Background: Small community, two competing hospitals, have a PA for a PCP; type 2 for 14 years; controlled by diet, exercise, meds, (janumet and amaryl) additional medical problems, arthritis, bad knees, PTSD, +more;
I am a non-compliant patient for practical words, but in reality, I am one who does her homework and knows what I will do and what I won't do as far as health issues are concerned. Right now, my diabetes is the least of my concerns, because here in SD I am considered a controlled diabetic. However, my PA is at a new hospital and they like to have you use all their testing ideas to the hilt, So she now wants me to travel 200 miles (about $200) to see a neuro-surgeon about some discs in my neck. I don't have that kind of $$ to do. We have several orthos who can and will see me about the discs and manage that care, however, they are not connected directly with the clinic I go to…they have their own clinic. She also wants to order several invasive tests which I have said "NO" to and she keeps on me. I understand and accept that it is her responsibility to do this, suggest this avenue to go down, but I have five major health concerns on my plate now, and these tests and trips are causing great stress in my family. We have no $$, no vehicle that will take a road trip like this, and quite frankly don't understand why I can't see the docs in town until they determine there is nothing they can do,. SO…what do I do? There are few docs in our are, this is a great hospital, good diabetic department, she's a good doc, just can't accept NO as an answer. What do I do?
Excessive treatment by buddy specialists and unnecessary tests are the basis of medical "billing mills".
In my life as a diabetic I have run across such billing mills several times.
I think as diabetics, we are both more susceptible to being trapped in such mills, and also more aware (because we have more experience with standards of care) when the threat of "see my buddy for unnecessary visits and a test" is being used on us.
Good points. Thanks, I guess as assertive as I think I am , I'd better be more so,
I think I get what you are saying, Tim. This PA doesn't know the doc, they are just part of the same system, When I live in a small town, with few docs that aren't affiliated with one or the other hospital, you kinda have to play that game...just to keep being seen. I was once "fired" by a physician because she and I didn't see eye to eye and I wouldn't bend over and kiss her you know what,,...and then I got a letter from the Mgr of the clinic when I asked to see another doc at the same place, who knows diabetes from education and his own experience, that I wouldn't be seen by anyone in that clinic...so location is part of the problem, also. I don't have a whole lot of choices,
That is really tough given the picture of your circumstances, location, dollars and choices.
I as a fault usually try to be most diplomatic so as not to raise emotional anger or reduce options. That said, I find myself in your shoes about being assertive enough. Some folks do not take hints easily and properly read the cue cards. Best wishes and keep pushing back carefully.
If the disc issues aren't life threatening and the doctor isn't a specialist who really would be needed just explain to her that you can't afford it and will be seeing a good doctor in your area. Most of those types of problems should be treated conservatively with pt, pt at home, pain meds etc.
In addition taking a 200 mile trip for something that can be treated at home is crazy.. it will cause more stress and more problems with your neck etc. most likely.
I also think a doctor who tries to pressure you to go to another fellow doc friend in this way is suspect in some way to be honest.
You sound like my husband and I debating the issue. The trip itself and driving that long would be horrible for my neck, even if things were rich....with all the bumping around even with a collar would be horrible; not to mention stressful causing BG numbers to go up,.GRRRRR. In defense of the PA, she doesn't "know" this doc either, only that he is a neuro-surgeon within their clinic system. Yet, still, for the best of her patient, I would believe that IF I say we can't afford a trip, WE CANT AFFORD IT,,,,for now we sit and bide our time...PT goes well, my pt has talked with the docs here, and surprisingly the doc out of town called her to check what we are doing (without seeing me in person) and we are doing the right things.,,.,. Just going to ignore PA for the time being on this one,
Ah....what memories your post brought back. I've experienced the same billing scam many times & in a bad economy, it's much more frequent. The first time was back when I was diagnosed T2. I was sent home after 90 minutes in the ER, during which time I received two insulin shots & a doctor actually stuck his head in the room, said "You're diabetic" & left. I paid the $2,500.00 bill in full, got my "Paid in Full" stamped receipt & left.
A few days later, I started receiving bills for $1,500.00 from other medical facilities 100 miles away (which I'd never been to). I phoned to ask about them & was told: "We sent your charts to four other doctors for evaluation & they have to be paid." After I stopped laughing, I said "You should have sent my charts to 100 other doctors; think of how much you could have charged." Then I said, "I didn't authorize you to send my charts to any other doctors; you're just trying to rip me off. Take me to court & best of luck collecting." They gave up.
Then, I tried to make an appointment for an eye exam. (Cash patient, no ins.) The first doctor I called said, "I will do an eye exam, then I'll send you to a "Retina Specialist." Yeah....great....so your & your golfing buddy can each make $1,000.00. I ended up having a complete eye exam including a retina photo for $150.00.
I think some doctors are worse than plumbers.
good idea, just keep doing the pt and try to keep as stress free as possible.. you will feel much better that way... most of these things get better on their own in time or at least improve... my new ortho wanted me to do tons of things.. I just did pt for a while, it didn't help as much this time and then I stopped and had started taking arnica.. I'm just back to my normal as far as my neck is concerned which is good.
Lol... wow.. that is hard to believe.. you should have reported them. When I was in the hospital last year, two doctors who actually did see me at some point billed around $800 or more each. Because they weren't on my insurance plan, the insurance didn't want to cover it. When I had figured out who they were, one I was never really sure of, I couldn't believe it. One doc came into my icu room and told me I had to worry about my feet- he was there for about 3 minutes! I looked at him like he was crazy and said I'm more worried about other things at the moment- I was still in dka. In the end I won- I told the insurance that I had no choice who treated me while I was in two separate life threatening conditions, they agreed and only partially covered the ridiculous fees.
That's exactly what my diabetic coach told me today, my stress level is WAY too high.....that doesn't help the numbers either...do what I can, and what I can't do now, hopefully isn't life threatening and can wait. Have you ever just wanted to scream, LEAVE ME ALONE?
yes, I have and I basically did that in the icu when they wanted to try for the 3rd time to put a new iv line in me- they left... that caused one of my blood clots in my arm too. just remember that you are in charge here, not them.. a lot of these people may mean well, but they aren't looking logically at what would be best for you, so you and your hubby and fortunately your dc have to do that together.... :)
I think they would make it clear if it were really life threatening- not sure what is wrong but they recently told me I have disc problems too, I had three different injuries, but I feel a lot better now and I plan to keep doing the things I have been doing- keep active, moist heat, tens etc. pain killers when needed.. and some lidocaine patches which I got last year- these are great for acute pain phases etc.
Yup, had a stroke and when in hospital was like a shark feeding frenzy.
Hey he has good insurance; we will send in all our consultant buddies.
It really is a nasty situation. I was fighting off bills for weeks.
That's why I question everything that she requests...even if it would be good for me to do. This hospital is growing in our area, and in the state in general...so they are buying newest equipment all the time, and of course, we have to try it out. It makes me wonder and question if sometimes they encourage docs (anywhere not just here) that we have this new machine, and we need to pay for it, so send all your patients for the tests....hate to think that way, but sometimes I wonder