I can't believe this

Discussion in 'The Watercooler' started by flutterbee, Aug 10, 2007.

  1. flutterbee

    flutterbee Guest

    My doctor is in a practice with 3 other doctors. I saw her last on Tuesday, 8/7. At the end of the appointment, they scheduled me for a follow-up on 8/29. I was given a new rx written for a one month supply and no refills - that would be taken care of at the follow-up. She ordered lab work and her office called me with the results on Thursday, 8/9. Told me that the lab work was all normal and that it is indeed looking like fibromyalgia and that they would see me at my follow-up.

    In the mail today was a form letter from my doctor's office with a handwritten date of 8/8 stating that after much consideration they are withdrawing as primary care providers for both my daughter and myself. :nonono: No explanation of why. My daughter and I are covered by different insurance - Medical Mutual for me and BCBS for my daughter - so I doubt that is the reason. I did miss one appointment in June (it was one that was scheduled 6 weeks out and I just completely forgot about it), but I seriously doubt they would drop a patient for one missed appointment. My God, I'm in there so much - several times a month. I'm not demanding or disruptive or any of those things.

    I am so upset. This is the first doctor in my adult life that I am comfortable with. difficult child really likes her, too. She just diagnosed me with a chronic illness on top of the other one I already have. And now I'm being dropped. It will take at least 2 months to get an appointment with a new doctor - that is AFTER I find one.

    I'm so sick of this :censored2:. I've had absolutely enough BS this year to last me a long, long, long time.
  2. timer lady

    timer lady Queen of Hearts


    When it comes to the medical community, I believe just about anything these days.

    Having said that, has this doctor, done any referrals on your part to a rheumatologist for the latest diagnosis? It may be a good start. Check in with your insurance company for reliable referrals as well.

    It's a bump in the road - one of many bumps you've endured over the last several months. You don't have the time nor energy to waste over being insulted, hurt or outraged. Your health in on the front burner.

    Now, on the other hand, if you'd like me to start a big old voodoo doll or something to help I'd be glad to pitch in.

    Take care, ladyl.
  3. Stella Johnson

    Stella Johnson Active Member

    Do you have an HMO? If so, this may be why. They receive less money sometimes if they have too many referrals for specialists. If you have fibro.... that means many referrals.

    I'm sorry this happened to you. I know how hard it is to find a doctor that you are comfortable with.

  4. Suz

    Suz (the future) MRS. GERE

    Heather, in PA you can't just be dumped by your docs without cause. There are procedures and steps they have to follow and only a small number of reasons you can be dumped. If you want to continue seeing this doctor, call your state medical society and read them your letter to see if you were dumped for an "acceptable" reason. If not, you can fight it.

  5. Marguerite

    Marguerite Active Member

    I didn't think this could happen anywhere in the world. I just don't understand. What about the Hippocratic Oath? There are very few reasons why a GP should be able to refuse to treat a patient - being closely related to them; having a restraining order out on them/from them; being in some sort of legal dispute which could compromise either patient care or doctor safety. Too many patients could mean that new referrals are not taken on board. But to ditch old patients with no reason? I don't understand.

    But because a patient might need ongoing care? That's what GPs are for!

    I would be asking for written confirmation listing specific reasons, also getting the date confirmed in writing. If you can talk to your doctor personally, find out if it's the practice, or her - that might help. There could be a reason that makes sense. Maybe she's just found out she's got some condition which will stop her from practising medicine at all, so ALL her patients have to be referred to another practice. My specialist retired, which meant I no longer have a specialist in that field.

    But keep all records, including your own diary with the appointment in it (an appointment card would be even better) and if you think you're being discriminated against simply because of your need for ongoing care, then there have to be avenues of complaint you can follow. The insurance company is a good idea - they have a vested interest in seeing you get the health care you need, so problems don't get out of hand (and more expensive for them).

