LaughingWater
Cathlete
Cat, I believe it depends on the plan. Our HMO is a real pain about it, and we've had to pay out of pocket for some stuff.
I need some support in this decision
- Thread starter nancy324
- Start date
hiitdogs
Cathlete
That's what I was thinking or hoping. Is there a coverage issue with the tests being ordered by a non-participating physician or does that depend on the plan? Maybe it wouldn't matter with a PPO?
Nancy, we'll get you to the point with your DH that all questions will be answered!
I am not sure how it would work with an HMO but with a PPO I know for sure it's not a problem.
SirenSongWoman
Cathlete
After years of frustration with pretty much everything you mentioned, especially the lack of communication among doctors, this is what I did: I whined about it to all my co-workers and listened to their feelings about their g.p.'s. One co-worker absolutely adored her doctor and strongly recommended him but was concerned he wasn't accepting new patients. He wasn't. So his office (which is associated with the University and has about 10 doctors) suggested I see his wife, a D.O. in the same practice. I'd been to everyone else so what the heck. She turned out to be a Godsend, and she keeps track of EVERYTHING and EVERYONE I see. Whenever I have to see a specialist (usually also associated with Ohio State University) she always has the results of everything I do (every test, every result) and she communicates with them. Every specialist her office has sent me to have also been excellent and whenever I can't get an appointment to see my g.p. there's another woman doctor in the practice who's excellent. I can't tell you how many doctors I'd seen before I found mine who were either unfocused or frankly, stupid and unconcerned. If I hadn't whined at work I would still be playing physician hot potato. So ask around. I'm sure someone you know knows a great doctor who takes your insurance.
BTW, my late mother had serious problems with this whole non-communication issue among all her doctors. If it hadn't been for her pharmacist, who caught EVERYTHING drug-related, she would have had some real close calls. In the end, she fell in love with a doctor someone had recommended to her and she ended up being doctor to both of us, until she got a grant and quit her practice to do physician missionary work among the Somali community... The good one's are so tough to hang onto. I remember what this was like, though, and I feel your pain.
BTW (again), MY doctor NEVER keeps me waiting long, nor does she try to rush me out of the exam room to get to the next patient in her overbooked schedule. Those doctors are dangerous.
BTW, my late mother had serious problems with this whole non-communication issue among all her doctors. If it hadn't been for her pharmacist, who caught EVERYTHING drug-related, she would have had some real close calls. In the end, she fell in love with a doctor someone had recommended to her and she ended up being doctor to both of us, until she got a grant and quit her practice to do physician missionary work among the Somali community... The good one's are so tough to hang onto. I remember what this was like, though, and I feel your pain.
BTW (again), MY doctor NEVER keeps me waiting long, nor does she try to rush me out of the exam room to get to the next patient in her overbooked schedule. Those doctors are dangerous.
Last edited:
nancy324
Cathlete
Stacey, good for you! I'm losing track of how many gynos I've been to. Last year I went to one who wasn't in plan. The total charge was $875 and I had to pay $600 of it, although it appears (it's hard to read these EOBs) that there was $375 of deductible included in that. So, without the deductible, I guess the ins. co. would have paid $600. That's actually pretty good!
Beavs
Cathlete
I'm lucky. I have a very insurance plan and two excellent doctors within the same medical group, both women. What scares me is that with doctors pulling out of health insurance, only the haves will be able to afford their services. As the number of have nots are increasing these days things should be interesting......
Nancy....this doc does sound great but have you fully explored if there are others out there who DO accept your insurance? Even if you don't find one who handles everything is there a medical group where your doctors coordinate care and actually are accountable to you as the patient who deserves their full attention?
Nancy....this doc does sound great but have you fully explored if there are others out there who DO accept your insurance? Even if you don't find one who handles everything is there a medical group where your doctors coordinate care and actually are accountable to you as the patient who deserves their full attention?
maddiesmum
Cathlete
I don't think that calling now and getting a mammogram appt for April is particularly unusual. The way most doctor's offices are run, you need to schedule wellness appts way in advance because each doctor only has a certain number of these appts to schedule each month, the rest of their daily time being made available to people who have just gotten sick and need to see someopne now or tomorrow, with kids getting priority.
Personally, I wouldn't go to anyone where they did not participate in insurance programs. I can think of so many other places where my cash would be better directed, like, say, your 401K.
If your PCP has been screwing up lately and forgetting tests and losing samples, well, then haul him/her onto the carpet for it and get better service. (My PCP lost my pap smear once between their offices and the lab: so what? It happens, the world is not perfect. I went back and did it again, after all, I need to know) And if that isn't available, find a new PCP. A good PCP should do everything for you, including your cholesterol checks, all your gyne work and back pain. You should not need to see an internist and pay outrageous health bills. You will resent it quite quickly,I think, watching all that money disappear on routing office visits.
I would resent it in a heartbeat. I resent even the idea of it. No support for that decision here I am afraid, but plenty of support from me for you to go demand better service from your PCP as well as an apology. Go be tough Nancy!
