Nurse Care Lines: Wait a minute, I Thought You Were the Expert?

My Blue Cross Blue Shield of Massachusetts card has a “Blue Care Line” phone number on the back. I’d never used it until recently but in the past couple weeks have had the occasion to call it twice. It’s a good service, which connects fairly quickly to an RN, who then uses a protocol driven system to help identify whether the patient needs to go to an ER, doctor’s office, or can perform self-care. I found it more convenient and systematic than calling the PCP’s office, and more considerate than calling my physician relatives and friends. And of course it’s easier and cheaper than heading to the emergency room.

I don’t know whether they still refer to these lines as “demand management,” but in the 1990s when co-pays were $5 the sales pitch to health plans was that they’d be useful in keeping medical costs down. The hard numbers were never there to prove it (maybe that’s changed) but it made enough intuitive sense that customers and acquirers bought into the notion.

Anyway, I got a chuckle out of one of the first questions that was asked both times: ‘What would you have done if you didn’t have access to this number?’ I assume the intent is to get an overall gauge of the patient’s perception of the seriousness of the injury or illness, but maybe they are trying to measure the cost savings of the service or just get a better window into consumer behavior. Whatever the case, it felt like a weird question. (It awakened memories of the old Eliza artificial intelligence system that more or less parroted back what was typed in.)

If I need to use the line again, maybe I’ll ask why they want to know what I would have done and how my answer influences the rest of the call and the ultimate recommendation.