Friday, January 23, 2015

Some Call this Medical Care

The winter dulldrums have set in so it seems a good time to address medical issues and get them out of the way.  A foggy day at Turnbull Wildlife Refuge matches my mood.  Since I have been without medical insurance a great deal of my adulthood it seems a number of issues on the back burner are begging to be addressed.  I should begin by stating I am grateful to finally have insurance.  I am however distressed at how diligent I am needing to be in order to receive any benefit of medical treatment.

Last year after the mass enrollment of Americans via the Affordable Health Care Act, I  started another waiting game..... waiting for the selection of Insurance Company.......waiting for the paperwork to arrive in the mail to verify the information......waiting to find and select a primary care clinic....and finally the assignment of a primary physician.

Then came our wonderful Utah trip and after 6 weeks at home on the road again for our nearly 8 week trip around Washington State. Being at home through the winter months while Hailey is in school seemed like a great time to address all our medical issues.  I should have sent a notice to the insurance folks....

I chose to use a clinic I had used when I had no insurance and received excellent care.  The clinic I was assigned to use was 30 miles away, near where I previously lived.  If I stayed with the previous clinic it would be a 60 mile round trip to each doctors appointment..  It required special permission to change to a Doctor closer to home which took five weeks.  After approval I finally had an appointment December 1.  Nice lady but I felt rushed and she made it clear there would only be time to deal with one issue for each appointment....... common on folks, at this rate we won't make it through by medical history before summer.   I had blood drawn and an ex-rays  order on my back and hip and another appointment made for the following week.

The Doctor ordered physical therapy without results of the ex-rays and order medications for my high cholesterol.  It took five more weeks to get pre-authorization for the physical therapy and medication after many, many calls to the insurance company and doctors office.

In one of my calls to the Doctors office, I was told that I need not call again, that they would call me when the authorization came through.  Two weeks later, when I call the insurance company, they had never received the request for authorization.  Clearly, I needed to do the follow up calling.  

In my opinion, going to the Doctor is only the first step towards medical care.  Medical care is what happens after seeing the doctor on the path to wellness.  It seems to me that the process as become concluded in many extra steps that must be managed by the patient.  My biggest concern is for those patient who are unable to advocate for themselves......  Who speaks up for them? 

After annoying persistence with the insurance company and Doctors office, today, the physical therapist went over the results of the test with me.  The vertebrae sit like joined  blocks on top of each other protecting the spinal column. In my mid back one portion of a vertebra has collapsed due to an injury and healed into a v shaped wedge which applies pressure on the spinal column.  The pressure causes pain and numbness that increases throughout the day and more with activity.  It is natural for the spine to try to compensate and straighten itself which causes more arches and bends.  So at this time, the treatment seems to be to try and strengthen the muscles in my core and back to provide better support. 

I guess only time will tell.

Some call this medical care.......

the verdict is still out as far as I am concerned.


  1. Yup. Learning that we have to do all the management, calling, appointment making, re checking, and as you said, if there is no one to advocate, you are lost in the mess. Not a good thing.

  2. so rry that you had to go through all this medical stuff....I have Medicare now that I am that age and have had very few problems with doctors or testing ...I have very close the same problem with my back just finished physical therapy to help strengthen my core and it does help hope it works for you

  3. I can only sigh about how hard it is to get medical care if you are not yet 65 or terminally wealthy or a member of the US congress. Because I drove 23 miles from the farm to the grocery store, 30 miles to have appointments with a doctor I like and trust doesn't seem too much to me. But you should not have to do that or check so carefully on everything. That doctor stinks and is clearly an example of "practicing" medicine. So sorry this is such a hassle. I really sympathize.

  4. UGH! I am lucky to have a great Dr. I have been going to for years. At one point I had to pick an ins. and I messed up and didn't ask the office which ones they allow. The Dr. at the clinic was in my opinion into ins, scamming. She never once listened to my heart or lungs. All she did was carry a laptop and then prescribe high blood pressure meds and a medication for diabetis which I have neither. I had such a bad headache I thought my skull was going to crack I stopped taking the meds and was fine. Luckily it was already time to change and I found the right ins. to return to my forever Dr. I think this Dr. you have is one of those. Good luck with the PT

  5. Wow, that is crazy. I didn't realize how lucky I have been. I have a great doctor and never have to do any kind of calls like that. Now, the insurance company, that is another story. Not as bad as yours sounds but still have to keep on top of them sometimes. Like having the wrong code on whatever paperwork got submitted and getting a bill for my mammogram which is supposed to be free etc. It always gets straightened out in the end but a pain in the neck (or other parts of the anatomy) having to make usually multiple phone calls to get them to fix the problem. I'm thankful to have insurance but wish the process was smoother.

  6. I'm sad to hear this is happening. As a now retired mental health care provider, I can tell you that much of the current difficulty comes from insurance companies who now run everything related to health care. Both as a professional and personally, I've found that it's best to make the calls (noting to whom you spoke & when) & do the follow-up yourself. Folks in primary care are absolute inundated these days & just don't have the staff to take care of all the details. It can be nearly a full-time job for consumers.

    One suggestion I might make is for you to consider choosing someone in internal medicine as your primary care provider once you can change (if you're currently seeing someone in family practice. Folks in internal medicine aren't as busy as family practice providers & they are really more adept at dealing with chronic conditions & problems.

    Hope you're not too far away from Medicare--it's an established system that's been around for quite some time & works very well. All in all, I think we would be much better served by a single-payer system but the insurance companies would lobby strongly against that & it will never happen. Our health-care outcomes just aren't that super here in the U.S. Okay, off my soapbox.

    Take good care on your journey toward wellness. Enjoy PT--work hard, do the exercises at home too (even after you've finished your course of treatment) & it should work well for you.

  7. Beautiful photos here. We will likely be experiencing the same as we transition into the Obama plan, expected as much though. Good luck

  8. Sorry you are having so many health and insurance issues. You need WB therapy. I am there now and it is 50 degrees and I am sitting in my trailer, after a long walk on the beach, in my t shirt and tights with the screen door open.....looking over at My Back Porch! could be here! Sorry, I just had to say that!