Advocate for yourself...

Today was one of the harder days. I am still paying for swimming last week and am pretty uncomfortable. But...it is easier to take knowing that the surgery is about five weeks away.

I got a nice email today from one of my aunts. She had read the blog and asked about the issues with my doctor's office to which I made reference prior to my first appointment in Boston. Some of you have heard this story, but I was thinking about it today.

I was talking to Sara last night and she told me that she thought I was doing great advocating for waht I need. This process has definitely reminded me of the importance of self-advocacy. I want to share it because I think it is important to manage your own health care.

Right after my arthroscopic surgery in March I had met with the "Dr. Bob" who did the surgery for post-op. He was not satisfied with my progress and decided to send me to the rheumatologist and then scheduled me to come back to him May 15. May 15 I went back to Dr. Bob and agreed that my next stop should be Boston because of PVNS. He knows "Dr. Stone," the specialist in Boston, from doing a fellowship with him. Dr. Bob's nurse said she would call me as soon as she had the appointment set up. Originally the first appointment was scheduled for July 20. I emailed Dr. Stone directly and asked if there was any way for the appt. to be moved up so that I could be off crutches by the time school begins in late August. He emailed me back, moved the appt. to June 1st and scheduled me for surgery before even meeting me. (See...it doesn't hurt to ask!)

So, I called my primary care doctor's office a day or two after my May 15th appt. to get them to do the insurance referral to go to the doc in Boston for June 1. The woman in my primary care doc's office who is responsible for processing the referrals is "Molly." I left Molly a message telling her about my appointment with Dr. Stone along with his info and asked her to call me so I knew she got the information. She did not call me back.

I called her again around May 18th to see if she had gotten my message. She told me she had the information and was getting it taken care of. I assumed I was all set. The hotel was booked for May 31st in Boston because I had to be at the hospital by 7:00 a.m.June 1. Because I am a little bit of a control freak I called Molly on May 30...TWO days before surgery...around 2:30 in the afternoon. I was surprised when she told me that she was unsure about the status of the referral, but told me she would call me by the end of the business day. She did not call.

At this point I was stressing and decided I would stop in her office on my way to work on May 31st. I spoke to Molly and asked why the referral had taken almost two weeks. She told me that their office had been having problems with their fax machine for a couple of weeks and that she was waiting to hear from my insurance company. She said she would call me before the end of the day. I said, "Just like you did yesterday, right?" I told her that by the end of the day I would already be on my way to Boston.

I left the office and called...my insurance company. I asked the woman who answered the phone why it was taking so long to process a referral for problems I have had for over two years, especially when they had approved the referral for Dr. Bob and for the rheumatologist for the same issue. The woman said she was confused because the first my insurance company had seen the referral the previous day.

I freaked! I was so mad....at Molly... I stayed calm talking to my insurance company and learned that if I did not have the referral for the appt. my insurance company would not only not be responsible for the appt. in Boston, but may not be responsible for the surgery! Ahhhhhhhhh..... by this time it was about 10:00 a.m.

I called my dr's office and asked to speak to the office manager. I was told that she was not in the office, so I asked to speak to Molly instead. I asked Molly why the referral had only been sent Weds. She again said it was because of fax machine problems. (I think it was because she had forgotten the referral until I had called to check on it which reminded her about it.) I told her that I did not buy it. That dr.'s offices depend heavily on fax machines and that an office would not go two weeks without having its use. I then asked Molly if I could speak with the office manage and Molly told me that they did not have an office manager. I asked her if that was the case, why I had been told she was out of the office. I asked her how someone who did not exist could be absent from her office. Molly said, "Well, we have an interim office manager." She then connected me to the office manager's voicemail.

