"Talk to your Doctor"

[red_mares]

@MsM

My PCP cant even refer well! Last visit I had to repeatedly tell him about an issue I was having. Finally he took a look and said he would refer me to a neurologist. After a few days with nothing happening I ask who he referred me to and get a number to call. The person there said that they were booked until August but they would put me on the list if they got a cancellation. I called my PCP back to see if they could refer to someone else. No reply.
So I googled and found a neurologist who could see me the next week. And now I am having an EEG and MRI this week!

I didn’t think doctors were allowed to refer to a specific doctor. Too many issues in the past about conflict of issue. Frankly, the last thing I want is a 3rd party setting up an appointment for me. They have no idea what my schedule is, how can they set an appointment? My mother talks about her doc’s office scheduling stuff and it baffles me.

Besides that, a couple of my docs are ~80 miles away (work is halfway between). If they order testing or labs, I don’t need to drive up there for that, I can do it local. They wouldn’t know where to call.

@LCDR - While the PCP I had sucked, my regular specialists are awesome. My ortho is fantastic. I called last Friday for an appointment, instead of making me wait until mid June, they shoe-horned me in yesterday. If I email/message him or the pain management/back doc, I get an answer within a day or so. My last physical therapist nominally filled the role of PCP. I asked him about almost anything. I’d worked with him through 4 surgeries, so he knew me well, besides being a really smart guy. He moved to just being the boss a couple years ago. His replacement is OK, just not the same.

[Mohan]

I’m sorry, navy medical has apparently gotten better. So has the VA. Imagine your patients and what they couldn’t say. Welcome to the care you provided.

[RMJacobs]

I get referrals all the time. They are usually to a specific doctor. The doctor sending the referral doesn’t set the appointment. They just send over appropriate records so the receiving doctor knows it’s a legitimate need. Without a referral, most specialists won’t see a new patient. Then the doctor to whom I’m referred has their office contact me, and we set the appointment.

As for labs, X-ray, etc., the doctor creates an order, hopefully asking first where your insurance will cover. In my case, I’m on Medicare, so most labs are fine. But my strong preference (and that of most doctors in this area) is to have stuff done at UC Health. They are a great organization and have locations in lots of places. The nearest one to me is a five to ten minute drive, and I can do labs, X-ray, mammogram, dexa and a bunch of other stuff there. They also have urgent care and an emergency room at that location. I’ve had nearly everything done there except the mammogram (it’s scheduled) since I moved here–all the stuff I listed above, plus an echocardiagram.

Rebecca

[FjordBCRF]

@red_mares

I didn’t think doctors were allowed to refer to a specific doctor

I also get referrals all the time. You don’t HAVE to go to who they refer you to, but it’s a place to start.

Reading the replies here, I’m very thankful for my PCP. I’ve been with her since 2007 and have a great relationship. She diagnosed me with EDS, got me on beta blockers which totally got rid of lifetime chronic headaches. She takes time, listens, and really seems to care.

I get more annoyed with the specialists honestly. PCP sees the big picture with my EDS and all the specialists don’t look at things holistically. I mainly get referred to make sure there’s nothing we’re missing when I have new issues pop up.

[trubandloki]

@red_mares

I didn’t think doctors were allowed to refer to a specific doctor. Too many issues in the past about conflict of issue. Frankly, the last thing I want is a 3rd party setting up an appointment for me. They have no idea what my schedule is, how can they set an appointment? My mother talks about her doc’s office scheduling stuff and it baffles me.

I have never gone to any specialist with out my doctor sending me there.
My insurance does not require a referral from my primary doctor, so I could call any specialist I want to, but I can see nothing wrong with typically going to whatever specialist my doctor recommends and I consider it a bonus that the doctor is willing to call and schedule the appointment.

@red_mares

Besides that, a couple of my docs are ~80 miles away (work is halfway between). If they order testing or labs, I don’t need to drive up there for that, I can do it local. They wouldn’t know where to call.

I would think this problem, and the problem of scheduling could easily be handled by simply communicating with your doctor at the time when you are discussing this other visit need.

I doubt most primary doctors are going rogue and forcing people to go places. People discuss their issue, doctor suggests that maybe this specialist or this testing might be the answer and then likely the doctor says they can suggest a place and have the people at the front desk schedule an appointment. Then the patient can say, “oh no Doctor, I want to schedule my own appointment with this place closer to my home, but thank you”.

[MsM]

In my area, doctors tend to be part of one of several “health systems”. Part of the problem is that I suspect the doctors only refer within their system. But they dont mention this.

When I needed a breast cancer surgeon, the in-system surgeon my oncologist referred me to was on vacation and then overbooked for several weeks after that. I had to do my own research to find my surgeon.

I can handle advocating for myself but worry about situations in the future when I wont be able to.

[trubandloki]

@MsM

In my area, doctors tend to be part of one of several “health systems”. Part of the problem is that I suspect the doctors only refer within their system. But they dont mention this.

I would guess one of the reasons for this is that communications inside their own system are easy and automated. Outside their system involves more paperwork and your doctor might not get updated information as quickly.

[FjordBCRF]

@MsM

In my area, doctors tend to be part of one of several “health systems”. Part of the problem is that I suspect the doctors only refer within their system. But they dont mention this.

Similar where I live. My PCP just moved from one big system to another. I saw her yesterday and asked about the referrals and having so many doctors at the old system. She said that the systems prefer you to refer from within, but there are no laws against it thankfully. If you have someone else in mind, it’s worth the mention when getting the referral.

Prior to her move, my rheumatologist had retired and she referred me to a new on that was out of both the systems.

