Need others experience w MD visits

[Sheanie]

I am 9 yrs out, 10 this August. Maintaining well at 125 since 3 yrs out.

Experiencing huge anxiety over current MD, a female who initially seemed very promising. Ordered correct labs, claimed to understand the malabsorption, etc.

What is pissing me off is her "policy" of booking appts. She has a PA, and you have to trade off every other appt w her. Cool. But, during a "well woman visit", also coded as an annual physical, they both refuse to refill Rx's, or to even mention other topics, such as depression, asthma, allergies, labs, or osteoporosis. THAT requires a SEPARATE appt, a different day. PERIOD.

What this has meant for me ended up necessitating 5 appts in the last year. Physical, osteoporosis, depression, asthma/allergies, and osteoporosis to argue the need for bisphosphonates.

Oh, and another appt with plastic surgeon to consult about a harmless folded breast implant. (Boy, was HE pissed!)

Most recently though, my husband took me to the closest ER on Jan 1st for dizziness and a sore lower leg. Ruled out DVT, did EKG, labs, and clot study. Left with bppv diagnosis, benign vertigo. Lasted a week, no driving, could only walk holding onto things. My iron is very good, had a recent infusion. BUT, MD's nurse called the next day to inform me the ER visit was unnecessary. Huh? Based on the diagnosis alone, she made that judgment. Well. Since the ER does not "communicate" with my MD, they would not send the full report.

I am proud that I did not snap a twig on this twat. I refrained from speaking profanities, barely. What I said was, "my husband, who is a doctor, made the call. I trust him with my life." (He is a dentist, LOL)

She has lectured me on needing vegetables, on eating a more balanced diet, and other things I just nod and smile about. But these money grabbing superfluous appts w a $30 copay each are on my last nerve.

What would YOU do? Go doctor shopping? My insurance company confirms these appts are wrong.

 

[Larra]

Sadly, it does sound like this forced appointment thing is designed to generate more appointments to generate more income, rather than for the benefit of the patients. It's up to you whether or not that pisses you off enough to change doctors. You are pissed enough to tell us all about it, if that helps.

 

[southernlady]

Pat of it is to get extra copays. Some of it is forced by insurance companies. Medicare rules here: http://www.communitycare.com/News/H...e-Annual-Wellness-Visit-vs-an-Annual-Physical

An annual physical is a more extensive exam than a Medicare Annual Wellness Visit. In addition to these services, a typical annual physical might also include services such as a vital signs check, lung exam, head and neck exam, abdominal exam, neurological exam, and a check of your reflexes. Any blood work or lab tests that may be part of a physical exam, are also not included under a Medicare Annual Wellness Visit.

The purpose of the annual wellness visit under Medicare is to paint a picture of your current state of health and to create a baseline for future care. Any additional tests or labs that may be required as a result of the findings of your annual wellness visit would be billed separately by your doctor and would fall under a different benefit than your annual wellness visit. Medicare also covers a number of other preventive services at no cost such as preventive cancer screenings, bone density measurement, and flu shots.

Annual Physical

• Doctor will measure height and weight
• Doctor will take your blood pressure
• Doctor will measure BMI
• Doctor will review your medical and family history
• Doctor will assess your risk factors for preventable diseases
• Doctor will check vital signs
• Doctor will perform head and neck exam
• Doctor will perform lung exam
• Doctor will perform abdominal exam
• Doctor will perform neurological exam
• Doctor will test your reflexes
• Doctor may submit urine and blood samples for lab testing

Medicare Wellness

• Doctor will measure height, weight, blood pressure and other routine measurements
• Doctor will review your medical and family history
• Doctor will assess your risk factors and treatment options
• Review Health Risk Assessment questionnaire
• Updating list of providers and prescriptions
• Looking for signs of cognitive impairment
• Doctor will set up a screening schedule for appropriate preventive services

The Medicare Wellness exam includes the assessments, but none of the "physical" tests where the doctor has to physically touch you. Under Medicare, a doctor will only perform these types of services if there is a specific diagnosis or symptom which necessitates that type of examination. Other preventive services will be scheduled, but not performed, during your wellness visit. You can find a complete list of covered preventive services under Medicare here. If you have more questions regarding Medicare coverage and what services are covered, you can contact our Care Coordinator at 518-782-3800.

