The Cowardly Lioness

That's me. I have a weak backbone. Today I called the insurance company because I read in the booklet that I can get an appt. with a specialist withOUT a referral from my pcp. He said yes, I can. Very helpful man, glad to help me out! I told him I hope I never have to call him again, but he said that's what he's there for. (Why can't he be an MS dr? LOL)

The first neuro put stuff on my record that he did NOT ever do, and basically "dismissed" me back to the care of my pcp. (I have an appt. with the pcp tomorrow, the ins. guy says I don't have to see the pcp; but I call it a Courtesy Call since the pcp did ask me to come back in 2 months and I figure it's only fair to let him know what is going on.)  

The neuro I saw recently is also in the building with an MS specialist. I called to get an appt. with the MS neuro and I mentioned that my records are there on the premises, as I saw the regular neuro, but I want a second opinion with the MS neuro.

The receptionist seemed to be very awkward about me doing that. She said "uhhh, that's kind of unusual.....ummm, you have to be to be released from the neuro, and taken on by the MS neuro." The unsaid words might have been "uhhh, you don't want to do thattttt!!!" ???????

I told her the neuro DID release me, back to the care of my pcp and that I called my insurance and they said I do NOT need a referral to see the MS neuro.

Still, she said, she will have to let the neuro sign off on me, and see if MS neuro will take me. Shall she call me back?

Uhhh, backbone time. DUHHHH.

YES. I am scared of confrontation. (I have been yelled at by a dr. before. Humiliation extraordinaire!)

However, if I ever want to get to the bottom of this, I am entitled to a 2nd opinion.

So, she will call me back in a few days.

Good gracious I hate this. Is she twisting things? Surely I am not the first person ever to be in this situation!?  

Suzanne    

[SOONERMOM]

For what it is worth, here is my experience w/the MS specialist.  I was first asked by the nurse what my symptoms were, and then asked to fax a copy of my MRI report and then told that the Dr. would review my info and then decide if he would see me or not.  I did have to have my pcp refer me and it took about 3 months to get in.  (apparently he doesn't see everybody who wants to see him---I have a friend who is having neurological issues and he wouldn't see her).  My insurance doesn't require a referral either, but it sure seems like the Neurologists themselves always want one (I've seen 3 now)???  Even after I saw him, it was billed as a "consultation".  I guess he usually only sees people with diagnosed MS--I don't know??

I have never had health problems before so this is all new to me.  It is like there are unwritten rules we have to follow.

Stacey

[doublevision1]

Wow, not sure what to make of all that.  Do you think the receptionist is trying to infer that you're better off staying with the same neuro (ie: some problem with the MS guy?); or do you think this is a case of fragile dr egos and not wanting toes stepped on, or what?

I guess despite the insurance company not requiring referrals, the specialists themselves can dictate how they want their practice to be managed.  It all is rather confusing.  Like Stacey said, it's like there are unwritten rules to all of this.  I'm in Canada, and in my experience, referrals have always been required to see a specialist.  Having said that, I've never had a problem getting them.  I just ask my family doctor to send me, and she does, with no resistance.  She even does some research to find the best one for what I need, and she has personally called me at home to follow up.  Yes, I am lucky to have her!

It can be hard to be assertive in these situations; when you are ill, everything can seem more overwhelming than usual.  There is a definite power imbalance between doctors and patients.  It took me some time to develop assertiveness in this arena, but with practice it did come, and it's now much easier for me to speak up, question things, follow up when I don't get a prompt call back, etc.  On that note, if she doesn't call you back within a few days as promised, I encourage you to call her.  This will send the message that you are determined not to let this go.  I hate cliches, but the squeaky wheel really does get the grease.

db1

[AMO]

hi suzannae,

what db1 says it is tough to be your own advocate when you feel so dumpy is hard, but glad to see you are forging ahead.

while my ins does not requirre refeal either, some of my speicalist, like my movement ddisorder neuros, or electophysists,etc. ,do.  Once i am 'thier' patient, i can call to make the followup appts myself.
The secrtaries always asks if i have beeen seen by them before they make a schedule, so this can be rather typical   of ms clincs.
hang in theere, amo

[SOONERMOM]

One more thought....You may be having problems because they are in the same office (building) together.  I remember years ago my grandmother got stuck with an incompetent doctor (cardiologist) and when my mother tried to switch to another doctor in the same practice it was almost impossible to do.  I don't know if this is your problem or not.  I am sure Quix would know how this works and if there are unwritten rules.  They might not want to step on each others toes.  

