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Old 07-08-2011, 04:01 PM
 
Location: Victoria TX
42,663 posts, read 75,823,792 times
Reputation: 36214

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Has this ever happened to you?

My cardiologist suggested statins for cholesterol, but I declined, and he said OK but monitor your cholesterol, which is borderline, and follow up as needed. Fine. After a year, I phone for an appointment, and ask if I can have the cholesterol screen done first, so we can discuss it. Nope. Make the appointment for two weeks from now, see the doctor, he'll decide whether to order the screen, then make another appointment for two weeks later to discuss the results. But . . .? Nope, can't do it, maybe your primary care doc will order it.

So I phone my primary care Dr, same deal, Nope, he won't order a cholesterol screen until he sees me, then come back later when he has the results, and he can bill Medicare twice for office calls, just for a cholesterol screen.

But my supermarket has a health fair every other Saturday morning, and I can walk in off the street, get a fasting cholesterol screen on the spot, no doctor's order, immediate printout of the results.

The only difference is that I have to pay the $29.95 out of my pocket, instead of having it paid by Medicare, if it were doctor ordered.

When the Dr office said "he can't do that", I said Yes he can, it is not a violation of state or federal law nor medical ethics, and he can do whatever he wants, Nurse Ratchet just said "That's how he treats patients". Yes, I said, I know EXACTLY how he treats patients. With greed and contempt, which has become the industry standard.

Anybody think I'm off the mark?

Last edited by jtur88; 07-08-2011 at 04:12 PM..

 
Old 07-08-2011, 04:25 PM
 
Location: Mostly in my head
19,865 posts, read 57,429,630 times
Reputation: 19171
You have the wrong doctors. None of mine are like that. When I leave their offices, I have an order form for the lab work to be done before my next visit.
 
Old 07-08-2011, 04:37 PM
 
Location: zone 5
7,329 posts, read 13,661,090 times
Reputation: 9638
I left a doctor for that exact reason. No other doctor among the ones my family and I have seen does things that way.
 
Old 07-08-2011, 04:51 PM
 
Location: Los Angeles area
14,017 posts, read 18,184,482 times
Reputation: 32365
Whoa! I need to mark this on my calendar or something. I agree 100% with Jtur88. Now I think this will cause me to re-evaluate my lack of belief in miracles.
 
Old 07-11-2011, 01:02 PM
 
Location: Georgia, USA
24,493 posts, read 29,524,653 times
Reputation: 30415
Quote:
Originally Posted by jtur88 View Post
Has this ever happened to you?

My cardiologist suggested statins for cholesterol, but I declined, and he said OK but monitor your cholesterol, which is borderline, and follow up as needed. Fine. After a year, I phone for an appointment, and ask if I can have the cholesterol screen done first, so we can discuss it. Nope. Make the appointment for two weeks from now, see the doctor, he'll decide whether to order the screen, then make another appointment for two weeks later to discuss the results. But . . .? Nope, can't do it, maybe your primary care doc will order it.

So I phone my primary care Dr, same deal, Nope, he won't order a cholesterol screen until he sees me, then come back later when he has the results, and he can bill Medicare twice for office calls, just for a cholesterol screen.

But my supermarket has a health fair every other Saturday morning, and I can walk in off the street, get a fasting cholesterol screen on the spot, no doctor's order, immediate printout of the results.

The only difference is that I have to pay the $29.95 out of my pocket, instead of having it paid by Medicare, if it were doctor ordered.

When the Dr office said "he can't do that", I said Yes he can, it is not a violation of state or federal law nor medical ethics, and he can do whatever he wants, Nurse Ratchet just said "That's how he treats patients". Yes, I said, I know EXACTLY how he treats patients. With greed and contempt, which has become the industry standard.

Anybody think I'm off the mark?
Yes, you are off the mark.

It appears that you do not think your doctor deserves to get paid for taking care of you. Medicare will not pay a single penny for care provided by telephone. In order to charge, there has to be face to face time with the patient. And Medicare requires that the copay be collected. If you cannot afford it, you need to apply for Medicaid.