    Fibromyalgia is a label which can make some doctors and insurance companies dramatically change their attitude. I was fighting a worker's compensation case which resulted in my current auto-immune health problems. The insurance company was paying up and being cooperative - until one of my doctors suggested fibromyalgia as a possibility, still as a result of the injury. Almost immediately the insurance company challenged my worker's comp claim and BACKDATED it a fortnight. This wasn't health insurance, it was workers comp insurance. I ended up having to fight it in court. But at no time did any doctor refuse to treat me - the argument was only over who pays the bill.

    Good luck. I hope you get some satisfaction.

  6. Steely

    Steely Active Member


    I don't know what to say except big big hugs. I mean, could it be a mistake? I know nothing about ins so I won't even guess........I only know enough to know that I hate the industry and I think they are all money mongers. And that is no help to you at all.

    Please take care, and try and think positive thoughts only. It will get better, it really, really will.
  7. DammitJanet

    DammitJanet Well-Known Member Staff Member

    They cannot dump you without providing you time to find a new doctor. It is unethical. They can be found guilty of malpractice. This does happen to people who have fibro frequently however. Doctors dont know how to help us so they dump us. It isnt fair.

    Go on that site http://www.imunesupport.com and check out the good doctor list and see if there is a doctor in your area that you could use or just start a post asking if someone knows a doctor in your area that is good. That is what some people do to find one. You are in a fairly large area so you may have some luck.
  8. WhymeMom?

    WhymeMom? No real answers to life..

    I think I would show up at your scheduled appointment and act like you never got the letter....let them tell you face to face...I hate it when I get form letters! Once when my difficult child's pediatrician moved away they hired a new doctor to replace him. Now the former doctor had built up quite a practice for handling
    ADD and ADHD kids. About a year later the new doctor said he was dropping all the ADD/ADHD kids. I found this out when I received a form letter and when I went in to pick up my son's records I gave the receptionist a piece of my mind, saying this was so unprofessional and why in the world would he come to a practice that was mainly ADD kids and drop them all?????? I asked to speak to the new doctor personally, but he was mysteriously out of the office. I had the feeling he was standing back in an exam room, cringing, I hope.......The poor receptionist had to hear my rant, as well as most of the waiting room people. Got a couple of claps on the way out......hah!
  9. Suz

    Suz (the future) MRS. GERE

  10. flutterbee

    flutterbee Guest

    Linda - I'll take you up on your offer. No referral to a rheumatologist. I'll have to look into that for future reference.

    Steph - It's PPO coverage, not HMO. And she's given me no referrals, so it can't be that.

    Suz - I can't tell if there is ANY reason, let alone an acceptable one. There is absolutely no mention of why they are doing this. It's very bizarre - the vagueness. Almost like they hope the ppl that they send these letters to will just disappear, no questions asked. Thanks for the links. I'll look into that.

    Marg - I was dumbfounded when I opened the letter. I'm certainly going to be contacting my insurance company and see what they have to say.

    Willow - I have no reason to suspect that it has anything to do with the insurance. I think if they were dropping me because of my insurance, they would have stated so.

    Janet - The letter stated they will see me for emergencies for the next 30 days. However, I don't know of any doctor in the area that I could get into within the next 30 days. It's normally a minimum 6 week wait...usually more. I also cannot imagine that she's dropping because of fibro. The letter was dated the day before the lab work came back. I'll check that link for doctors and other info.

    WhymeMom - Good for you for taking your pediatrician's office to task. I was initially planning on calling the office Monday to find out what is going on, however I want to talk to my doctor to 1) see if she's even aware of this because I certainly didn't get the impression at my last appointment that she didn't want to treat me and 2) find out why. It's harder to give ppl the run around face to face than it is over the phone. So, I'm going to keep my appointment on 8/29. They are obligated to treat me as it is a follow up to a diagnosis she gave me and she changed my medication without giving me enough to carry me if she's not willing to treat me any longer.

    This is what happens when we expect the "market" to cover critical needs, such as healthcare, instead of regulating it.
  11. flutterbee

    flutterbee Guest

    And I'm also sending them a certified letter on Monday requesting copies of my medical records.
  12. Marguerite

    Marguerite Active Member

    Heather, you said, "also cannot imagine that she's dropping because of fibro. The letter was dated the day before the lab work came back."

