How to move PCP along

[DOstrugglebus]

So I did an at home sleep study through Novasom last week and got the report last week as well. It says I have mild sleep apnea and with my new dx of afib its recommended that I start on a CPAP machine. I am young guy and just about to graduate medical school and start residency later next year.

The problem is my PCP, since she ordered the sleep study and my HMO is about as understanding as a mad red headed Italian women whose pasta you just insulted I need her in order to kick the can down the road. I have called twice and even spoken to her in the doctor’s lounge of the hospital but she keeps insisting that she is waiting on the DME company to stop by her office. The DME company “gets around to offices every so often” according to the high school kid they hired that answers the phone

I was hoping to get this thing up and running in a matter of days and now it looks like its going to take weeks to get things moving. Have any of you experienced this? Did I make a mistake by not getting referred to a sleep center/doc?

Thanks!

[Julie]

Watch out for replies from Italians... not sure I'd trust them now.

Otherwise, just get a copy of your results and script from the doctor and take them to whichever DME your insce. co. will let you. You don't have to use the one the doctor's waiting for (esp. if she has a stake in their business).

[DOstrugglebus]

Watch out for replies from Italians... not sure I'd trust them now.

Crap didn't even think about that

[Pugsy]

You might want to read this.
https://maskarrayed.wordpress.com/what- ... me-part-i/

Then call your insurance company and find out exactly what your options are in terms of DMEs.
Get a copy of your RX for cpap and use the DME that you prefer to use and not necessarily one your doctor wants to force you to use.
Take charge yourself instead of waiting for the doctor to do something.

As to how to light a fire under a slow to do anything doctors' butt.....good luck on that one.

Just remember your frustration later in your life when you are the doctor in charge of things.

[chunkyfrog]

Oh, HELL no! Avoid that kickback!
Get the prescription, and call every supplier in your network.
Go to whoever will get what you need ASAP.
If you have no insurance, or you have no cpap coverage--BUY ONLINE
Our hosts, cpap.com, can overnight it.
(You are in the continental USA, right?)
If you have trouble getting the Rx, remind her of the A-fib.

[avi123]

The PCP who ordered the study might refuse to continue giving you results. HIPPA State laws include conditions in which a physician who orders the test could refuse to hand the results to the patient. One such condition is that if you could cause "harm" to yourself or to some one else after you find out the results of the test. If it was me I would delete in your above post those nasty words that you posted related to the PCP. I would continue with her.

[JimW159]

Since you have a verifiable Dx of afib, I assume that Dx was made by a cardiologist. If not, can you self refer to a cardiologist? Any doc of virtually any discipline can write a script for xPAP. Consequently, if the cardiologist sees the underlying correlation between apnea and cardiac risks, he/she may well write for you. Depending on your insurance, you may well have many more avenues to get what you need. If the doc who ultimately writes the script is cooperative, it could be you specifying what machine you get and what capabilities it will have. My personal rule of thumb would be "get what you want, not what the DME wants to give you - and - NEVER accept a brick." It is your life - never turn it over to anyone whose only motive is profit. At some point in your professional future you will be writing scripts - always keep in mind how you will feel and react when a DME or others tell your patients "you don't need that."

[palerider]

The PCP who ordered the study might refuse to give you the results.

best to ignore (foe) avi, he's a nutjob.

[DOstrugglebus]

So your PCP is not obligated to give you the results if she suspects troubles from you.

Overall I am confused by your post but I understand your concerns... But, I have the report already and just need the prescription. Also just to be clear the physicians needs to suspect based on the information given that I would cause myself harm or someone else. I doubt me getting the results of a sleep study or a prescription fall into that realm.

[DOstrugglebus]

Sounds like I just need to get the script and do some of the leg work myself- thanks everybody!

[JimW159]

To expand on my earlier comment: Given that you are in Medical school, have you identified a mentor on faculty or has one shown an interest in your progress? If you are shadowing and following on rounds, you have had many opportunities to evaluate faculty, including adjuncts, and they you. If you have, and he/she is also in practice and licensed (almost a given except for PhDs), perhaps you can find an opportunity to engage them in your support. If approached as part of a diagnostic thought process or exploration of a specialty, this could result in a script from him/her or a referral to another faculty member who would write. If your program has a sleep medicine center attached to something like pulmonology or neurology, you might look there. Even if out of network, they may well as a professional courtesy. In my experience DOs often see themselves as distinctly apart from MDs as having a more personal engagement in the healing process - if that is common in your program, use it for your own benefit. The nitty-gritty: look for points of attachment and commonality and use them.

[DOstrugglebus]

To expand on my earlier comment: Given that you are in Medical school, have you identified a mentor on faculty or has one shown an interest in your progress? If you are shadowing and following on rounds, you have had many opportunities to evaluate faculty, including adjuncts, and they you. If you have, and he/she is also in practice and licensed (almost a given except for PhDs), perhaps you can find an opportunity to engage them in your support. If approached as part of a diagnostic thought process or exploration of a specialty, this could result in a script from him/her or a referral to another faculty member who would write. If your program has a sleep medicine center attached to something like pulmonology or neurology, you might look there. Even if out of network, they may well as a professional courtesy. In my experience DOs often see themselves as distinctly apart from MDs as having a more personal engagement in the healing process - if that is common in your program, use it for your own benefit. The nitty-gritty: look for points of attachment and commonality and use them.

First I just wanted to thank you for the post above! This worked perfectly for me and I am picking the machine I want and all the stuff today. I have an ablation for my afib scheduled at the end of this month and in talking with my cardio, EP, and PCP I was able to get the ball moving and it was mainly due to me approaching things like you said more diagnostically. Thanks for the help!

[chunkyfrog]

Congratulations, doc!

[bwexler]

Congratulations.
I am more of a brute force guy.
I just call every couple hours until I have what I want. And, when they say can I call you back, I say no thanks, I will hold.

[avi123]

In my experience DOs often see themselves as distinctly apart from MDs as having a more personal engagement in the healing process - if that is common in your program, use it for your own benefit. The nitty-gritty: look for points of attachment and commonality and use them.

Comment:

In my local DOs are inferior to MDs but these DOs near my home refuse to accept new patients who are on Medicare:

http://www.pcpligonmill.com/FAQ.html