I went to the Internal medicine doctor today to find out that a lot of the tests and exams I already get from my other doctors and specialist. So could some one tell me why do I need her. She could not even give me a flu shot, the pharmacist did that.. By the way she was a NP and not the doctor. I think I'm getting doubled billed. for example: I have a rheumy for lupus, kidney doctor, who does blood work every month, a heart doctor who checks my heart and gives me blood pressure medicine, a gynecologist for women issues, psych doctor for bipolar , endocrinologist for diabetics and thyroid . and dermatologist for rashes. What doctors do you see? Are the primary doctor and internal medicine doctor repeating procedures, exams and tests? Help! I'm drowning in medical bills and about to fire my primary and internal medicine doctor.
The idea is to have one doctor manage and coordinate your treatment and meds. However my experience has been that doctors don't play well with each other, do not or will not communicate with each other especially if they are not all part of one big health system, down here the big dog is Lee memorial health system, if your doctor isn't one of theirs you can forget getting them to work together, thats what happened to me I had a total of 10 specialists, each doing their own thing, it was crazy I finally got fed up fired all the doctors and quit all the meds, NOT A SMART THING TO DO. While I've been lucky so far, my luck is running out I'm getting sicker and need medical care once again. I have a plan I'm going to a teaching facility, where I know all the doctors work together, USF has a great lupus program, its 150 miles away I've had to wait since july for an appointment in Nov, that's how hard it is to get in, mayo clinic has the same program but tampa is closer than jacksonville. Anyway depending on what organs are involved and how bad it is sometimes you can consult a specialists who can recommend to your primary what treatment and meds you may need, a heart doctor to treat high blood pressure, unless you have heart damage he's just taking your money. My lupus is very old and complicated affecting my CNS, heart, lungs, skin, intestines, kideny, digestive system, joints, plus the APS and anemia and the low platlets and low red cell counts and swollen lymph nodes pain and fatigue. Some of my issues, well now most are quite serious and I know I'm looking at the merry go round of doctors I'm just hoping they all can check their egos and greed at the door. Before you fire your primary you might consider having a talk with her to find out if she's willing to manage you and only send you to specialists when there's a significant change in your labs or symptoms, except the psych a good psych or therapist is worth their weight in gold. I'm hoping this helps a little have a great day!
I totally understand what you’re saying. I hear your frustration and as you’re listing your specialists, I’m mentally adding up the costs you’re incurring. I like what hopeful had to say about going to a teaching hospital where the doctors do seem to work in concert and generally it’s less expensive than seeing a bunch of specialists. However, I have a pretty long list of specialists myself. They run different test for the most part, some overlap, but it’s been important to me to have specialists on my journey. But here’s the pain in the butt part, every time I see one doctor, I have to give them my list of other doctors to cc their notes to and blood work results. It gets annoying, yet I’ve found it extremely helpful to keep everyone on the same page. I think I’ve lucked out with doctors after many years of searching. And I do come across some of the specialists getting defensive if another specialist says, for example, you’re rheumatologist shouldn’t have you on so much prednisone or, why are you on so many psych meds. The company’s definitely add up. But, it makes me comfortable knowing I have specialists on the case, and all reporting to my PCP. If I didn’t have good insurance coverage, I would definitely check out a teaching hospital. I may need to do that for my dental work because so much needs to be done (thank Sjögren’s) and it’s costing a fortune. I don’t know if any of this helped. But, if you try to get your blood test results to each doctor, especially your primary, they will most likely not run the same exact tests and cost you more money. I think you have an excellent question and I’m interested in how others feel. Best of luck to you!
PS. Sorry for the typos. Damn autocorrect! LOL
With all the conditions you have, it sounds like you need all the doctors you can get! The idea behind "specialists" is just that- they specialize in your particular illness. A PCP (Primary Care Physician [aka Family Doctor]) is there to take care of a little bit of everything, but when the conditions they care for get chronic (meaning the condition your PCP is trying to treat either keeps coming back, or is too hard for them to handle), they will refer you to a doctor who has had MORE training and MORE experience with said illness that has gotten out of your PCP's control. That's why we have so many specialists! For instance, I have Fatty Liver Disease, a condition where fat practically attacks your liver and it could end up pretty bad if uncontrolled. My PCP told me to lose weight, and I did, but the condition was soon found to be chronic, meaning that my weight loss and other simple methods were not working, so my PCP sent me to someone who knew more about it- a specialist, who was a Gastroenterologist (GI) doctor. SO- although your doctors may be "repeating tests", please know it is necessary for them to do so. Having the specialist run the test, and not pull from the PCP's records allows for quicker response times, and a more sure way of knowing the best treatment plan. Please don't fire your IM doctor or your PCP. They are only doing their jobs! However, if you do feel worried about having too many specialists, or too many bills, your first stop should be your PCP. They can revise and redetermine, if necessary, if you should still be seeing a specialist for each of your conditions. Also, don't let $$$$$ stop you from seeing a doctor and getting the necessary medical care! They worst they can do is send your bill to collections, at which point you send a written notice to the collection agency asking them to stop contacting you- its the law they stop (at least in Ohio)! Lastly, you might see a NP because either the doctor was in surgery, or something else, I don't have a whole answer for that one. BUT, a NP is a highly trained individual, so they know what they're doing, but if you would rather see a real doctor for whatever reason, be sure to say so when making the appointment, and when you check in the day of the appointment!
