doctor won't let Me buy on-line

[dakota07]

Hello, I am a newbie and am glad I found this forum. The support here is necessary and terrific.

I just got a prescription for a machine and the doctor wanted to fax it to a DME in the local hospital where I had the titration. I told the doctor that I was shopping around for DME's and that I didn't want her to fax the prescription but to give the prescription to me. I also told the doctor I was going to check out on-line suppliers and the doctor stopped writing and told me she couldn't be my doctor if I used an online supplier because i needed the "support" that the brick and mortar supplies.

That took me aback. I did leave with the prescription, called one local DME and saw how high the prices were. I have messages with two other local DME's and one called me back and left a message stating that they would help me and get the prescription filled " right away" .

I haven't even talked to the DME representative and he assumes I will be getting the machine from him.

Two questions; 1. if a doctor told you he/she wouldn't be your doctor if you filled the machine prescription online, would you find another sleep doctor? and 2. can this second DME fill a prescription without getting my permission and by getting a copy of the prescription from the doctor thereby forcing me to use them?

Suggestions would be appreciated.

[Debjax]

Two questions; 1. if a doctor told you he/she wouldn't be your doctor if you filled the machine prescription online, would you find another sleep doctor? and 2. can this second DME fill a prescription without getting my permission and by getting a copy of the prescription from the doctor thereby forcing me to use them?

1. Yes. Absolutely. If the doctor wants to act like I have no control over my own therapy, then I will find another doctor.
2. Sure, they can fill the prescription without your permission, but you don't have to pick it up from them. If you don't take delivery, you wont' sign any paperwork, they can fill all the scrips they want, that is not your problem. Contact the DME and tell them that you have not yet decided where you will be getting your equipment, and will contact them when you are ready, IF you decide to go with them.

[dels]

I find it frightening that a doctor can have this degree of control.

Where I live, its up to the patient to decide where they purchase their items. My better half was given a scrpt with a list of places he could go to, along with prescription. He made his choice where he went. I also did the same. I also have bought on line. I suggest get a new doctor.

[ozij]

If the doctor is a good doctor, make her aware of the price differences, and ask her what kind of support she thinks you may need.
If she's thinking of having your results tracked by the DME's software, tell her you can buy the software on your own - and have the service cheaper. A doctor who insists on having your data tracked is very much worth keeping - and maybe she really isn't aware of the fact that you can do that without a DME's help.
If she's thinking you need help with mask fitting, see if you can come to a win win deal with a DME about that -- I'm not at all sure its possible.
If she maintains her stance, after you explain prices and the software, then I would definitely look for another doctor.

Sleep doctors often know a lot about sleep, but very little about the nitty gritty of the machines, software, and masks- it's like the orthopedist who diagnoses your broken arm, but does not put the cast on it. Which is why I suggest you give her the benefit of the doubt, and try to educate her. If you still feel she's into power plays, then, by all means, drop her.

O.

[Slinky]

Yes, the doctor can refuse to continue as your doctor. But I believe that to legally drop you as a patient they have to refer you to another doctor and maintain your care until you have found another doctor.

I can understand a doctor's concern that you won't be able to get the support from on online supplier as you are supposed to get from a local DME supplier. These doctors don't have a clue about the price differences between online and local. Nor about how much insurances do and don't pay. They usually do know how crucial the right mask for you is. And that it can be easier to exchange mask until you find that right one with a local supplier rather than an online supplier.

All that being said, the doctor would have been better off advising you WHY she didn't want to see you going w/an online supplier rather than handing you an ultimatum.

[elg5cats]

I believe that to legally drop you as a patient they have to refer you to another doctor and maintain your care until you have found another doctor.

Most states have patient abandonment laws which prevent MD's from dumping patients in the midst of providing care. However, not all states will require the MD/Health Care Provider to ensure a patient is cared for until linked to a new provider. Health care providers can document in a letter they no longer will provide services to a patient and do as little as list other similiar providers who a patient can contact for care.

