My Dr. is not happy with me

[LyleHaze]

OK, so I'm new to all this, but I've been reading as much as I can, trying to become an "educated consumer". This forum has been the most valuable resouce so far.
I have been through the first sleep study, and showed AHI's somewhere in the high 50's. A few nights ago I went back for the titration. I was told to sleep only on my back, and the tech woke me when I'd roll over and ask me to get back on my back. No problem, and I got some sleep!
Today I went in for my results. I saw a different Dr. than before, and he was happy to inform me that I would be taking my machine home with me today. I asked about getting an "APAP" machine, and he got quite upset with me. He gave me five minutes on why APAP is not suitable for me, and how it will prevent me from any benefits that CPAP has to offer. Something sounds fishy here. Apparently APAP is only for people who cannot be titrated. There are no other benefits to using one, and the fact that it cannot hold a steady pressure makes it less useful than a CPAP machine.
I politely took a stand, explaining what benefits I though that APAP could offer, and also explaining that I could sdwitch it back to CPAP mode whenever desired. Nope, apparently APAP machines cannot work in CPAP mode. My mistake. I could give more details, but I'm tired.
I then found out that my Dr. is also my DME. They provide equipment for all their patients right there in the office. Didn't expect that! They also stock CPAP machines only. If I want an APAP, I'll have to go "somewhere else" to get it. He then faxed my Prescription to a DME of his choosing, and told me to expect their phone call in a few days.
I didn't bother telling him that I've been shopping around, and I have a quote from billmyinsurance.com that I'l be comparing their quote with.

Anyway, it's really uncomfortable to take a stand when the Dr. expects you to follow blindly. But I did, and I'm glad. It'll take me a few more days to get my equipment, but at least I'll have the machine I want. I figure if I'm paying for it, I should have some say in the choice.

Do many doctors sell equipment as well? I'll admit that it really made me suspicious, especially when he got upset so quickly that I didn't just take what he offered.

LyleHaze

[tangents]

LyleHaze,

My doctor issued my CPAP machine, too, and I was later informed by his assistant that it was the only one he "stocked". Bottom-of-the-line.

I'm really proud of you for standing up for yourself, and hope you get your machine of choice really soon! It's just WRONG of health care professionals to take advantage of sleep deprived patients. Not much different than being robbed by a policeman, if you ask me.

Let us know how it goes!
Cathy

[Snoredog]

OK, so I'm new to all this, but I've been reading as much as I can, trying to become an "educated consumer". This forum has been the most valuable resouce so far.
I have been through the first sleep study, and showed AHI's somewhere in the high 50's. A few nights ago I went back for the titration. I was told to sleep only on my back, and the tech woke me when I'd roll over and ask me to get back on my back. No problem, and I got some sleep!
Today I went in for my results. I saw a different Dr. than before, and he was happy to inform me that I would be taking my machine home with me today. I asked about getting an "APAP" machine, and he got quite upset with me. He gave me five minutes on why APAP is not suitable for me, and how it will prevent me from any benefits that CPAP has to offer. Something sounds fishy here. Apparently APAP is only for people who cannot be titrated. There are no other benefits to using one, and the fact that it cannot hold a steady pressure makes it less useful than a CPAP machine.
I politely took a stand, explaining what benefits I though that APAP could offer, and also explaining that I could sdwitch it back to CPAP mode whenever desired. Nope, apparently APAP machines cannot work in CPAP mode. My mistake. I could give more details, but I'm tired.
I then found out that my Dr. is also my DME. They provide equipment for all their patients right there in the office. Didn't expect that! They also stock CPAP machines only. If I want an APAP, I'll have to go "somewhere else" to get it. He then faxed my Prescription to a DME of his choosing, and told me to expect their phone call in a few days.
I didn't bother telling him that I've been shopping around, and I have a quote from billmyinsurance.com that I'l be comparing their quote with.

Anyway, it's really uncomfortable to take a stand when the Dr. expects you to follow blindly. But I did, and I'm glad. It'll take me a few more days to get my equipment, but at least I'll have the machine I want. I figure if I'm paying for it, I should have some say in the choice.

Do many doctors sell equipment as well? I'll admit that it really made me suspicious, especially when he got upset so quickly that I didn't just take what he offered.

LyleHaze

Like most, your doctor is full of it. When I had AETNA, they discouraged me from using the sleep center I wanted to use because they said it was owned by the doctor, a conflict of interest as they put it, they couldn't prevent me from going there but they made sure I was aware of it. Same when it came to equipment, doctor wanted to also sell me the equipment for therapy. Oh you didn't have a choice, it was the only machine available for your condition.

I told him no-thanks, I'll just take the sleep study and the prescription for the machine and told him I was going to my ENT for a 2nd opinion as I was considering surgery. Oh he didn't like that.

Finally, I took the sleep study back to my regular GP doctor, he crumpled up the Sleep doc's cpap script and re-wrote one for an autopap. He said, yeah we had problems with that lab and doctor before.

They won't tell you the real reason you cannot have an Autopap because that means you won't need to visit them as often for every little change needed as the machine automatically takes care of it. If your doctor owns or is a partner in the sleep center it means you won't be going back for follow-up PSG's, that really hurts their wallet.

Oh its even better (for them) if they supply you the equipment, they can bill your insurance for several months rental first calling it a trial, then turn it into a 10-month rent-to-own and charge upwards of $1700 for a $300 machine. You should see what they charge for a $69 mask, that can turn easily turn into $300.

[muld00n]

Do many doctors sell equipment as well? I'll admit that it really made me suspicious, especially when he got upset so quickly that I didn't just take what he offered.