It just seems to me that WE are the customer and if We are willing to pay then it should be OUR decision which doctor we get to see....especially when one of the doctors is incompetent, dismissive or even fraudulent!  I hope you are able to get in to the MS specialist and feel like you have really be evaluated properly.  I am sure that is all you are wanting.

Good luck and keep us posted!

Stacey

[CtResident]

Yeah, it sounds like that might be the problem (same building).

I do know of 3 ladies who see the MS dr., but I guess their MRI's were showing lesions; mine has none. (Or so I am told, at this point I don't know what to believe.)

One lady I spoke with was seeing another general neuro there for her MS and they had a falling out, so HE sent her over to the MS dr. down the hall! She says the MS guy is wonderful, makes eye contact and explains everything.

So I guess if I have a falling out with my neuro, he could send me to the MS neuro too! Right? Right! It's been done before. Same place!

Suzanne



  

[SOONERMOM]

Sounds like the "precedent" has been set.  LOL

[ELT]

I so know what you mean about it being difficult to stand up for yourself with doctors in general, especially if you have had a difficult time with one.  

I went to the emergency room so they could document my drunken walking.  My doctor wasn't in that day, or, I'd have stopped there.  The doctor stood there, listened to me, then said, "Well, what do you expect me to do?"  He told me I was wasting 'valuable' emergency room time.  And that it was people like me who unnecessarily clogged  up ER waiting rooms.  I said I'd talk to my doctor about it, and he said, "Oh, yes, don't worry.  I plan on telling your doctor you were here."

I staggered down the hallway to the exit doors, bouncing off the wall to my left, the whole way there.  And sobbed and stumbled, all the way home.  I avoid unnecessary doctors appointments like the plague.  In the first two years off work, started three years ago, I saw over twenty doctors.  I was a nervous wreck by the time they stopped making appointments.  I just knew they all knew the same thing, it was all in my head.

It's only been in the last year, in fact, more likely the last half year, that I have become as certain as I am, that no matter what the tests show, or what doctors or anyone else for that matter, thinks, I have ms.  It will turn up eventually.  Some of my symptoms are fairly specific for ms.  My neuro must know that, even if no one else does.

Go, push, get that appointment.  If you hound them enough, maybe they'll see u just to get rid of you.  LOL LOL

I'm sure it will happen.  :)

Erica

[Siddy1]

This is a touchy situation because I bet these two Neuros know each other even if they are not that friendly. They probably  get to meet at seminars and other situations.

As the second Neuro you want to see is an MS specialist I think you have every right to see him if he will see you.  What kind of records has this first  Neuro got that you need the second one to see? You said he  virtually dismissed you back to your pcp and it would be very misleading to take records that contain (as you said) " stuff on my record that he did NOT ever do".  The signing off the receptionist was talking about may be a formality, because I guess doctors can be touchy about another doctor taking their patient?  

Now that you have made the second Neuro's office aware of your other Neuro you may very well have to play by their rules of getting signed off by the first one - or find another one.

I don't have to have referrals either and the same thing happened to me. I wanted to see a second Neuro that my own primary care doctor had recommended (for a second opinion) and he happened to be in the office right below the first Neuro.  For some reason doctors in the same field often inhabit the same office buildings - or at least where I live they do.  The only difference was that the first Neuro recommended that I see a particular MS specialist in Tampa that he thought highly of and who had his office  much further away.  He  seemed a little put out by me wanting to  see the one downstairs so I ended up going to Tampa.


I myself  thought about it after and it would have been kind of awkward to get my records from the Neuro upstairs and give them to the one below.  It is kind of like saying I don't trust/believe this one so I am giving you a shot (which is the truth actually) but they don't want to hear it.

In my case the first Neuro wrote a three- page letter introducing me to the specialist in Tampa and I think they had this buddy buddy system of recommendation.  Quite often the first Neuro does the legwork and tests and then the "expert" reads them and gives a second opinion and writes a letter thanking the first Neuro for the recommendation.