I have worked in medical institutions where physicans to be are being trained.........I think the best of training is from a patient in real time. When a MD performs well, give postive feedback in person. When they do not, also give feedback. I informed a MD I will not schedule any future appointments with her due to poor communication and failure to involve patient (me) in decision making........she's still lost, sent me a letter with lab results & invitation to call with questions.......documentation that is CYA in nature, but clearly displays cluelessness that she is no longer involved in my health care, AKA: FIRED!!!!

I suggest seeking clarification with this MD if you are inclined to do so. If MD continues to disrespect your ability to intelligently participate in your own care, a MD respecting your input is indicated..........if she can't trust you to have decision making in which machine and where you will purchase from, I don't know why she would authorize you to have a machine at all.........logic is absent in that linear thinking.

Be assertive, it's your health, experience and $$$$

elg5cats

[Goofproof]

1. You have a script in hand, if you are paying for the equiptment, You have all you need. https://www.cpap.com/ can take your script and sent you the machine of your choice, as far as masks, really two are needed, but one will do a FF mask covers you if you have trouble breathing through you nose, and the times when you are congested.

Getting a machine that records full data is good, as is getting the software and reader to see the data. The hardest part of treatment is getting a mask that works for you, size and type. also a Heated Humidifier is useful, and filters for your machine. I would get a APAP with exhale relief, as they off the most treatment options. Most people find the help here exceeds the quality of treatment you can get from a uncaring doctor. Jim

[Guest]

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[azmanatheart]

Dear Dakota07,

This is an interesting dilemma. You must sort out things and try to determine your doctors motives for taking this stance. I take it you have no insurance to offset some of these costs, otherwise you might have to follow your doctors directions to get compensated. You have to understand some very important things to sort this out.
1. There is a 50% drop out rate of people who start CPAP therapy and stop for a variety of reasons
2. Usually those reasons involve being able to adjust your lifestyle, accept your condition and that cpap is the best therapy for you, and most importantly, being able to get used to and comfortable with you cpap equipment.
3. How well do you know your doctor? Do you think he has your best interest in mind or do you mistruct his motives, and is he willing to talk to you about it.
4. Sleep Doctors come in many variety's, some are equipped and willing to help with the nuts n bolts of getting you started on a successful therapy, some would rather outsource that key responsibility to a DME, probably one they have experience with, and hopefully a good track record of getting patients to comply with therapy.
5. DME's come in all varieties too. Some will come to your house once, set you up and forget about you. Better ones will be real interested in your success and wellbeing, and follow-up with you and offer that you call them if you have any problems,(and you will)

So, with a good DME, there is a 'value added' benefit of having someone more accessable and actually more knowledgeable that you can physically see or speak to as you begin your therapy.
The begining can be the most important part, and while this forum is terrific for support, having someone you can stop by and see and speak to can be very worthwhile. WHich isn't to say that all DME's provice that service!

So you need to sit down after speaking to the DME, best if you meet the DME, and have a preliminary meeting to see what they propose and see if they have a follow-up probgram and try to get a feeling if you can work with this person. If not, then there is no 'value added' to be had by paying a higher price than you can get on the internet.

By the way, I've dealt with 2 DME's; the first one couldn't get out of my house fast enough and I never so or heard from them again. Over 1 1/2 years passed and they never offered to replace my mask or see how I was doing, the second is a brick and mortar DME in my doctor's building who I stop by and see regularly. I have also bought a mask from CPAP.COM, and it was the most pleasant and patient Customer Service rep who helped me and gave me all the time and advice and personal opinions I needed to make an informed decision. No pressure to buy, and she offered to be there if I had any questions, concerns, or needed anything at all. They seem to be a real good online company(and sponsor of our website)

The last thing is, try to find out if your doctor has a financial motive for sending you to a particular DME. If so, drop him. He is putting his wallet before your well being. If he truly believes that you will have a better chance for success with dealing with a tangible DME that he is very familiar with, he has a point and you shiould respect that he may get frustrated by having so many patients that don't continue treatment, that he has decided to make sure that they get started with the best chance for ultimate successful treatment.

Hope this helps, DISCLAINER- I am not affilitaed with anyone in anything remotely related to CPAP, not a doctor or health professional(although I should hvae listened to my mother and become a doctor!)

Good luck- get started on the right foot, and you have made a very helpful step in finding this forum.