[RMJacobs]

@MsM

Part of the problem is that I suspect the doctors only refer within their system.

I just got referred to a podiatrist outside my PCP’s system. I could have gotten the work on my feet done by someone in her practice, but since I would have had to make a new appointment, I asked her to send me to someone else. She didn’t push back, just did what I asked. I’m very unhappy with my PCP, but she’s referred me to some excellent doctors. I just had my podiatrist appointment today, and really like this doctor.

Rebecca

[Bicoastal]

@NancyM

I had to make a special appointment for these to be looked at (it took 2 minutes to do that) but she could not look at or DO anything else on that visit.

This is for insurance compensation. One code per appt. A second problem? That’s a second code. Gotta make a second appt.

I REALLLLY wish I could afford concierge medical treatment. Medicine is going to get more and more corporate-fied with time. There’s almost no way for a new physician to start and sustain their own small business today.

[Texarkana]

What do you all think about the travel medicine phenomenon?

I first heard about it over 10 years ago— a friend of a friend’s company offered it as part of their medical plan.

Currently, one of my former teachers who I still keep up with through social media has been doing it a lot. She was recently in Mexico for a series of dental procedures— staying at an all inclusive resort, scuba diving, exploring the local scenery and cuisine. She was quoted over $7000 to have the work done in the US but ended up spending only $1200 for it in Mexico. She has har several surgeries done in other countries, including cancer treatment. She raves about it.

[Djones]

Most drug spend is in diabetes, anti-inflammatories, and in dermatogicals. I would hope that those seeking medical care to manage their diabetes or their plaque psoriasis would have a physician involved in their care.

[BlueDrifter]

You have probably long figured this out – but when I was 8 or so, I had the symptoms you describe in your 20s – eventually beat it and life went on.

Then, at 64, I had my blood drawn for general wellness exam and I had HepC antibodies!! No viral load, but was told I will always test positive for antibodies.

Boomers are the largest population with HepC now, and it is not because of drugs or wild sex – rather, they theorize it is because of our vaccinations. Needles were not disposable, but autoclaved, which I guess left some room for contamination.

Anyhow, I am positive my 8 year old body was fighting off HepC for those three months. And they didn’t know about HepC then.

PS: I was wondering why HepC antibodies hadn’t been found in me earlier, I mean, surely I had my blood drawn in the ensuing years. Turns out screening for HepC was not a requirement until 2012.

[BlueDrifter]

I just found out that when the doc schedules the referring appointment for you, they use the “concierge” number and get immediate assistance. I didn’t know that and always scheduled myself, but now that I know…

[LCDR]

Sometimes there is no need to travel out of the country, just go to a different region of the USA.

Mexico medicine can be a little iffy. Though one of the best known and published facial reconstruction surgeons of my time was in Mexico City and my university sent our plastic surgery residents there to work with him as part of their training.

Off topic a bit - make sure that your surgeon has experience in your needed area. Unless you specifically ask about numbers of procedures done and success and complication rates, a surgeon has no obligation to tell you that you are her first patient after she attended a continuing education course to learn about a new procedure. This is way more important if the procedure is being done in a private office versus a hospital. At least the hospital requires credentialing.

[Scribbler]

@BlueDrifter

You have probably long figured this out – but when I was 8 or so, I had the symptoms you describe in your 20s – eventually beat it and life went on.

Then, at 64, I had my blood drawn for general wellness exam and I had HepC antibodies!! No viral load, but was told I will always test positive for antibodies.

Boomers are the largest population with HepC now, and it is not because of drugs or wild sex – rather, they theorize it is because of our vaccinations. Needles were not disposable, but autoclaved, which I guess left some room for contamination.

Anyhow, I am positive my 8 year old body was fighting off HepC for those three months. And they didn’t know about HepC then.

PS: I was wondering why HepC antibodies hadn’t been found in me earlier, I mean, surely I had my blood drawn in the ensuing years. Turns out screening for HepC was not a requirement until 2012.

Interesting! I am not sure if I was ever tested for Hep C antibodies. I associate Hep C with my acquaintances who dabbled in heroin, which I never went near. Interesting to know that it was also medically spread, really scary. I don’t think there would have been a Hep C transmission event in the time frame for my symptoms, I hadn’t had vaxx for a long time and was single and my ex boyfriend was strictly beer and grass :). But it’s exactly the sort of chronic virus that fits the picture.

[RMJacobs]

I’ve been tested for HepC. No antibodies here. I had plenty of fun in the 60s and 70s, but avoided injected drugs like the plague. I have a family member who was a heroin addict. He died in his 30s. I’d call his death due to drug side effects: he was standing in a busy road, high of course, and was run over. But that was years after my misspent youth.

I had to be tested for hepatitis in order to stay on biologic meds for rheumatoid arthritis, since they can cause a dormant infection to become active. I was tested for A and B as well, and have no antibodies to those, either. Plus I have to get TB tests every five years.

TB tests have changed a lot since I first had one in early 1998. Nowadays it’s just part of my regular blood draw instead of an injection under the skin.

Rebecca

[BlueDrifter]

I didn’t know HepC can remain dormant… and possibly activated later in life!

[RMJacobs]

@BlueDrifter

I didn’t know HepC can remain dormant… and possibly activated later in life!

That’s what I’m told. I’m on immune suppressors, which makes everything more complicated.

My first husband had hepatitis in 1979, when we were still married. I don’t know which one specifically. Somehow, I didn’t catch it, even though he did all the cooking. I was lucky.

Rebecca

[BlueDrifter]

HepA&B were discovered in mid-1960’s. HepC not until 1989