Interaction With a Physician's Office

[IllMilkman]

I was wondering if anyone had found effective ways of dealing with their doctors and doctor's offices. I see it's a common point of conversation, and has been the norm in my experience, that we can't get in to see doctors in a timely manner, and when we can, it's difficult to get them to recognize issues we are dealing with. Has anyone found tricks or tools to advocate for better care?

Here's a little background on what brought me to ask this question: I've currently been pretty sick for the last two months (cramping, fatigue, joint pain, headaches, mouth sores, alternating cramping/diarrhea). I'm currently seeing an Internal Medicine Specialist who diagnosed me with Crohns via the Prometheus Test one year ago,but hasn't been able to verify it with scopes or other tests, however my symptoms seem to support it.

When I first started feeling sick, I made the first available appointment which was two months away. They will not allow me to speak to the doctor via phone, I have to speak to a "medical assistant" and relay messages back and forth. These messages are rarely relayed completely or accurately. The office staff is generally rude and dismissive when I call or show up to the office (there is too much to get into here). I have been unable to work during this time, and they have been dragging their feet on the appropriate FMLA, STD, letters, and other paperwork. When this paperwork is completed, it's usually for a week at a time, and I must start on the next round immediately. Its very frustrating, and I don't think it's too much to say that the stress only adds to my symptoms.

So, there's the background. Has anyone found effective tools or tricks to advocate for better treatment (or any treatment at all).

 

[peggyann]

I suggest that you call your insurance company and request that you be assigned to a Nurse Case Manager. This is what I have done and it has been very helpful. If I have a problem or concern, I can call her and let her deal with the doctor's office, medical assistant's etc. She is able to get answers and action much more efficiently than I am due to her position alone and when they realize that you have a nurse case manager overseeing your care, you are likely to get better care! good luck!

 

[Cat-a-Tonic]

I have a couple work-arounds for situations like this. I've found that receptionists are often pretty clueless (they've never heard of the medications I'm on, etc) and have no sympathy if I'm calling and needing fairly urgent attention. So whenever I call my GI's office, I just automatically ask to speak to the nurse. The nurses are familiar with my situation and can get messages to my GI much more quickly and effectively, they are far more knowledgeable than the reception staff so they can answer some of my questions themselves, and they are generally more sympathetic to when I'm suffering and they can sometimes bump up appointments to be sooner.

Another things I do is, I just email my GI directly if I have a question but it's not super urgent. He usually takes a few days to get back to me, but he always responds himself and sometimes he calls me directly if his response is too long/complicated to write out in an email. So if you don't have your GI's email, ask him if you could have it as a way to bypass his staff.

 

[rrhood1]

I have email access to my GI as well. I can email questions and when I did have a flare that was not stopping, she made arrangements for me to be admitted to the hospital.

I also deal with the nurses rather than reception - reception hasn t got a clue and the nurses are always much better informed and willing to help.

 

[IllMilkman]

Peggyann, thats a great idea to use a Nurse Care Manager. What insurance do you have, if you don't mind me asking? Are they very pushy with you?

At my doctor's office, her "medical assistants" are her nurses. They don't seem to know much about anything that goes on, and can't make any decisions or adjust medication without consulting the doctor. I've also asked to contact the doctor directly, and they told me they don't do that because "no, that's what the medical assistants are for" (lol).

I do have a second opinion scheduled for Monday with a doc that has IBD himself, as well as my emergency (two months later) appointment next Thursday. I've also been referred to the Cleveland Clinic, but I've heard that can take time to get into as well.

Im really interested in how everyone else deals with this! It's frustrating to not have much to tell the people in my life and at my job after two months!

 

[northwesterner]

I'm most curious why you were diagnosed with Crohn's via Prometheus test at an Internist's office and not immediately referred to a GI for further care and a colonoscopy.

Internist's normally do not handle follow up care for Crohn's unless you are living in a very remote location where there are no practicing GI's and scopes are done by surgeons.

 

[IllMilkman]

No kidding, northwesterner. I've seen this internal medicine doc for about a year now (Side note, my mother, who has Lupus, has seen the same doctor for 14 years and has had no issues with her whatsoever), and was under the care of another internal medicine doc off and on for about 10 years prior. They have both done numerous scopes, upper GI''s, Pill Cams, ph tests, etc, etc, etc. They've both eventually suffered from the same problem: being very difficult to deal with and/or unresponsive when I'm sick.

 

[nogutsnoglory]

I'm also a fan of emailing the docs but it's hard to get in touch with them unfortunately.