Unethical endo behavior?

I’m going to try to keep this short, but it will still end up being long, so I apologize in advance.

I moved to a small Texas town a year ago. The closest endo is 2 1/2 hours away, so that’s where I’ve been going. At my first visit, his nurse was very concerned that I’m on Animas & Dexcom because they only do Minimed. I think she was on the verge of telling me I would have to switch if I wanted to see this doctor. (I’ve been on a pump for 14 years - 12 with MM, 2 with Animas & I am not going back to MM.) She informed me that if he didn’t want to treat me, they should be able to get me in to another one of the in-town endo’s, since it wasn’t as if I were non-compliant. According to her, the endo’s are a tightly-knit group & will refuse to treat a patient that another doctor is refusing to treat.

Once I was in to see the doctor, my fears were quelled. He was not at all concerned about the pump - primarily, he said, because I’ve been T1 for so long (31 of my 37 years). I was also very impressed with him. Altho he left a little to be desired in the personality department, he conscientiously typed notes in the whole time we talked - which was probably close to 2 hours. At the end of the visit, I received a copy of the notes & a few days later, my blood test results, including notes that he had made when he reviewed them. Very thorough!

My second visit was much different. It was still a lengthy visit, he still typed up all the notes, but talked over the top of me when I tried to ask questions, to the point that I just gave up. I was very disappointed, after spending 5 hours in the car, & began to rethink my decision to see him. However, I had talked with him about switching to Omnipod & he seemed amenable to it, so I figured I would give him the benefit of the doubt. Maybe he was having a bad day.

When I called the office to get the official go ahead for the Pod, his nurse was once again very concerned that this wasn’t MM. For the sake of brevity, suffice to say that I really had to jump thru hoops to make this happen. They finally agreed, stipulating that I had to complete the training in their office, so they could go thru the training at the same time (according to the Omnipod rep & trainer, the office had already received training).

A month after receiving the Pod, I went to the training. The nurse checked my blood sugar & I went thru the training process. His nurse & one other wandered in & out, but never stayed long enough to receive training. As I stood up to leave, the nurse stopped me so the doctor could come in. He came in, said hello, asked the Omnipod trainer if all the settings were the same as my old pump & left.

Two weeks later, I received a statement from my insurance company. His office billed them $110 for an office visit, $85 of which I am responsible for. I do not consider the training session to have been an “office visit,” as I did not “see” the doctor. His office manager was extremely unhelpful when I explained the situation, saying, among other things, that the doctor had to speak with the Omnipod reps before & after my training. She said she would mention my concern and “we’ll see where it goes” when I asked if I could expect a call back.

So it would appear that I have to pay this bill or be blacklisted by the endos. Neither of those two options seem right to me, so I’ll be going with Option 3 - begin seeing a doctor 4 hours away. But I can’t help wondering: Am I overreacting? If not, isn’t there some governing medical body that might be interested in my complaints?

Thanks for reading my long-windedness!

Liz

Hi Liz- That sounds like the way my Endo visits started with my current Endo. He was very thorough at first, I felt like he was really lsitening to me… and then a year went by and now he hardly asks any questions. He ends up having me make my own decisions and doesn’t listen to my concerns anymore.

As far as the bill thing… I apologize, but I don’t know. I’ll take a look around, but I just wanted to pop in and say “Im sorry!” and give you a virtual hug.

I don’t know specifically about your insurance, but I know with mine, even a “nurse visit” is considered an office visit and I pay the same specialist co-pay. The only person I see in my endo’s office who I don’t pay a co-pay for is the dietician, and I’m not sure why but I think it has to do with how the visits are coded. I’ve paid my $50 co-pay for every visit with my CDE… which included my pump training/followup.

HOWEVER, since you were actually there to see the OMNIPOD trainer and not specifically someone from your doctor’s office, I’d fight this. Typically the cost of training is covered by the pump company when you use THEIR trainers.

That said though… is there a pressing reason you need to see an endo? I think if you could develop a relationship with a good GP or internist closer to you, there’s not truly a whole lot that you’d be losing… it’s not like you’re new to managing T1.

Its your money and your body. If you dont want to wear MM dont do it. If you like Animas then wear it. All pumps do basically the same thing. They give a small amount every few minutes to mimic your bodys own basal rate. Then when you eat you bolus, like your body does, to treat rising sugars.

The docs job is to review your sugars and help set rates… acciording to your patters(very hard if you have no pattern). What pump you wear should make no difference to them, unless they dont have the software to download it… or their getting kickbacks from comapnies…

It sounds more like you you talked to a medical assistant or secretary. Ive found most of them to be irritating at best. They just kinda weed out the BS so the doc doesnt have to deal with it. Working for an Endo doesnt make you one, or very smart either.

As for paying for training session. That a crock. You pay thousands of dollars for the pump. The teahing is included by the maker. Then the doctor or their CDE needs the training to, I would refuse to pay that. Actually I would charge them. Think tha would work?

I second Sarah and Carrp on the whole training thing being covered by OmniPod. I had one of the OmniPod reps come see me from 2 states over so that I could test out the demo w saline solution. And I wasn’t even a committed buyer! They didn’t charge me a thing.

Here’s my two cents:

  1. It sounds like the nurse is the one pushing MM. I wonder if she has “ulterior motives.”

  2. I bet your insurance company would be interested to learn that they were billed for an appointment with the doctor that never happened. Charging $110 for the use of their office space, when you could have done the training at home, is ridiculous. I would definitely pursue it from that angle.

  3. Some doctors are all about the money. I once made an appointment with a dermatologist to have a mole looked at. Since I was there, I wanted to talk to him about the fact that I was in my thirties and still breaking out with pimples. He took (literally) 30 seconds to tell me that the mole was fine. When I aksed him about the pimples, he said that I’d have to make another appointment to discuss it. I thought he was joking. He wasn’t. Jerk.

I hope you get some resolution for this issue.

Shannons right to. Medicine is a buiness. They only do one thing at a time and bill for everyting. It is expensive being a doctor. Renting office space and paying for 6-7 medical assistants probably cost 500K a year, but it is quite annoying being a piece of meat.

+1 i bet your insurance company would be interested in your doctors definition of a “visit” and you don’t need a endo that doesn’t listen to you. frind a good doc that will listen to you

My endo is the same way, very thorough, but bills for every little thing. When I got my pump from Animas, my endo told me that I had to go through the Georgia Center for Diabetes to have my pump training, well, I found out that they were going to charge me $625 for the pump start. Well, I called my endo and told him, nearly in tears, that I had just bought my pump in cash as I don’t have insurance and now I have to pay for the training??? You’ve got to be kidding me is what I told them. I called Animas and they were appalled. The pump rep that I had worked with had even worked in my endo’s office and had no idea that they charged at all for the training as it was the reps doing it! I had my pump training done the next day for free at my house. It was awesome. There would be no way in hell I’d pay for something like that especially when the pump companies provide that as a service.