How many chances should I give a “good” doctor?

February 7, 2014

Finding a good PCP* (primary care physician) is really hard. I need to find someone who is open-minded and respectful. They must consider my opinions and be willing to read the research I bring in. They must not dismiss my symptoms as unimportant. They must be willing to give me referrals to the doctors who are most likely to help my health, not just the ones their hospitals get the most money for. You’d think this would be the bare minimum to expect of any doctor but, sadly, that’s not the case. At least, that hasn’t been the case in my experience.

Last fall I thought I’d finally found the one. He seemed to meet my basic requirements and then some. I liked him a lot. We only had a get-to-know-you introduction meeting, but I liked him enough after that to think I could stop searching.

I hadn’t had my old PCP’s records sent over before my visit, just in case it didn’t work out. Why go to that bother for no reason, right? So after the appointment I had them sent. Also, after the appointment, thanks to a new system, I could see his notes online! This was awesome! Unfortunately, there were some mistakes. I might have let them go, but since I knew the Social Security Administration and also the private long term disability insurance would be requesting them to evaluate my condition, I wanted to make sure they were as accurate as possible. So I wrote a letter full of corrections that I wanted made and/or added to my file. Then at the beginning of January, I called and left a message to make sure the old records were received and my letter of corrections had been addressed. I didn’t hear back.

Three weeks later I called again. I was told it was very unusual that he wouldn’t have called back. I left another message. She said that she would mark it urgent so that I’d hear back right away.

That was two weeks ago.

I called today and left another message. I made it clear that I was getting ready to look for a new doctor. The receptionist stressed that this never happens, that he always calls back. Regardless, he hasn’t called me back. I’m feeling so torn. I really like this guy. Medically, I think this is the way to go. But if he can’t return calls, even if the matter isn’t urgent, then what good is he? What happens if the disability insurance company asks him to fill out a form and he never does it? What happens if I call about something that really is important? Then what?

I think this will be the last chance. Today is Friday, and the office is closed over the weekend. But if I don’t hear from him next week, then I’ll have to look for a new doctor. I hate to do that. I liked this guy, I really really liked him. And looking for doctors sucks. But my health is too important to take these chances. I just hope that this time he calls.

*For those not familiar with HMOs, the PCP is the gateway doctor. Insurance will not pay for any specialists unless I have a referral from a PCP, so it’s vitally important that I get someone fantastic.

6 Comments | Decisions, Expectations, Frustration, Healthcare, Rants | Permalink
Posted by chronicrants

Some things I wish were covered by health insurance

January 28, 2014

I look at the many, many medical thing I pay for that aren’t covered by insurance, and I wonder why they aren’t covered. I would think that most of these would be cost-effective for the insurance company. I won’t go into the financial aspects now, but I just want to mention a few of the things that I think should be covered. Please add your own in the comments!

  • Supplements. If prescription medications are covered with a copay, why aren’t supplements? My doctors all want me to take multivitamins, vitamin D, calcium, and others. They tell me to. Yet the supplements aren’t covered.
  • Massage therapy. Ok, I found out yesterday that it’s covered, but only if I get a prescription for physical therapy, find a physical therapist who does massage therapy, and get it billed as a physical therapy session. And it counts as part of my physical therapy sessions for the year, which aren’t unlimited, so that means I’ll get fewer other physical therapy sessions. But I think it’s necessary. It’s expensive, so I only do it 1-2 times per year, even though my doctors and physical therapists say I should do it 1-2 times per month. A few days ago, my neck hurt so much that I could barely turn my head. After today’s massage therapy, I feel so much better. I can turn my head again!
  • Acupuncture. This has been one of only two things that has ever helped my chronic pain, and yet it’s not covered! I can go to a pain clinic under insurance, even though it won’t help, but they won’t pay for acupuncture treatments.
  • Marijuana. In fairness, medical marijuana is new in my state, but I still doubt insurance will cover it any time soon. They pay for all sorts of painkillers that have lousy side effects and that don’t do much to help me, but they don’t pay for marijuana, which is the only thing besides acupuncture that helps the pain. I don’t use it often, but when I need it, I want to have it handy, without worrying about the ability to pay for it.
  • Orthodics. My insurance covers a visit to the podiatrist and it covers physical therapy. But for some odd reason it does not cover my orthodics, even though they are completely necessary to prevent all sorts of problems. I am completely lost as to why they aren’t covered.
  • More mental health visits. I get so few, it doesn’t even seem worth going. I’d run out just as the doctor was starting to know me, and I wouldn’t be able to pay out of pocket, so why bother? So I’m missing out on useful treatments because of inadequate coverage.
  • Naturopaths. I can’t really blame the insurance company here, but I still wish naturopaths were covered, like they are in other states and in other countries. Unfortunately, the state of Massachusetts won’t license naturopaths, despite all of the good they can do, so insurance doesn’t cover them. That means that I have to pay out of pocket, even though my naturopath has been more helpful than the 10 previous doctors I had seen, combined.
  • Various tests. There are many very valid tests that aren’t covered by insurance. Some are used in medical research. For certain things, they are more accurate than the covered blood tests. The insurance company will cover the inaccurate blood test, but not the saliva test or urine test that’s more accurate. Lovely.