LyleHaze

Doc: (Shaking finger at patient) Don't you realize how expensive these payments are on my Benz ??

[rested gal]

Anyway, it's really uncomfortable to take a stand when the Dr. expects you to follow blindly. But I did, and I'm glad. It'll take me a few more days to get my equipment, but at least I'll have the machine I want. I figure if I'm paying for it, I should have some say in the choice.

Indeed, you should have quite a bit of say in the choice.

Good for you, Lyle, for doing your research ahead of time.

I politely took a stand, explaining what benefits I though that APAP could offer, and also explaining that I could sdwitch it back to CPAP mode whenever desired. Nope, apparently APAP machines cannot work in CPAP mode. My mistake.

heheh. Well, as you know, you're not mistaken. And as for any doctor specializing in "sleep" who doesn't know that ANY APAP can be used in CPAP mode.... well, lectures from him about what APAPs can and can't do ....<shrug>.

[hayeswildrick]

CONGRATULATIONS!

We have a clothing store in this area that used to advertise "And educated consumer is our best customer." Too bad that doc didn't agree!

I remember back in the days when I used to pay premium dollars to go to an eye doctor, who then "conveniently" stocked contact lenses in his office to sell me. When I suggested I'd rather have a prescription so I could buy my contacts at Costco, he got kind of chilly.

My new eye doctor doesn't sell contacts at all. He makes his money the old fashioned way -- by examining my eyes. He fits me with contacts provided free to him by the contact lens companies. Then I get my contacts at Costco for 1/3 the price I used to pay.

That's the way it should work with medical equipment.

What you really need to do is get your original prescription from your doctor. Happily, billmyinsurance.com will be pleased to do that for you if you choose them. Then, find a new doctor.

By the way, expect HIS DME to give you the same line and tell you that he only prescribed CPAP, so that's all your insurance will cover. Not true.

Jeff

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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP, DME, Prescription

[Wulfman]

Lyle,

Well done!

Welcome to "The few, the proud, the informed".

These doctors need to realize who they're working for.

Best wishes,

Den

[LyleHaze]

Thanks all for your words of encouragement. I can't brag about being "an informed consumer" because I owe that to each of you.
Indeed we are becoming the "information age", when we can research and network, amongst ourselves, independent of those who used to rule unchallenged.

Wow, that almost sounded prolific or something!

Thanks to All,
LyleHaze: still sleepy, but there's hope in my future.

[lvwildcat]

HOORAY!!!! Score one for the good guys -US!!!
Not only are your MD's Benz payments expensive but he's probably also paying for his wife's and girlfriend's(sorry I just COULDN'T resist!)

[dieselgal]

Good for you! I know I was glad I found this forum before getting my machine. If it was up to the DME I would have gotten the bottom of the line thing they were discontinuing or something. Because I had read a few things here and had some information I got one I am happy with. I would do even better if I had it to do over again today because I have learned a lot more. They should be ashamed but they aren't so you have to watch out for yourself! GREAT JOB!

[girlsaylor]

Congrats Lyle! You've gained more than you've lost. There are other docs and DMEs out there, and you don't need these guys any more. Just get a copy of your script and run away!

girlsaylor

[SleepySandy]

It sounds like Lyle might not be far from getting fired by his sleep doc.

I think there should be an award for people who get fired by their sleep doc or DME for being educated patients.

Lyle - it sounds like you didn't get a copy of your prescription from your sleep doc. You're going to need that. Others will need to correct me here, but I *think* you can get an Auto even if the prescription just says CPAP. If that's wrong, I hope you can get your GP to write the Auto prescription.

Also, did you get a copy of your sleep studies? Get those as well. Ask for everything together - sleep studies, including the hypnograms, and the prescription.

One thing we recently learned about billmyinsurance.com is that they won't take machines back, even during the rental period. This can be a problem if for some reason the first machine isn't quite right for you. The advantage of a good local DME (obviously, NOT the one chosen by your doctor) is you start off with the machine in a rental and if during the rental period you need to change machines, the change is made and the rental fee is just applied to the new machine. At least, that's how my DME works. The other advantage of a good local DME is you can try on many different masks. And, many DMEs will allow you to exchange your mask if you have a problem.

Don't get me wrong - I think buying cpap supplies online is great, particularly when you can save money. But, if the cost to you is equal, I would consider a local DME for my initial equipment.

[Guest]

This post apparently got deleted for some reason, so I'll post it again... if it was deleted because it seems to have nothing to do with the topic of sleep doctors discouraging APAP use and recommending CPAP, for heaven's sake look up "sarcasm" and "allegory":

"You don't need a fishing pole! They don't work well, and they aren't for you! You won't get any benefit out of one. What you need is a simple plate, on which to place fish for eating. The plate is much better than a fishing pole, and much more affordable too. Please, put these ideas about getting a fishing pole out of your head, they're unnecessary and they don't work nearly as well as a plate.

Oh, by the way, I sell plates.... right next to all the fish at my fish market. Stop back often!"

[TXKajun]

WTG, Lyle.

Like someone earlier suggested, get a copy of you full sleep study results and a copy of your prescription before your Dr. fires you totally!

Kajun

[BadThad]

Another great story.....good for YOU. There's nothing like the web for gathering information on ANY subject. It's costing doctors millions of dollars! LOL

I was preparing for a battle (I don't even have my machine yet) because the "tech" doing my second study told me "The doctors don't like the APAP machines. You won't be getting one because you don't need one. A regular CPAP is best for you."

Well, rather than argue with the dumb tech, I bit my tongue....and my shiny, new APAP is on it's way to me now! LOL