Post
by brasshopper » Thu May 11, 2006 10:56 pm
So, I saw my doctor in Fort Myers, FL. I have decided that I am going to change doctors and would be interested in recommendations. Clewiston, LaBelle, Naples, Fort Myers, North Fort Myers, anyone have a sleep doctor that they like?
He showed me a sleep study that only talked about my titration. It did not mention my diagnosis except in passing. I asked him about it - despite the fact that he had signed the study, it was apparent that it was the first time he had looked at it.
I asked him if he had gotten a study like this through Medicare. He said, "Of Course. We have many patients on medicare." I asked him how, since no where on the study did it say how long the diagnostic part of the sleep study was.
He finally looked at the study and said, "Um, no, this is totally wrong. They only scored half of your study."
He wandered off to yell at someone.
He came back and said that they were going to reread my study and that I could expect it today. Of course, I called in today and there was no reading. The reading of the study totally disagreed with what the tech had said following the study and the central apneas were not mentioned at all in the study.
Now you have to understand that the doctor's name is on the study as if he read the study. He had not only not read the study, he had not read the results. I find it hard to understand how a report could have been prepared over his signature and he didn't see it. I understand that someone else might do the dogwork of reading a sleep study, but I would have thought that he would look at the data and verify that the reading was accurate before having his name put on it.
I suggested that based on the variation, I would be happier with an APAP.
He warned me about the evils of Internet DMEs and I told him that the local DME, who wanted $165 for the cheapest nasal mask, cash, simply was not going to get my business (I've paid $75 for such masks without qualm, I recognize that the local guy needs a larger markup than the guy who is selling out of a warehouse on the Internet, but it really shouldn't be more than two-three times what I have paid for the last equivalent item in the equivalent storefront. A markup of more than 300% over what someone else can sell the same mask for, retail, is just plain ridiculous). I walked in and asked for a particular mask in a particular size, this was simply going to be a sale.
Anyway, the doctor then suggested that there was a DME that was associated with the place that did the sleep study. I told him that I thought that medicare specifically disallowed studies from a sleep center that was associated with the dispensing DME except for hospitals. He asked me what I was going to do if I needed some service on the CPAP. I told him that my old CPAP had needed service once in 20 years and that I lived so far in the sticks that my service would be coming from UPS overnight anyway.
So, after our visit, suddenly, the doctor has a policy against doing paperwork by fax. I had never heard about this policy and had even mentioned faxing stuff in to his office people, but, well, there it was. He agreed to do this one last paperwork exchange by fax. Gosh, just because I wouldn't take his steering.
At this point, I was ticked - I suspected that the doctor's office was just trashing the stuff they got. I believe that they were, in order to make one final effort at steering me to the local DME. Finally I conferenced cpapforseniors and the doc's office and they faxed something and agreed that they had it - it had a problem - the doctor's first name was wrong, but then later I got a call from cpapforseniors that they had gotten confirmation from the doctor's office that the paperwork had been sent correctly to the doctor's.
So, is this sort of steering common? Ethical? Anyone have a suggestion for a better sleep doctor in my area? Sorry, but I am not of the belief that this doctor has my interests in mind. I suspect that he is more interested in the relationship he has, whatever it is, with the area DME. [/code]