I know when I had some back pain a few years back I went to my very first Neuro who was a bully.  He wanted me to go to a specific Neuro to get the EMG tests done and he was furious when I went to a different one.  I would have gone to the other one but when I called the office he was moving to another state and was not taking any more patients.  He wouldn't let me explain.  He said "I specifically wanted you to go to this Neurologist for the EMG"  and he just flung the report back at me  and said "I can't read it in this format".

Just throwing some things out there from my own experience - it may not help at all.
Good luck

Marcie

[gollie]

Ct:
Hi,  Just stopping in, to place a comment!
It does sound abit to me, by the way the receptionis spoke
to you, that there may be some friction there about that situation.
Ofcourse she just cant come out and say that to you. but she can
make the type of comment she made and hope that you will pick up
on it.
I went threw this one time, same way exact!!! lol Ya know what happened,
the new one refused to take me, and  the first one offered to see me again.OMG!!
First one trying to cover his butt....

I refused and found another doc on other side of town.   Just my experience
and opion...    

I hope you can get this worked threw, soon
                                                           All My Best Gollie

[CtResident]

The first neuro did the testing of MRI w/ and w/out contrast of brain and c-spine, EEG, VEP, BAER. He was very nice to me, but would talk over me. He did not want to see my timeline or even let me refer to it myself. He did not do a thorough neuro eval, but the written reports of those office visits sound like he did everything under the sun. The last visit he did tap the reflex hammer on my knees, but the report had the whole battery of tests listed as if he did them all, all over again. (The report has a stamp on it that says "dictated but not proofread" so maybe his typist did that on his/her own?!)

When my dh said fine, if she doesn't have MS, then what does she have, the neuro threw his arms out expressively and said "you wanted me to rule out MS, she doesn't have MS, so she goes back to her primary dr." With a smile on his face but kind of exasperated-held-in-check...........

He indicated that perhaps I needed bloodwork done. The bloodwork WAS done by the clinic I'd gone to for vertigo before I ever saw him, only 3 weeks prior. It was IN the records I brought to him! He never took the time or effort to read my stuff!

He sweetly suggested that I don't want to go see the MS dr., that is for people with all sorts of white things in their brains, and I don't have that (said with a saccharine smile!) He said I don't want an LP, they HURTTTTT. (said with a saccharine smile again!)

Patted on the head, no lollipop.

Suzanne  

[CtResident]

Hi Gollie! This MS clinic is only 10 minutes from my house. Right in with the neuro guy. Only 1 MS dr. though.

I hope I don't have to go out of state, but the insurance guy said I could if necessary.

Let's hope it doesn't come to that all because of egos. I won't go back to the first neuro, but I admit I'd be scared to see him in the hall! I told dh that when/if I go to the MS dr., if the first neuro is there and gives me a hassle, at least dh will be there with me!!!!!  

My mother used to say Man-on-Manichewitz when frustrated and I never knew what that meant. Now it came back to me in a flash.

Suzanne  

[CtResident]

I just wanted to read out and give you a big {{hug}} and say I am so very sorry you went through that horrific ER experience. You walked there, and back?? Just to be dismissed. I would have driven you there!

And what did your dr. say to this ER yahoo's report?  

Hoping you exit Limboland soon!

Suzanne

[ELT]

Unfortunately, as I live in a small town, all the doctors are involved with one another, regularly.  The have a medical building, one floor, and they are mostly all there.  All make their rounds in the emergency room of our local hospital.

He idly made the comment, the next time I saw him, that the emergency room was really for emergencies only, and that I had been seen by doctors about my complaints already.  sigh

So, unless I have blood pouring out of a deep gash, or I'm missing a limb, I won't go back.  The only reason I called the neruo and set up and appt, was because I felt my neurological symptoms would, at this point, be more 'visible'.

I have a great respect for good doctors, unfortunately, in the diagnostic process I have run into some right idiots.  Having a license to practise medicine doesn't make a person smart, and the arrogant ones only become more so.  

In the doctors defence, he was right in saying the emergency room was for emergencies.  He just could have had a more palatable bedside manner.  I have known him, well, not KNOWN him, but, we look familiar to one another (small town-itis, LOL), and I do know he's a little whacky, but, he is a good doctor.  Just odd.

thnx for the kind words,

Erica