So you think the doctor should just order the test and call you to discuss the results and phone in a prescription? Even if he does all that for free so you do not have to pay your copay?

It has been a full year since your last exam. What about a physical examination? Is he supposed to do that by telephone, too? If you have cholesterol problems, you need to have your blood pressure measured, weight monitored, eyes checked, your heart and lungs examined, blood vessels checked in the neck and legs and perhaps have an EKG. The fact that you have been seen by a cardiologist suggests that you already have a heart issue of some kind. An office copay now might help prevent a hospitalization in the future.

Until the doctor examines you, he will not know whether you need other blood tests, not just the cholesterol.

I am reminded of an experience my father had. He saw his internist because he was having some upper abdominal pain. Since he had a history of stomach problems, he could easily have called and just asked for something for indigestion. Fortunately, he went to the office instead. That visit averted a possibly fatal heart attack.

Your doctor is not there just to order the test for you. He is there to interpret the results. If all is normal, he very likely will just notify you by phone or letter. If anything complicated is found, you should go to the office, sit down with him, and the two of you decide about treatment. That can be a lengthy discussion, and he should get paid for doing it.
 
Old 07-11-2011, 02:41 PM
 
Location: Visitation between Wal-Mart & Home Depot
8,308 posts, read 35,013,248 times
Reputation: 7115
Quote:
Originally Posted by jtur88 View Post
Has this ever happened to you?

My cardiologist suggested statins for cholesterol, but I declined, and he said OK but monitor your cholesterol, which is borderline, and follow up as needed. Fine. After a year, I phone for an appointment, and ask if I can have the cholesterol screen done first, so we can discuss it. Nope. Make the appointment for two weeks from now, see the doctor, he'll decide whether to order the screen, then make another appointment for two weeks later to discuss the results. But . . .? Nope, can't do it, maybe your primary care doc will order it.

So I phone my primary care Dr, same deal, Nope, he won't order a cholesterol screen until he sees me, then come back later when he has the results, and he can bill Medicare twice for office calls, just for a cholesterol screen.

But my supermarket has a health fair every other Saturday morning, and I can walk in off the street, get a fasting cholesterol screen on the spot, no doctor's order, immediate printout of the results.

The only difference is that I have to pay the $29.95 out of my pocket, instead of having it paid by Medicare, if it were doctor ordered.

When the Dr office said "he can't do that", I said Yes he can, it is not a violation of state or federal law nor medical ethics, and he can do whatever he wants, Nurse Ratchet just said "That's how he treats patients". Yes, I said, I know EXACTLY how he treats patients. With greed and contempt, which has become the industry standard.

Anybody think I'm off the mark?
Sounds like you have a really shytty doctor and should find another if you're able OR it sounds like your doctor has really shytty front office personnel.

Jturr, when you were in the military you had good officers, bad officers and incompetent officers, right? The ratio of good/mediocre/bad/incompetent is probably very similar between officers and physicians. The good thing about a shytty doctor is that at least you don't have to take any sheet from him (or his overconfident, undereducated, underskilled secretary with delusions of elitism) unless you just want to.
 
Old 07-11-2011, 03:43 PM
 
Location: zone 5
7,329 posts, read 13,661,090 times
Reputation: 9638
Quote:
Originally Posted by suzy_q2010 View Post
Yes, you are off the mark.

It appears that you do not think your doctor deserves to get paid for taking care of you. Medicare will not pay a single penny for care provided by telephone. In order to charge, there has to be face to face time with the patient. And Medicare requires that the copay be collected. If you cannot afford it, you need to apply for Medicaid.

So you think the doctor should just order the test and call you to discuss the results and phone in a prescription? Even if he does all that for free so you do not have to pay your copay?

