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After Covid time to look for a new doctor/sleep doctor
#1
After Covid time to look for a new doctor/sleep doctor
My internal medicine doctor's practice also does sleep medicine. She sent me for a sleep study 21-years ago. Problem the person in the sleep center is passive-aggressive and does not help me with my CPAP supplies. DME companies can be a pain and I have a few special needs. If I complain my doctor takes her employee's side and suggest I might be happier with another doctor. No patient deserves to be treated as I have been. I have decided she is right, I would be happy with another doctor. Questions, do I look for a sleep doctor and an internal medicine doctor, a practice with both, change to a big organization, HMO, what is next? I am on Medicare. I have been paying my Medicare Part B and an additional $250 for a secondary through my pension.

Do I tell my doctor? I am really hurt. I have been her patient for 30+ years.
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#2
RE: After Covid time to look for a new doctor/sleep doctor
First request a copy of your old sleep study and all current records. 
Second, a combined practice is a convenience, not a necessity unless you are travel-limited.
By all means, tell your doctor. They may be unaware of the problem. 
You are not tied to any DME. Use your Medicare handbook or call your insurance carrier to locate an approved DME and request a telephone conference with their respiratory technician.

As my parents taught me: if you do not ask, you will not get.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#3
RE: After Covid time to look for a new doctor/sleep doctor
Thank you. I got a new CPAP in January. I was having a lot of trouble with that DME company and told the "Manager" in the Sleep Center I wanted to change DME companies. I tried 3 companies. The first two did not respond to the sleep study, notes and prescription she sent them. The second one did fax her and say they would not provide me supplies because I am on contract with the first DME provider. They will bill Medicare for 13 months, but she never told me. After 4-weeks when I did not hear from them I called the DME company. I did not get the significance and found another DME company. I mentioned this and explained I wanted to buy supplies from them. The manager drug her heel responding to the new DME company. When they were ready to send the supplies their billing department called and told me their policy was NOT to provide supplies to someone "on contract" with another company because Medicare will pay and then pull money back months later. Ah ha. I was stuck with the company "on contract" company. I think she should have known that. I was doing all the foot work. I jusst needed her to fax the sleep study and prescription and other items and of course tell me when she was contacted by the company telling her they were not going to sell instead of leaving me in a void. I was using a mask that was 5 months old and falling apart. I can get the records. I will tell the doctor. All of the correspondence I was sending through the doctor's message portal. I was told the doctor was reading those messages. Of course I was being very polite. I will tell her however, it is going to be hard to be nice because I have been steaming dealing with this woman. The doctor's eyes glass over when she says, "XXXX will take care of it."  When I would let her know that XXXX did not take care of something she would say, "she said she would take care of it right away, I will remind her." I think I should wait a few days. I should have spoke up immediately.
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#4
RE: After Covid time to look for a new doctor/sleep doctor
It sounds like you may have a series of cascading misunderstandings. Perhaps it would be beneficial to ignore the backstory and past performance and list all of your current concerns. Submit a copy to your doctor and one to the DME. Ask for the name of the person responsible for resolving the issue. In writing!

It is likely that there will be some finger-pointing, so list the person responsible for each item in your issue list and re-submit them. Work your way though the list until you are satisfied.

You may ask if anyone serves as an ombudsman which is an advocate to help you through the process. If you are a senior citizen, many community senior citizen centers have such advocates who are freely available.

If you remain dissatisfied you can send a query to the state medical board or legal aid -- both of which generally have ombudsman programs.

Document all calls: date, time, person, discussion, and keep all written communications in chronological order in a single folder.

Be patient. Some of those contacted are likely to be under personal or professional stress in these days of the COVID-19 pandemic.

You indicate you got a new machine in January, but list an older machine (S9) in your profile. You should have been given the latest machine (S10 - Airsense Autoset) and this may also be an issue.

I wish you well.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#5
RE: After Covid time to look for a new doctor/sleep doctor
Thank you. I copied everything you wrote to help guide me. I updated my profile. Yes, I have an Airsense 10. 

By ignoring the backstory, are you suggesting I ignore everything that has happened up to this point?  I am so hurt and therefore so angry that my doctor of 30+ years, who owns the practice, would allow an individual employed there to not take care of following up with the supply orders and not replying to my efforts to contact this employee. My health was of no concern to this individual, yet the website talks about how they want the sleep and other patients to be happy. No patient should be shoved off this way.

I would be willing to summarize what happened, with dates that would include the e-mail when the doctor told me, "She said she would do it right away, I will remind her," and the other dates and incidents, etc. with a note that I will not be working with that person in the future and after Covid next sleep study will be done at another sleep center and that center will handle that part of my healthcare. Unsaid is after Covid I will be finding another doctor.

