duke has a weak dermatology and skin cancer dept - we go to UNC for those. Carpal Tunnel surgery - DH's great ortho doctor does that surgery, but we took him to Raleigh Hand instead. Got brain cancer? One of the best places in the world for that is Duke. Got a serious autoimmune disease? You might be better elsewhere.
Primary doctors - a mixed bag. And finding one that is taking new patients (especially with DH's Medicare) isn't always an easy trick. but I LOVE the online system for making appts, getting Rx renewed, asking questions, etc.
As for their billing dept. - They are truly awful. And with that huge deductible that I have, pay virtually 100% of the bills out of pocket. So - trust me. I scrutinize the crap out out of those things, and find them to be confusing and wrong A LOT (especially those billings codes.) I've found that all hospital billings systems suck, but Duke's is the worst of the bunch.
Between DH and I (with a $5K deductible on my individual insurance), we've seen at least 12 different specialists in the last 5 years. Unless there was surgery, biopsies or tests involved, this has not happened to us EVER. The bill is for the doctor's time only.
DH has had major surgery 3X in those five years. All went very smoothly and with great results - but the food is ****-poor and the parking at the main hospital is awful.
ER rooms - three visits, two at Duke Raleigh Hospital Wake Forest, the other at Duke Main in Durham. The two at Duke Raleigh were pretty awful and I was totally unimpressed. The one at Duke Main was totally outstanding (except for the $4995 bill I received for 2.5 hours of care).
People should realize that different health care systems have different strengths and weaknesses. IMO Duke has a weak dermatology and skin cancer dept - we go to UNC for those. Carpal Tunnel surgery - DH's great ortho doctor does that surgery, but we took him to Raleigh Hand instead. Got brain cancer? One of the best places in the world for that is Duke. Got a serious autoimmune disease? You might be better elsewhere.
Primary doctors - a mixed bag. And finding one that is taking new patients (especially with DH's Medicare) isn't always an easy trick. but I LOVE the online system for making appts, getting Rx renewed, asking questions, etc.
As for their billing dept. - They are truly awful. And with that huge deductible that I have, pay virtually 100% of the bills out of pocket. So - trust me. I scrutinize the crap out out of those things, and find them to be confusing and wrong A LOT (especially those billings codes.) I've found that all hospital billings systems suck, but Duke's is the worst of the bunch.
This all has to do with how the bill was "coded" for insurance. We use UHC, which is a major provider, so I assume it is not too different from others. But even just the plebotomy clinic at duke is out of network, so we either pay $50 for every single test they run (with one draw), or we go to a LabCorp facility, walk in, get drawn, walk out (no bill) and they send the results to Duke.
As for the part of mine you quoted, that is odd. Duke Doctors have always done this. I've even had a few say THEY hate it. I pay my copay to see them (usually $50, for a specialist), but the one's I have seen are all on Duke main campus. Each person that talks to us has their own code so that is it's own deductable or copay. If you run a lab (example: Breathing tests for our Pulmonary patient), they charge you the deductable for that "in patient service". No getting around it. I had the same experience seeing an endochrinologist there. One bill from him, another from the clinic. One was a copay, the other was a deductable. Cost me hundreds of dollars.
Not blaming Duke, just giving the OP things to consider, and watch out for. Better to know (and check) up front.
I'm baffled if you can go to a clinic, see multiple professionals (Doctor, PT, etc...), and get out for $50. Baffled.
To me, Duke is a place when you go when you need specialized/advanced care vs "normal" hospital visits. I was there for major surgery a couple years back. The staff, care and overall experience was phenomenal. The one thing I found curious was they still had 1970s type meal service, where the cart came by at certain time and you got what was on it. You did get to choose, but that was the night before, for your meals the next day. Compare that to Rex, where you had a menu in the room, picked up the phone and ~45 minutes later, you had your meal. Of course, I did not go to Duke for meal service!
I go to a Duke-affiliated gynecologist, but for primary care I was told that no one is taking new patients but nurse practitioners, PAs, and residents. Now I have no issues with NPs and PAs, but my insurance won't cover them for primary care. And I'd prefer to not have residents as primary care. So I ended up with a great PCP affiliated with UNC and the rest of my care (endocrinology) seems to have defaulted to there.
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