P.S. I see a GI doctor and my PCP! :-) Hope this helped!!!
-R
I see specialists also. I don’t feel most primary drs have the ability to manage us. They don’t have the extra schooling a specialist does nor the experience. I agree teaching hospitals, or places where all charts online is easiest that all drs can see. I also for 20 yrs get copies of all my labs. I have used them yrs later to check things. Bring current labs to all dr appts so not to repeats results. Def don’t pay for duplicate testing. Give them copies of labs.
Most laboratories will send your results to any physician you ask them to - so you can reduce the duplicate testing by asking the lab to forward your results to your other doctors. Also, getting copies of your lab results sent to you every time is a great idea - bring them to every appointment. If you switch doctors or health care systems, do try to get one who has the whole system on-line - that way every specialist you see should have access to your lab results and the other physician's treatment plans/meds/etc.
One thing you might reduce is having a PCP/family doctor AND and internal med doctor. An internal med doctor can act as your PCP and is probably a better choice for those of us who have more complicated medical conditions. Personally, I try to avoid NPs and Physician Assistants. They may be okay for routine stuff for healthy people - but lupus complicates everything.
A board certified internal medicine is highly trained in managing multifaceted illness such as lupus with multiple co-morbidities- IMO they do best with the chronic care and utilize specialists for input in the best and most current care for that particular problem Once you are stable you could cut down on specialist visits and let the primary steer the car down the straight roads- use the specialists for the windy bumpy routes! Overall my internist manages my illness the best cause he doesn't get locked into the tunnel vision of specialists. And the family doc is also the one to treat the more mundane like the flu etc- many specialists won't treat the routine everyday illnesses
you need to get itemized billing for the last month for all your doctors, an compare them, if you are getting double tested, you can bring it to their attention then, if they ignore it and tell you it is something else , I would get your case worker on it , if you are on ssi or social security......purrs..catspaw1955
My primary care dr is great! She really understands me and does all she can to help. She did tell me very directly that she will not treat my lupus, my rheum does that. She helps with everything else like the chronic sinus infections I get, UTI’s, yearly physicals and “minor” issues. She leaves my lupus meds totally alone. When I go to rheum I have him copy my labwork and send to her and vice versa so everyone is in the loop. You’re never going to find one dr who will treat you for everything, I’m sorry but keeping everyone in the treatment loop helps.
I overlap my lab work. I time the testing so that duplicate labs are taken care of at the same time. But I have an HMO. Are your doctors in the same medical group? Do you have an online account (furnished by your insurance company/health care provider) so you can monitor your medical records, visits, labs, past visits?
As Nikki mentions have labs sent to different docs.
Why do you have so many medical bills? Have you signed up for the national health plan? Or, are you from one of the states that doesn't subscribe to medicaid.
Hope you can figure this out. It is daunting and overwhelming to manage your health care. Docs won't be bothered about what needs to be done here. You are your best advocate.
Nikki said:
Most laboratories will send your results to any physician you ask them to - so you can reduce the duplicate testing by asking the lab to forward your results to your other doctors. Also, getting copies of your lab results sent to you every time is a great idea - bring them to every appointment. If you switch doctors or health care systems, do try to get one who has the whole system on-line - that way every specialist you see should have access to your lab results and the other physician's treatment plans/meds/etc.
One thing you might reduce is having a PCP/family doctor AND and internal med doctor. An internal med doctor can act as your PCP and is probably a better choice for those of us who have more complicated medical conditions. Personally, I try to avoid NPs and Physician Assistants. They may be okay for routine stuff for healthy people - but lupus complicates everything.
Good Morning LupusRRJ
I too have many specialists, but they are all in the same group. The hospital in Nashua NH "owns" all the drs. Everything all drs do is on my record. I think thats important for everyone to be on the same page. I KNOW they are in touch with each Thank God. I am OLD LOL., I have medicare and they pay real good.
Cindy
Thank you for your reply to my discussion. I got some really good answers. I have to keep my specialists I know. Some of them have clinics which make them cheaper and I have Medicare but not Medicaid and I'm too young for supplemental insurance. The Doctors are real generous. I don't have to pay a $50 or $75 co-pay, but the balance is adding up. I usually pay my Kidney, Heart and Lupus Doc $20 a month. I pay the other Doctors what I can, as I don't see them that often. The verdict is still out on the NP at the internal medicine office. My largest bill is my hospital bill. I do not work. I'm 53 on disability and I will make it work with all the advice you have given me.
Thank you again....
You can get SSI and medicaid. Hopefully you're not in one of the states that doesn't participate in the medicaid program. I can't imagine paying doctor bills on disability. In know of a person who is 22 and qualified for disability along with SSI and Medicaid.
Check it out. Sounds like you should quality for at least SSI.