It has been a full year since your last exam. What about a physical examination? Is he supposed to do that by telephone, too? If you have cholesterol problems, you need to have your blood pressure measured, weight monitored, eyes checked, your heart and lungs examined, blood vessels checked in the neck and legs and perhaps have an EKG. The fact that you have been seen by a cardiologist suggests that you already have a heart issue of some kind. An office copay now might help prevent a hospitalization in the future.

Until the doctor examines you, he will not know whether you need other blood tests, not just the cholesterol.

I am reminded of an experience my father had. He saw his internist because he was having some upper abdominal pain. Since he had a history of stomach problems, he could easily have called and just asked for something for indigestion. Fortunately, he went to the office instead. That visit averted a possibly fatal heart attack.

Your doctor is not there just to order the test for you. He is there to interpret the results. If all is normal, he very likely will just notify you by phone or letter. If anything complicated is found, you should go to the office, sit down with him, and the two of you decide about treatment. That can be a lengthy discussion, and he should get paid for doing it.
I believe he was talking about having to make 2 appointments, not one. A doctor I went to briefly did that. One to get your checkup and your orders for bloodwork and tests, then make another appointment to discuss test results. "I don't give results over the phone." I've been to a few different doctors and she was the only one that did that. It's not necessary, it's just moneygrubbing.
 
Old 07-11-2011, 04:06 PM
 
Location: Victoria TX
42,663 posts, read 75,823,792 times
Reputation: 36214
Quote:
Originally Posted by suzy_q2010 View Post

It has been a full year since your last exam. What about a physical examination? Is he supposed to do that by telephone, too? .
No reasonably healthy person needs a full medical every year. The cardiologist said "follow-up as needed". Blood pressure and cholesterol can be monitored without a full physical examination taking place to determine advisability or necessity of the tests.

A more careful reading of my OP would have revealed to you that I had already made an appointment to be seen by the doctor, and nothing was ever stated or implied about examination by telephone. The doctor cannot tell my cholesterol level by looking at me or prodding me or palpitating me. He needs to see a blood test result, and if there is none for him to see, what is the use of seeing me? If he wants me to have other tests, he can order those on the first consultation AFTER he sees the cholesterol scan results. If he orders additional tests without knowing my cholesterol levels, I would have serious doubts about his competency as a physician.
 
Old 07-11-2011, 04:19 PM
 
Location: Georgia, USA
24,493 posts, read 29,524,653 times
Reputation: 30415
Quote:
Originally Posted by subject2change View Post
I believe he was talking about having to make 2 appointments, not one. A doctor I went to briefly did that. One to get your checkup and your orders for bloodwork and tests, then make another appointment to discuss test results. "I don't give results over the phone." I've been to a few different doctors and she was the only one that did that. It's not necessary, it's just moneygrubbing.
So, you also believe that the doctor's time and expertise to interpret the results for you and come up with an individualized treatment plan does not deserve any compensation?

If you talked with an attorney on the phone, you would be charged, I guarantee you!
 
Old 07-11-2011, 04:40 PM
 
Location: Victoria TX
42,663 posts, read 75,823,792 times
Reputation: 36214
Quote:
Originally Posted by suzy_q2010 View Post
So, you also believe that the doctor's time and expertise to interpret the results for you and come up with an individualized treatment plan does not deserve any compensation?
Don't you think I can interpret the results of a cholesterol test myself? And take my own blood pressure. Here they are:

Total Cholesterol, fasting= 155
HDL = 61
LDL = 68
Triglycerides = 133

Would you call your doctor and pay him for an office call and "his expertise" and take a half a day out of your life, to interpret those for you? What do you think his "individualized treatment plan" is going to be? The last time I saw him, his individualized treatment plan was "follow-up when needed".

I've never had any trouble, by the way, getting an attorney to talk to me on the phone for ten minutes, no charge. If I present a case they can win, they offer to schedule a meeting and talk about fees and contingencies. If I don't, they say so and tell me to have a nice day.

Last edited by jtur88; 07-11-2011 at 04:54 PM..
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