    Sometimes lab results are phoned through a day or so earlier than the printouts come in. Also, if someone senior in the practice was checking out possibly long-term liabilities to the practice, they may have noticed the likelihood of a prospective FM label heading your way - ANY patient who has a history of six months or more unspecified malaise, muscle aches, fatigue; coupled with all blood work coming back negative - from a medical practice point of view, patients like this take up far too much valuable time. A lot of resources and doctor time go into seeing and eventually (maybe) diagnosing that one patient. If, instead, they can use that doctor time to see 10 patients, their stats look much better. is it possible that they're trying to sell the practice? Or maybe working towards selling the practice? It is something to consider - an incoming doctor will pay more for a practice with a higher number of patients. If they are systematically eliminating the patients who have taken up more than average doctor time in the last six months then patients needing more long-term care, or who have had a more difficult year than usual, would find themselves eliminated. It's part of making the financial side of the practice look good - it's easier to sell a practice when the books are in good shape. This isn't just patients statistics (numbers, overall costs, etc) but also the spectrum of diagnoses. A sports medicine practice, for example, will attract a certain kind of doctor which will attract a certain range of patients, so the change perpetuates.

    A practice that comprises mostly senior citizens needing chronic care is going to not attract someone interested in treating workers with colds & flu, or bandaging sprains.

    I do wonder if, also on their 'hit list' are drug addicts trying to reform, any patients with chronic conditions and 'needy' patients who would see the doctor about twice as much as average.

    In Australia decisions like this would be made by the practice manager, who is not necessarily medically trained. They are accountants and managers, not doctors as a rule. Any actual attempt to formally 'move patients on' without an acceptable reason would be actionable. But it probably does happen, informally. There are laws, and there are ethics. They're not always the same thing. But discrimination is generally actionable, in this day and age.

    I would be quietly sniffing around, maybe find a cooperative doctor friend to find out of this practice is about to come on the market. Don't ask anyone associated with the same practice; ask someone totally away from the area. And, of course, meanwhile get your information in writing and make notes of what you are told. If making a fuss in the waiting room gets any other patients talking to you about also being excluded, see if you can find a link between you, that could explain the reasons.
    Another sneaky trick to try - get someone you know but who is unknown to the practice, to telephone and try to get an appointment. Invent a couple of different conditions - 1) he/she (there's a start) has been feeling feverish and with coughing and sneezing for a few days, need a medical certificate for work. 2) - feeling run-down for several weeks, thought it was flu but the fatigue hasn't gone, feeling depressed, having trouble sleeping, maybe need a check-up to make sure it's nothing serious.
    I'm betting that if they take 1) but not 2), my theory is right - they're excluding the "time wasters". Utterly reprehensible, except to accountants.

  13. flutterbee

    flutterbee Guest

    Well, I did a bit of research and learned a couple of things. First of all, according to the Ohio State Medical Board they are in compliance with the minimal standard of care with that letter. the OSMB requires they send a letter like they sent to me; it doesn't state that a reason need be given.

    Second, unbeknownst to me this practice is owned by the same health care organization as our previous pediatrician's practice; they each operate as DBA's. That prior relationship didn't end well. The doctor we had been seeing left the practice and moved out of state. difficult child had strep and we saw a different doctor in the practice who, because he had a patient in the past not take the antibiotics and developed scarlet fever, required strep patients to get a shot rather than take oral antibiotics. difficult child's anxiety goes off the charts when it comes to shots and she was heading straight to meltdown. The doctor was still refusing to prescribe oral antibiotics. The conversation dissolved into something like:

    doctor: "You're going to let a child make the decision?"
    Me: "She's not. I am."
    doctor: "You're the mother, but I'm the doctor."
    Me: "You don't trump me."

    When I left the office that day, I requested copies of my children's medical records as I was planning on finding a new doctor and was told I couldn't have them; that they are the doctor's notes on my children. Of course, that is in violation of state and federal law. I then sent a certified letter with my request and cited the law.