Clare
Personally, I wouldn't go to anyone where they did not participate in insurance programs. I can think of so many other places where my cash would be better directed, like, say, your 401K.
If your PCP has been screwing up lately and forgetting tests and losing samples, well, then haul him/her onto the carpet for it and get better service. (My PCP lost my pap smear once between their offices and the lab: so what? It happens, the world is not perfect. I went back and did it again, after all, I need to know) And if that isn't available, find a new PCP. A good PCP should do everything for you, including your cholesterol checks, all your gyne work and back pain. You should not need to see an internist and pay outrageous health bills. You will resent it quite quickly,I think, watching all that money disappear on routing office visits.
I would resent it in a heartbeat. I resent even the idea of it. No support for that decision here I am afraid, but plenty of support from me for you to go demand better service from your PCP as well as an apology. Go be tough Nancy!
Clare
nancy324
Cathlete
Clare, I had to laugh at this. I'm hardly the quiet type!
I chewed off my doc's ear for about 20 minutes and she swore that my input would have a permanent effect on the way she practices. I also told her how appalled I was with my DH's cardiologist for not mentioning diet or exercise as a way of reducing blood pressure. She swore she was going to have her office call my DH to come in and give him the speech. Never happened! All the doctors I use are part of a prestigous well-known group associated with NYU hospital. Several of their docs are regularly mentioned in New York Magazine's Best Doctors (but note, the ones listed in NYM do not accept insurance). They ALL have my complete files at their fingertips, yet they don't even look! I can only imagine what a less prestigious group would be like.
Last edited:
Tamrahan
Cathlete
Her age would be a drawback for me-not that I'm against seniors mind you. Just because I don't want to have to shop around for a new DR in a few years.
I've been with my DR forever, like since 1985. My last GYN exam last spring she told me this was her last time she would be seeing me as she was retiring in September. I was bummed out. She was only 60.
She was with a group so my new Dr is younger maybe 35. Hopefully she'll be my last DR.
The Dr you are considering is 60 and could retire at any time or she could practice for another 10 years. Do you want to be looking for a new Dr when you are 63? Just something to consider.
I can only imagine what a less prestigious group would be like.
Hmmm...maybe they would be better.
Often times prestige = higher client load, which does not lead to better care. Just a thought...
hiitdogs
Cathlete
I guess that's a matter of priorities. Having a bad doctor may not let me enjoy my 401k down the road
Last edited:
nancy324
Cathlete
I have to agree with Gayle. My doctors toiling away in small town upstate New York have been awesome. Maybe it's because their egos haven't gone to their heads
I know. My mother's doctors in New Jersey are also awesome. Less hurried, less overwhelmed. Time to talk to patients. I've considered moving.
I honestly don't understand why they say NYC has some of the best health care in the world. If you've lied around in a hospital waiting for an MRI as I have, constantly being pushed to the bottom of the list because your situation isn't an emergency, and finally being released after 3 days without ever getting that MRI, you know that NYC is not the place to be when you're sick.
Last edited:
nancy324
Cathlete
I guess that's a matter of priorities. Having a bad doctor may not let me enjoy my 401k down the road
I was thinking the same thing, Carola. To me, health is the number one most important priority. If you have your health, you can make everything else work.
LaughingWater
Cathlete
How most docs practice has less to do with ego and more to do with the business of medicine. In our experience, the biggest problems come with having a hospital-owned practice.
Beavs
Cathlete
I honestly don't understand why they say NYC has some of the best health care in the world. If you've lied around in a hospital waiting for an MRI as I have, constantly being pushed to the bottom of the list because your situation isn't an emergency, and finally being released after 3 days without ever getting that MRI, you know that NYC is not the place to be when you're sick.
I have to say that the Hospital for Special Surgery in NYC is fabulous and in my experiences with my SO there, they have been the Nordstrom of hospitals and medical care. I wish more tried to emulate them.
LaughingWater
Cathlete
I just had my first visit with a new internist. He took over an hour with me (and I have no special issues...quite boring, actually), and I kept thinking, "What time is it?! Doesn't this guy have other patients?"
I really like him, and he's a well respected, experienced clinician, but I'm so used to the 10 minute oil change-style visit. I was totally thrown off by the time and effort he put into my history and exam.
I really like him, and he's a well respected, experienced clinician, but I'm so used to the 10 minute oil change-style visit. I was totally thrown off by the time and effort he put into my history and exam.
SirenSongWoman
Cathlete
I guess that's a matter of priorities. Having a bad doctor may not let me enjoy my 401k down the road
Most people can't afford to see a doctor without insurance and doctors know that. If doctors only want patients who can pay the full bill in cash they should have gone into cosmetic surgery.
hiitdogs
Cathlete
I understand what you are saying but I don't think it is that simple, Stacey. With the way health insurances are operating these days it doesn't allow good doctors to do their job anymore. It totally takes health decisions out of physicians and patient's hands and into the hands of a bureaucrat at the health insurance whose only job is to keep the cost low and the health insurance profit high.
Not exactly the way I would want to operate if I was a doctor.
Don't get me started on what is wrong with health care these days