for what are we paying?

my wife is required to get her blood thinning levels (known as an International Normalize Ratio; or an INR) checked every so often. She has been on Coumadin for six weeks now (with four and a half months to go, at least) and in the beginning her levels will fluctuate as the doctors try to pinpoint the correct dosage for her body chemistry and eating habits (certain foods can counteract the effectivity of Coumadin).

a therapeutic INR level is between 2.0 and 3.0 (where a 1.0 is "normal"). she has gone to the clinic weekly to get it checked out, and it's fluctuated rather wildly. it rose up to 3.7 three weeks ago, whereupon her dose was adjusted. it dropped the subsequent week to 2.4 (just about where she needs to be) and was told to come back in two weeks. being the vigilant and intelligent girl she is, she went back the next week (just last week) surmising that without an adjustment it is likely her INR had continued to plummet.
it had dropped to 2.0.
then, the doctor told her to come back in a month without adjusting her dosage! A MONTH! he obviously didn't review her chart, or the trend of her levels, or anything like that. anything BELOW a 2.0 and she is at risk to have another clot. jesus h. christ!

well, my vigilant and intelligent wife KNEW a month wasn't right as her levels had been steadily dropping, and who was to say it plateaued at 2.0? she went back this week to get it tested and lo and behold! it was at 1.6! well below the therapeutic level. if my wife wasn't vigilant and intelligent, she would've been walking around with an increased chance of having another thrombic episode, and we would've been through the same hell we just went through six weeks ago.

so, my question is this: what the hell are we paying this guy for, exactly?
insight? no.
concern? no.
expertise? no.
incomptence? apparently.
apathy? definitely!

i can tell you this, we will no longer be paying him a dime. we're looking for another clinic that can handle the workload; with doctors who care, understand trends, and with the time (or ethics) to do their job right.

and all of this now reminds me of a little joke:
Q. what do call a person who graduates last in his class in medical school?
A. doctor.

it appears we found ourselves such a guy.