Under, I believe it is Stark laws they cannot require me to use their sleep center. I just used it. 

There is no ombudsman at that medical group because it is a small group. I am original Medicare with a supplement. I realized if I belonged to an HMO or a Kaiser, and was paying so much less, I would have had someone to go to and would not have been putting up with this.

I thought about the medical board, did not want to do that to a doctor I have been with for so long. On the other hand I have felt bullied when I know she will stand with her employee and tell me to get another doctor.
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#6
RE: After Covid time to look for a new doctor/sleep doctor
(07-29-2020, 05:28 PM)Kellysfriend Wrote: By ignoring the backstory, are you suggesting I ignore everything that has happened up to this point?  I am so hurt and therefore so angry that my doctor of 30+ years, who owns the practice, would allow an individual employed there to not take care of following up with the supply orders and not replying to my efforts to contact this employee. My health was of no concern to this individual, yet the website talks about how they want the sleep and other patients to be happy. No patient should be shoved off this way.

I would be willing to summarize what happened, with dates that would include the e-mail when the doctor told me, "She said she would do it right away, I will remind her," and the other dates and incidents, etc. with a note that I will not be working with that person in the future and after Covid next sleep study will be done at another sleep center and that center will handle that part of my healthcare. Unsaid is after Covid I will be finding another doctor.
Yes, I am suggesting that you ignore all of the hurt, anger, and backstory as it colors your perceptions and actions. I have always told my people that living in the past is counterproductive to producing current and future results. Treat everything as a business transaction and professionals as consultants.

Many people imagine they have a real relationship with their long-term care providers but cannot seem to grasp the concept that they are simply another customer and what they are seeing is a professional bedside manner. That's why lapses in performance are so hurtful. Think of it as a professional acquaintance, not a friendship.
Perhaps a new doctor is the best approach for a clean slate.

As for HMO's, you need to ensure that there is some coverage if the doctor at the ER (likely to be a per diem contractor or non-employee) will be covered by your plan if they apply strict out-of-group standards.

I am not a fan of Kaiser due to assembly-line medicine based on statistical norms -- but that just my opinion. On two separate ocassions, they demanded two of my friends be transported in critical, but stable, condition to their facility because they were unwilling to pay for care in the receiving facility.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#7
RE: After Covid time to look for a new doctor/sleep doctor
If I had or was seeing a doctor that I wasn't happy with for whatever reason, I'd be looking for another. I can't say that I've had to experience that, but it seems pretty simple and straightforward to me.  Eat-popcorn
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#8
RE: After Covid time to look for a new doctor/sleep doctor
You are correct on a number of things. I tried to figure out why I was so angry. Under anger is hurt. Over the years the doctor and have know a lot about each other, she did a lot for me, but we are not friends. I have always approached doctor's as consultants, but the final decision on my healthcare remains with me. She has respected that and this is why I have continued with her. I did expect her to pick up on what was going, that was probably unrealistic. She will eventually figure the employee out. In the past when I complained about a medical assistant and she got pushed out of shape she later told me, "So and so had some real problems, blah blah blah." You are also correct about a new doctor and a clean slate. It is a pain. Sometimes it takes going through several until a person finds the right one but it is time. The current doctor will retire eventually. 

You are correct about not living in the past. The thought of engaging in this further is painful. Being angry feels awful. I would rather be happy and do productive things.

I agree about Kaiser. The other issue is I live in the high desert. The nearest Kaiser hospital is "down the hill." I have to drive down the Cajon Pass to Fontana or Ontario to a hospital. Their are medical offices in Victorville, but Covid came along and Kaiser freaked and closed them. However, as it is I am driving from the high desert to San Juan Capistrano now to see my doctor. Kaiser does moved patients out of hospitals to Kaiser facilities. It works for my brother who lives in Orange County. It is close and it is all he has used for years. Also, I have retina issues and use a specialist in Beverly Hills. I am not convinced I want to give him up. 

You have been very helpful. Thank you for giving me permission to let this go. Feels so good.
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#9
RE: After Covid time to look for a new doctor/sleep doctor
That is the plan. During Covid it is not easy since an in person visit is necessary. I am going to look into possible new doctors and when the coast is clear make the change.
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#10
RE: After Covid time to look for a new doctor/sleep doctor
(07-29-2020, 07:03 PM)Kellysfriend Wrote: You have been very helpful. Thank you for giving me permission to let this go. Feels so good.

Unfortunately, many of our choices are driven by geography and as we age, our mobility. 

My parents also taught me that I was the only one who could make myself feel bad and needed to give my permission to others before someone else could make me feel bad. My father explained that life was all about expectations. That I had to manage my own expectations and not live my life according to the expectations of others. 

Be well and take care.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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