[Billy6]

I smell kickbacks. (and Apria)

[roster]

It is your money, your health, and your life. You need to be in control of all the decisions. The doctor and the DME, whether online or brick-and-mortar, are being paid to advise and support you.

You will live with the decisions 24 x 7 x 365. The doctor and the DME will only spend a few minutes per year with the decisions. Their lives and their pocketbooks are unlikely to suffer when poor decisions are made about your situation. Your life and pocketbook may suffer.

You have a copy of the prescription. Take control from this moment on.

Seriously consider joining the forum and educate yourself.

Good luck,

[Gerald]

Listen to the chicken (Rooster)........

He's tellin' it like it is.

Gerald

[yardbird]

Some will say we're biased towards our hosts, cpap.com, but as a 10 year (approximately) veteran of CPAP therapy I can state with absolutely no reservation at all, that I have gotten FAR better service and support from the folks at CPAP.COM than I ever did from a local brick and mortar. Not only in making purchases, but I have called with questions of various types and ALWAYS got to speak to a human who cared. I never felt rushed to get off the phone and move on to a "buying customer" when I just had questions.

Now, granted, I can't physically go to cpap.com and have a person help me with mask fitting, etc. But the local DME never did this for me either. I said, "This mask really hurts" and their response was (you'll love this...)..."You'll get used to it."

HUH?

There is one local DME (CpapExpress) that, while their prices are high... let's face it, they're playing the insurance game... the PEOPLE there were nice and allowed me to try on a Quatro and a UMFF (at pressure) when I really needed to see the difference. Sometimes this human interaction is helpful especially for beginners. I bought a UMFF from them even though I paid a little more for it because they were there and spent time with me. Everything else I own I think I've gotten from cpap.com.

But for a doctor to make the statement that they won't be your doctor if you buy online? That smacks of someone getting a kickback from the DME (my sleep doc was getting them... I fired him). Either that or the doctor doesn't know how this works.... this is not real uncommon. If this is your primary care doctor, his/her specialty may not be sleep apnea treatment. If this is your SLEEP doctor... then here's where I'd compromise a little...

FIRST OFF you're the PATIENT. PATIENT does not equal DUMMY or MORON.

Explain to your doctor that you want to be involved in your treatment as this is, for all intents and purposes, a lifelong condition, not a sinus infection.
Explain that while you understand the doctor's concern about receiving support, there are also financial considerations and that forcing you to purchase everything through the DME will cause undo financial hardship. Hardship severe enough that you may have to forgo therapy altogether simply because you can't afford it. Compromise here. Tell the doctor you will get the MASK from the local DME since that is the most difficult piece of this therapy to get right. But that you want the ability to purchase the best MACHINE that you can afford. One with complete data reporting and the ability to be shifted into other modes of operation AT HIS/HER DIRECTION to spot check certain changes after you get used to the therapy as a whole.

You can try the above.
You can ignore it and just be a sheeple and get in line and do what they say.
You can ignore the above and simply fire your doctor and go elsewhere.

Know this:
By NOT writing that script, when he/she KNOWS that you need treatment, this doctor is effectively WITHHOLDING TREATMENT from a patient. Use this phrase only if other reasoning does not work.

Your sleep study results BELONG TO YOU
This prescription BELONGS TO YOU.

Get them and get them now

[DenFtlaud]

For a doctor to "drop you" all they need to do is send you a certified, return receipt letter, telling you that you are no longer their patient. I don't use a home health care agency, but it started out that my insurance company paid for my machine, and the company never came with supplies as promised. I just dropped them and started buying on the internet. I now need a new machine, and am not sure how that will work out as I now have Medicare. Does anyone know how to purchase online and get medicare reimbursement?

[6PtStar]

I now need a new machine, and am not sure how that will work out as I now have Medicare. Does anyone know how to purchase online and get medicare reimbursement?

I am on Medicare as my primary insurance also. I have talked to everyone that I could get them to transfer me to and from what they told me there is NO WAY that they will reimburse me for any purchases I makeon or off line. Billing must come from a company that is registured with them as a Medicare Contractor or Medicare Provider. If they are a provider they have agreed to take what medicare sets as the price. Contractors can bill you for the difference.

Jerry