It's gotten real screwy in the last 15/20 years in an effort to get physicians to keep appts under 15 mins each patient.

 

[Sheanie]

Sadly, it does sound like this forced appointment thing is designed to generate more appointments to generate more income, rather than for the benefit of the patients. It's up to you whether or not that pisses you off enough to change doctors. You are pissed enough to tell us all about it, if that helps.

I should have asked, is this the experience others, too, are dealing with?

 

[Sheanie]

Liz, is this what YOU encounter?

 

[Munchkin]

I know someone who is below poverty level and has Medicare, Medicaid. And Medicaid even pays his Medicare premium. His medical, all of it, is free. Doesn't even have copays or payments for prescriptions. All he does is go Dr. appointments and have extensive testing done. Scans/bloodwork you name it. But, there is NOTHING wrong with him. He sees a cardiologist but has no heart problems. A podiatrist and his feet are fine. An ENT sees him twice a year and does nothing. He also sees an ortho and GI docs but he has none of these issues either. Seriously, this guy goes to the doc more in an average year than I have been in my lifetime. I think he sees his primary 4X per year. Going to doctors is his entertainment. His hobby. Something to do.

Considering his age, there is nothing wrong with him. The sad thing is he has been convinced he needs to do all this. They just schedule appointment after appointment and he just shows up. This is how they make money on poor people.

 

[southernlady]

Liz, is this what YOU encounter?

I have. Although I have learned to request 30 mins versus a standard 15 min appt and let them know I will have three items to discuss. If you keep it to three short items, you are more likely to get them all addressed.

 

[conceit]

I stick to three items, most urgent concerns first. Doctors book way too many appointments. Like I had a doctor who only addressed one issue and then would get me to book another appointment. She was always running late, which was a mystery because she barely spent any time with patients Luckily, I am in Canada so healthcare is covered. The extra visits were more an inconvenience when I didn't have any chronic issues. Now with t2d, I don't want to waste time waiting for another appointment in 3 weeks. It was part of the reason why I changed doctors. We talk, comfortably, about 3 pressing concerns. He didn't say 3 was the limit, but that's what I try to stick with.

As for changing doctors, I always say trust your intuition. In your situation, i would definitely go out doctor shopping. I am also annoyed at that bitchy nurse. what a condescending lil shit.

 

[conceit]

Do you have t2d and a DS?

if you're asking me, I haven't had the ds yet.

 

[Sheanie]

I had t2d before DS, just beginning. With GERD, and beginning heart disease with high blood pressure and high cholesterol.

 

[Sheanie]

Oh my goodness, yes! A spectacular success! I would do it again in a heartbeat. Only thing I would do differently is I would get it done sooner. I was 49 and lost some years to obesity that I wish I had back.

 

[southernlady]

Sorry, yes I was asking you. The reason is that my understanding is that DS will ,if not cure, then make meds unnecessary for t2d.


Good luck,

G

For 95-98%, that is true.
I am one of the 2-5% that did not stay in remission. I am back on medications.
My story here: https://bariatricfacts.org/threads/diabetes.5590/

 

[Sheanie]

Yes, there are some for whom t2d comes back.

Make sure you understand the commitment you are making with this surgery of labs and vitamins, but also with self-advocating.

 

[southernlady]

Thank you for the link

Sorry for the relapse, that said metformin is both benign and inexpensive, so some good there

Thanks. I had been on metformin from 1997 to 2011 so I knew of its side effects and they were ones I was willing to handle.