I felt like Molly was totally manipulating the situation and not telling me the truth. After I left a message for the office manager, "Barb," I began drafting a letter to her to express my frustration and the added anxiety her office had caused. As I typed I thought about the office. The office is in a hospital, so I figured that there would be other fax machines within a few steps, that were most likely working. I called the office closest to my dr's office...literally 10 strides away... their fax was working fine, and had been working fine for the last few weeks with no problems. In my letter I said that the fax is a terrible excuse. I said that there were other available fax machines, that the window of time would have allowed for alternate methods of information exchange, including FedEx, DHL, and the good old fashioned U.S. Postal Service. I said that that rescheduling this appointment was not an option...the deadline to cancel the hotel reservation had passed and I would have to pay for it and I needed to see this doctor . I finished my letter, and....around 11:15 or so....

some of you may see where this is heading.... I FAXED the letter to their office. I called a few minutes later and asked that they call me as soon as the fax arrived to confirm it had been received. They called around 11:30 confirming the receipt of the fax. (Estimated departure time for Boston was 5:00 p.m.) When they called I asked that Barb call me as soon as she arrived in the office.

1:00 p.m. Barb calls. I aske her if she has read the fax, she says no. I explain my situation and she says she is sorry for the frustration and that she is unsure about the circumstances, but that she would talk to Molly and get back to me by 2:00 p.m. I told her to make sure she recognized that by receiving my fax, Molly's fax trouble story, seemed like a farce.

2:10p.m. Barb calls...(paraphrasing) "Hi Kim, we have not yet resolved the referral, but I have spoken with your insurance company and they said they will have a decision for you by 4:00 about whether or not the appointment would be approved." I told her that she was not giving me new information, my insurance company had already told me that.

At this point I am really angry... I flew off the handle a little... I told her that I felt Molly was lying to me about the fax machine, that she lied to me about the existence of an office manager, and that this situation was because of an oversight on Molly's part. I told her that I did not need the added stress. I told her that I was going to my appointment in Boston. I told her I was going to have the surgery that was already scheduled and that I would not be paying for it. She told me again, that she would make it a priority and would keep checking in with my insurance company. I told her that before I heard from her again I also wanted her to check to see what her legal liability was in this situation because if my insurance company was not going to cover this appt. and not cover the surgery because of an error in her office, she was going to have to pay for it. She said that she would look into it.

I was beside myself...my blood was boiling. In our health care system I had done my part...called the people I was supposed to call....and believed the people who are responsible for my health care would take care of their end of things. This taught me that I am the ONLY one who is responsible for my health care, and even if it means being the squeaky wheel, I am going to call to confirm things, and call again to make sure things are all set.

The appointment was approved. I got a call as I was leaving town for Boston. I was relived, but still so mad about the way my day had gone. Prior to this fiasco, this process has been long, frustrating, scary, and stressful...and my doctor's office caused this situation...on the day before my appt. I told Barb that I was relieved, but that the issue was not over.

I called her back on June 4th to follow up and to ask about pre-op physical therapy. She did not return my call. (Bad form Barb.) I called her again Thursday and spoke with her. She apologized for not returning my call. I told her that I do expect phone calls to be returned and that this whole situation, including her delay in calling me back, damages the relationship I have with my doctor's office. I said that it makes me lose confidence in their office. She assured me that she doesn't want me to feel that way. (I really like my doctor and will stay there, for now.) I asked her about whether or not she had followed up with Molly. She said that they had only a brief conversation but that she would follow up and that the office would be looking at how referrals are done and tracked. She was very happy to process my request for pre-op physical therapy. I told her I appreciated her help and that the issue with the referral to Boston isn't going away, and at the very least, I expect an apology.

Maybe I should let it go...but I don't want to. I feel like it was wrong on their part, and they have yet to apologize for and take ownership of their mistake. I don't want to make Molly's life horrible either. I am sure she has helped a lot of people by processing many referrals, mine included, but this really made me realize how much of a toll the process of heath care takes on people.

So... advocate for yourself, check, and double check your appointments, referals, prescriptions...everything...not because your paranoid, but because you are the ONLY person who will make your health a true priority!

I like my life to be drama free...and it seems that so much over the last year + has been anything but.... so... that is the doctor's office story.

Phew.... that was a lot..... hope y'all are still awake. So as my dad would say... "Enuff said"... for now.