    Anyway, now that I know they are owned by the same group, I have no desire to return to the practice. Which I really hate because I like my doctor so much and so did difficult child - she's board certified in internal medicine and pediatrics, so we both saw her.
  14. TerryJ2

    TerryJ2 Well-Known Member

    Ohhh, I am so sorry!
    You are correct in that perhaps the dr doesn't even know. She should review her files but she may not have the time.
    Interesting that you checked the dates and surmised that you didn't think it was because of the test results of insurance. Still, it's likely an insu. issue. And you are correct that one missed appointment is not the reason.

    My husband is a chiro and has dropped pts on occasion. However, in our state, he is required to offer the names of doctors for referrals. If you drop a pt with-o a referral it is considered abandonment and the dr is legally liable if the pt has no care.

    by the way, he dropped them because they were extremely difficult. And they all knew it.

    Chances are, you'd know.
  15. Marguerite

    Marguerite Active Member

    I do think this is economics, not you being difficult in terms of being a pain in the neck to treat. "Difficult" in that it's more long-term and less 'cosmetic' on the practice books - definitely.

    If you can somehow do it, I would communicate with your doctor to let her know, at least, of the letter and your decision to go elsewhere. Ask HER who she recommends you see. Surely a referral from her will be to someone who SHE respects as a doctor and therefore may have similar attitudes and values? Also, I would protest the "effective from" date and request a final appointment, for handover and to sort out prescriptions that were postponed - the doctor expected to see you, you expected it too. The button to push with the practice - "it will make the practice look negligent in their duty of care, if I am in a desperate rush to see someone urgently, simply because I was not permitted to keep my scheduled appointment, when the plan was to finalise and organise all longer-term repeat prescriptions."
    If they want to bring your next appointment forward, let them (unless it is too soon for the prescriptions to be written - a problem we have in Australia). At this point you can also request a referral, or failing that copies of your files. In Australia there is still some argument over who owns the files. Freedom of Information applications can often open doors, but not necessarily with patient files. There has been a lot of argument over this - doctors make their own notes, often in their own personal terminology and so such notes have less relevance or meaning to another doctor (and certainly not to a patient who has no medical training! as they tell us). However, they are notes about US, often valuable information can be there which can help.

    I mentioned that my specialist retired. Several years earlier he had referred me to a rehab specialist for inpatient treatment. At the consult with the rehab specialist my doctor's referral letter lay open in front of him. I am very adept at reading upside down and was very upset by what my doctor had written. But when I took it up with him and argued about it, he told me I had no right to have read it. I said I was glad I had, I didn't realise how badly he had misunderstood me. Soon after I was admitted for treatment by the rehab specialist who lost interest in me when my specialist's letter was proven to be wrong. "She's not so interesting, after all." My specialist then had to take over inpatient treatment and realised HE had been wrong, too.
    When he retired, far from keeping my files confidential, he posted me the lot - it was huge, like a legal file. And it includes ALL the referral letters, including my own vehement protests in writing back to him!
    My GP recently changed practices (again). This time he asked us what we wanted to do, and then with our permission took all our files with him, so we could transfer too. The previous transfer he had been told the files belonged to the practice, not to him. So he was very naughty - I had some X-rays needing to be looked at, he tucked the files in with my X-rays and let me out the side door. He knew he would have been searched. The files would have been no good left where they were, since we were never going back there. My doctor could have argued and made a case for the files being his and NOT the practice's, but he didn't want the legal fight dragging on.

    Rules change. Doctors detach, constantly. The best assistance you can get in your own medical care is a GP who is prepared to liaise with all your other practitioners/specialists and all. The GP doesn't have to be brilliant, just good at paperwork and prepared to listen. Anything more is a bonus. And a practice that is more concerned about its bottom line - run, don't walk, in a different direction. They're like fair weather friends, who enjoy partying with you but will ignore you or cross the street to avoid you, when life (or your health) turns sour. The ones who stick with you are the true supporters.

    We live in a world which increasingly needs good quality long-term medical care, and yet we see all around us the burgeoning of medical clinics which only deal with acute care. The reason? The profit line. Not good.

    Good luck with this one.