Is this as shady as it seems?

[Netskimmer]

Let me start by saying that this issue is my mother's, not mine. She isn't very tech savy and doesn't really mess around online much. She lives in West Virginia, USA and I live in a different state. I'm getting most of this second hand over the phone. She basically tells me the troubles she's having with her pain doctor but I don't know how to really help her.

It all started when her old pain doctor sold his practice and retired. The new doctor told her that since his practice was new, he couldn't bill insurance or Medicare for a certain period of time, so she had to pay him in full. After several visits he changed her pain meds to something different and the new ones made her feel terrible so after a few months he finally changed her back but and a reduced dosage and refused to increase it to where is was. He finally told here she didn't really need pain meds, she just needed physical therapy. My mother is over 60, has arthritis, fibromyalgia, pins and rods in her shoulder, ankle, and fused vertebra.

A few months after that he change locations without telling her, she called to confirm her appointment and got a disconnected number. She got a new number and found out he was in a completely different location. This was about the time that Medicare would have kicked in but he said that since he changed locations, the process would have to start over again from scratch. So she had to keep paying him. This is about the time that all the staff that worked for the old doctor quit suddenly and he hired a bunch of girls that seemed to have no idea what they were doing.

He is giving her just enough pills to get from one visit to the next with none extra to cover breakout pain. At one point he rescheduled her appointment the day she was set to go in to a week later and of coarse she didn't have enough pills to cover the extra days. He then indicated the he thought she was selling her pills because she didn't have enough meds in her system.

Medicare should start to kick in soon but he wants to change from a pain clinic to a general practice due to the lesser restrictions and since he has to change the name of the practice, you guessed it, he had to start the Medicare process all over again. So she will have to keep paying.

He sent here a letter in the mail saying that he needed x number of new patients in addition to his pain patients to be considered a general practitioner so he was asking all of his pain patients to get so many people to sign up with him. Later he said that if each patient did not sign up two other patients for general, that he could no longer see them. My mother had her friend sign up along with her son. Her next appointment is tomorrow and the receptionist told her that one of them would have to come in with her or the doctor wouldn't see her! How is that even legal?

The whole thing just doesn't make sense to me. She isn't the only one having problems. Several of his other patients are getting the same treatment.  Is this legal? Who would she contact to help her with this?

[remar]

Oh my gosh! I can not believe this man and what he's doing to your mother and other patients. I'm so sorry she's going through this. In my opinion, he is indeed a con artist.
I'll recommend this. Tell your mother to see her primary Dr to let them know what's going on. I would think her primary would work with her as far as prescribing the medication she needs until she can can find a real pain specialist. Yes, it can be very to find one and it can take an awful lot of time. Maybe your mothers primary Dr can sit down with her and go over a list of specialists who will take Medicare. Her primary can also give your mother a referral.
No, I do not think your mom has to be worried about being labeled in any way. The pharmacy will have records of when she got her medications and it will show that this Dr. was a week late giving your mom her medication. Of course she's going to run out.
I'm hoping our Community leader sees this post. He is a wealth of knowledge.
Please talk to you mom about making an appointment as soon as possible with her primary Dr. The sooner she gets away from this con artist the better. In the mean time she has to know that her primary will be there to help her with her medications and also to hopefully help her find a real pain specialist.

[Netskimmer]

Thanks for the advice everyone. My first thought was also to have her check her statements. As I'm sure you know, switching pain doctors can be a nightmare, and the fact that she lives in the country makes it even harder. He's the closest one to her and he's about 1:30 minutes away round trip. Sitting, let alone driving, for that length of time is difficult for her. Most of the pain doctors farther out don't seem to be accepting new patients.
She has been looking for some time though and I have been pushing her to get a new doctor. She has some paperwork filled out for a doctor a family member goes to so hopefully she will get in with them.

She is also a little spooked and his "concern" that she may be selling her pills. I'm kind of wondering if the last minute reschedule and following drug test, which he had to know would show her med levels low, wasn't setup to scare her into shutting up. As tough as it is to find another doctor, it would be even more so if he decided to label her as someone that sells pills. As you said, guilty until proven innocent.

I'll start pushing her harder to get in with someone else, but until she finds another, she's stuck with him.

[ChristNonsense]

In my opinion, either stay out of it, or, get fully involved.

If you wish to get fully involved, then you need to see if your mother is willing to sign a privacy waiver and allow you to accompany her (yes, in person) to her next visit with her doctor, so that you can interview him.

It is really a nightmare to play doctor and/or play pain-patient-advocate for someone that a.) isn't you, and b.) is out of state.

You have no way of knowing exactly what is going on.

I'll repeat:

Stay 100% out of it
-or-
Get 100% involved

[CPain4]

I had to log back on to ask you one question Netskimmer . I was wondering if your Moms doctor is not only taking her money but maybe billing Medicare also ? I've seen a lot of elderly people get taken advantage of because this new breed of doctors are not the same as when your Mom was younger . Medicare sends out a statement once a month that's suppose to list the things that have been billed to them by doctors , but I don't think it would hurt to find out it has and does happen all the time . I have a 75 year old Mother myself and I check things like that just to be on the safe side . I may be as they say barking up the wrong tree , I just hate to think how its an OKAY thing to do elderly people ....they have earned better than that .

[CPain4]

One problem I am seeing and hearing more of is that some Doctors feel that since Medicare only pays a fixed amount which means the Doctor and Medicare negotiate and agree on a certain amount of money for their services and since they are not getting their full fee they charge for office visits they feel that somehow they are being cheated (remember the keyword is SOME DOCTORS ).

Also a lot of primary care physicians are no longer dealing with pain management since the government is cracking down on drug addicts . The problem is that a lot of innocent people are getting hurt simply because they group the abusers with the people who are not abusers , another words you become guilty until proven innocent .

As far as the Doctor in your Mom's case ? He's defiantly taking advantage of her simply because he can . I like YardBull think she's needs to say goodbye and good riddance. You may want to check with your Moms Medicare plan and see who is in her network as I don't see this doctor changing anytime soon . It makes me sick to know someone gets treated this way . I have heard of Doctors not accepting Medicare but never it having to kick in. You either do or don't accept it .  I wish your Mom all the best and please let her know she will be in my prayers . Just please get her away from this jerk because if he can do this to her ??? How can she trust his judgment at all ? She deserves better .

[YardBull]

Your title about sums it up.  I'm amazed that your mother is still playing this guy's games.  She should head for the exit and never look back.  Find another doctor who works with her insurance and Medicare!