Those are a few of the things I wish my health insurance covered. I know I’m lucky. I have one of the best health insurance plans in the state, and access to pretty decent care. Still, after rent well over half of my spending is for medical care, and that’s even with health insurance. So yeah, I wish this other stuff was covered. What about you? What do you wish was covered by your health insurance?

1 Comment | Expectations, Frustration, Healthcare, Limitations, Medication, Pain, Politics, Rants, Support, Symptoms | Permalink
Posted by chronicrants

Why I haven’t showered lately

January 16, 2014

This is the kind of stuff I wish the social security and insurance folks would see. My hair is stringy and I just feel sort of, kind of, well…. gross. I’m sure you know the feeling. We’ve all had to go days without a shower before. It can be because of the flu or a sprained ankle or stitches that can’t get wet. It happens. And this is one of those times for me, but the situation is less acute.

Earlier this week I made the mistake of taking a shower. I shower most days when I can. I know it’s not good for my already-dry skin or for my terrible body temperature regulation, but I find it refreshing. The other day, though, was a mistake. I’d been home for most the previous week because I was in too much pain to go out. That day, I felt like I might finally be able to manage a trip to the grocery store, but the shower destroyed those meager hopes. Suddenly, I was in so much pain I could barely stand, never mind walk to my car and then walk around a store. And forget about actually driving. I thought I might go later, but the combination of the shower and the pain were so exhausting that I just didn’t have the energy.

Yesterday I figured I should try going to the grocery store again. This time, I skipped the shower. I thought I might shower later, but I was just too tired from shopping. Still, I had groceries* and, even better, I’d gotten out of my apartment and experienced fresh air. Finally!

Today I had to make another choice. I could feel that if I took a shower, that would be it for me, and I had a family member I really needed to visit. I debated, then skipped the shower. Tonight, I thought about showering, but had to choose between that and cooking dinner. I chose to cook dinner.

I am not complaining about the lack of showers. Talk about a first world problem! I’m so fortunate to turn the faucets and have clean water come out any time of the day and night. I once lived in a place that was prone to droughts. No one there ever showered two days in a row, so I didn’t either. That was fine. Really, I don’t mind the lack of showers too much. What I mind is the reason for the lack of showers. My choices shouldn’t be

  • groceries vs. shower
  • family vs. shower
  • cooking vs. shower
  • feel not completely horrible vs. shower

These are lousy choices. Just pitiful. These are the choices that most people don’t know we have to make regularly. They don’t see this part. They see me walk from the car to the grocery store and give me a dirty look for parking in a handicapped parking space. They don’t know what I had to give up just to get to the store, or how tiring and painful it will be for me to get home again. They don’t understand the constant decision-making, prioritizing, choosing. They don’t understand that working at a paying job is completely out of the question, because even getting to the job every day is impossible. These are the things most people don’t see.

So the next time a doctor or an insurance person asks for an example of why I can’t work, I won’t bother to tell them about pain and exhaustion. I’ll just tell them I had to choose between taking a shower and cooking dinner. Maybe that will help to clear things up.

*For those who read the last post, yes, I finally have some bananas!

2 Comments | Decisions, Educating, Expectations, Fatigue, Frustration, Healthcare, Limitations, Pain, Rants, Symptoms, Unpredictable | Permalink
Posted by chronicrants

Guilty until proven innocent

January 8, 2014

Doubts. They come from parents, friends, children, siblings, doctors, co-workers, classmates, bosses, teachers, and strangers.

I get dirty looks when I park in a handicapped space. Doctors have questioned if it was “all in my head.” My sister thinks I exaggerate my problems.

And then there’s the government and insurance companies. I was denied long term disability insurance, but incredibly, I won the appeal. I applied for the disability version of medicaid and was denied. Luckily, I qualified for and received the low income version. I applied for social security disability insurance and was denied. I appealed and was denied again. Now I have a hearing coming up very soon.

I know this is considered standard practice, but it’s not right. They are so concerned about fraud that truly sick people go without the benefits we deserve. There was another article in the paper today about a massive fraud scam. These people are scum. But just because they fraudulently got SSDI, does that mean I should be scrutinized so much harder? There will always be assholes and criminals in this world, but I’m tired of being treated like one just because others exists. I’m tired of so many people assuming I’m not truly sick. They seem to assume I’m guilty of lying to them, of fraud, until I convince them otherwise. The burden is on me to convince them that I’m sick, even as I’m too sick to do so properly.

The system is broken. Anyone who has tried to get through it knows this. And I’m so damn tired of being punished because other people  get away with fraud. Don’t punish me for their guilt. I didn’t do it. I’m innocent. And I deserve to be treated as such.

If only others felt the same way.

11 Comments | Expectations, Frustration, Healthcare, Insensitive, Politics, Rants | Permalink
Posted by chronicrants

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