Another hold up ...

[Maria]

This is something I cannot believe but I'm going to rant a bit here because I've just "been thru it"..

I finally got WC to approve surgery ~ hybrid at this point with fusion at L5S1 and ADR at L4.

Ok, so even tho I was orginally referred to a certain Spine Surgeon at a certain Spine Institute .. that surgeon didn't have time to see me or something like that so referred me to a partner.

I saw this partner twice and the second time he/the office dropped the ball when it came to the paperwork that needed to be done for WC~ there was a 20 day reply time for the paperwork to be submitted. I called and talked with his PA who was NOT helpful at all.. and believe me, being an RN,NP and running offices, performing the same type position albeit in OB/GYN and FP, I KNOW how things SHOULD be done even in EXTREMELY busy offices. I also left messages at least 3 times for a return call and left messages with voice mail for doctor's personal secretary.

OK, so the paperwork wasn't completed and I struggled 9 more months with WC and probably only by utilizing Mark's expertise as a PA on a 2nd surgical opinion did things get approved with WCAB.

WC said I can go to the doctor that I want to go to~ I can have surgery with whomever I want, wherever I want, whenever I want (in the US).

My Nurse Case Manager calls the same Spine Institute to make an appt.with surgeon that I want and the office will not allow me to make that appt. as I have to come in to follow up with Dr. so and so since my surgery has been authorized~

I'm so angry about this that I'm pretty sure I won't go back. It's my choice what to do~ and I'm being told that "the office policy is once you see one surgeon there you cannot change surgeons"...


I'm just so displeased about this~

[chasswen]

maria
i am very sorry to hear of your continued bull crap. but remeber its there game and you must follow there rules for abit longer.
i surely would get this procedure done asap as they may forget they approved your surgery.
i surely hope things go alittle better for you as things fall into place.
chuck

[Eddie G]

Just keep jumping through their hoops and it WILL pay off in the end. I got my best help from doctors who were ADR friendly but I had to play their game by their rules. It is definitely a tough game but a winnable one if you have thick skin, a sense of humor, perseverence and the ability to fend off the faeces they'll fling at you like the monkeys that they are. Don't give up because that's what they are counting on you to do.

What really burns my ass is that my company never fixed the problem and someone else may wind up hurt just like me. I just dont get it. They'll spend 2,000 a month to medicate me, thousands of dollars in operations and procedures, physical therapists and aides, plus months of lost work time and the problem has remained the same for years.

[dshobbies]

Maria,
As my kids say, SOSDD (same old s--t, different day). We've all faced disappointments both through the system and the doctor's financial bedside manner. You have to hold onto what is in your own best interest and forge ahead, just as you've been doing to too long now.

When choosing a gp or dentist, you can be as choosy as you like but in the adr world, it's slim-pickins. So take a deep breath and do whatever you have to do for yourself. I wish you every luck,

Dale

[bek]

Hi Maria

this is the second time I've heard of this BS with doctors being able to refuse to do a second opinion or to see a patient because their colleague has already done so.

I have recently learnt that my back surgery is a screw-up and I am having trouble getting any other surgeon to either see me, or give an honest opinion about what has been done to me if they do. I cannot get anyone so far to offer surgery - no one wants to touch someone else's mistake.

I am continually dumbfounded at the level of self-interest doctors now exert. They are getting close to omnipotent and medicine as you say has become all about the $$$$ for so many of the people who entered a profession that is supposed to be about patient care. It must frustrate you terribly having worked in the field yourself.

Please keep us posted on what you decide to do and/or what options open up to you.

Rebekah

[dshobbies]

I think that's one of the reasons, aside from expertise, that Dr. B & Z are so popular with their respective patients. Dr. Z even told a British patient that he would come to her to do her revision if necessary because she couldn't afford to come to him.

While in the hotel in Straubing, Dr. B's team from Bogan made a 'house call'. These doctors do not bring their ego's into their practices. I understand that affording Germany is not possible for all but as someone who would not have gone if at all possible, I'm a convert and wouldn't hesitate for a second to recommend the care, compassion, and most of all, the knowledge and proficiency of these doctors.

I woke up from surgery with my left leg completely numb. I am positive this damage was unavoidable... yet I blame my American doctor for not recommending the proper care and possibly causing this damage to become permanant. He simply didn't care. My best to you Maria. I understand your frustration level and can only sympathize. To some doctors, you're nothing more than a notch in their belt and pocketbook.

Dale

If any American doctors are reading this, this is the reputation most of you have earned. Your patients care should be first and foremost but you've turned the Hippocratic oath into the hypocritic oath. I apologize to those doctors to which this statement does not apply and thank you for your caring and concern.

[sahuaro]

Maria:
Is it at all possible to do an end-run around the staff and speak to the surgeon you prefer directly (or have a patient advocate speak for you?).
Unfortunately, this is a policy of many group practices but as you know sometimes the staff can be inflexible when the docs themselves might be willing to bend the rules.
I sincerely hope you can work this out to your satisfaction--enough is enough!

[Maria]

Thank you all for your thoughtful replies. I thought I'd wait for an update before responding~ here is what I have to report:

WC is miffed at the idea that Dr.X's office states a policy that won't allow change of physicians (prior to any surgical intervention) when WC is referring to a specific surgeon. The plan is to get the referring surgeon to make a call and/or write in my behalf.

As a second option (tho actually my continuing first plug/desire) I brought up surgery in Germany with Dr.B (have brought this up quite a few times) and this time was advised to get all the pertinent info sent to Nurse Case Manager and she will forward it to the Claims Adjustor who at this point cannot turn anything down re surgery so it will forwarded to the CA. WCAB and maybe just maybe the difference in $$$$ would be an eye opener (!!!) but mostly I have to show that I would have someone to follow me up here after surgery in case anything happened later on and need to have some stats/info on Dr.B ~

Something should move along one way or the other ~ since at least the fight for authorization is over, thankfully~

I'm enduring a major flare up right now and have to be travel ready (Florida next friday/3 seats coach/Air Tran w/change of planes in Indiana going and Atlanta upon return... need to be well enough to take my father for some testing that he needs to have~

Oh yes, the flare up by in large was brought on by an evening "run on the beach" with my dog and playing ball w/her. I must have been crazy but I actually was so amazed at myself that I felt I "could" run and was loving it...I play I pay...

I have been so bogged down by this flare up that I left a message for my NCN to see if I might get an "emergency ESI" squeezed in before my trip ... I know rest is what I "have to" do but ESIs are like magic for me~

Maybe some Cadillac Margaritas would slow me down

[ans]

Running!! Wow..

M: My fingers are crossed that insurance would pay for Dr. B. as this would be cost-effective for them. Keep it up and have a safe trip.

ans