Monday, December 31, 2012

Happy Damn New Year

I see from The Sarcastic Boob's latest post that I am not the only one suffering at the hands of medical politics right now, but I usually stew about a bad situation and cry it out and pout for a while before getting mad enough to finally blog it out.

And I could still have a few days of stewing left in me, so I thought I ought get at least the basics down on blog.

Last year, my oncologist's office merged with another oncology business (I say business, not practice, because it is clear after a year where their focus lies), then six months later broke with the MAJOR insurance/hospital group in our area (over money). I had a "continuation of care" to continue seeing him until the end of the year, at which time I would have to change insurance companies or change oncologists.

I worked very hard (or rather, my insurance broker did) to find a Medicare plan for me for 2013 that my oncologist now accepted, which also included my primary care doctor, without whom I would be lost. We felt certain that (in November, during open enrollment) we had found a very good solution for me.

Friday, midday, I saw my oncologist. My oncologist of SEVEN YEARS. I thought all was fine, we had a nice visit, I left my new insurance card info with the front desk. I had my blood drawn through my port in the infusion room, at which time the nurses informed me that as of 01/01/13, they would no longer be drawing any blood through ports in the office. Not even on an exception basis, the basis on which I had been getting my blood drawn there still since the new business tried to nix it. I had JUST seen my doctor, who surely KNEW of this change, who definitely KNEW I was one of the exceptions he had cleared and he said nothing. I told the nurse that I would no longer be getting weekly blood draws then, Xeloda protocol be damned. I have bad veins in the one arm not at lymphodema risk, and frankly I doubt I could even do MONTHLY blood draws in the traditional way without serious mental and physical pain. (long story there) She told me they could set me up to be able to the infusion center on an out-patient basis at the hospital. I asked if she would arrange it at the hospital nearer my home, rather than the one nearer to the oncology office, since obviously, why would I make the weekly drive to the further facility. I also have vowed never again to go into that particular hospital.

Needless to say, I was crying. I was crying on my way out of the building, where I ran into my oncologist. In my tears I said to him, in accusation, that he hadn't told me I would no longer be able to get my blood drawn there. He indicated that the decision had been taken out of his hands this time. I told him I could not use my veins, and that the nurses said they would set me up at the hospital. He assured me that he understood that I needed to use my port.

He KNEW how I am about needles, and KNEW of the policy change, and KNEW that after seeing him I was headed to the infusion room for a blood draw, where surely he KNEW the nurses would inform me of the change in policy.

Frankly, I think he WIMPED OUT (if someone is a woosie, what is the past tense of that? Woosed out?) He WOOSED out on being the one to tell me about it.

I sat on a bench in the building and cried while texting someone for a few minutes, then made my way to my car and sat sobbing for at least 30 minutes. When I was regrouped enough to drive, I headed home, and on the way decided that I needed to drown my sorrows in chow mein.

But wait, this isn't even the BAD part.

About a half an hour later, in the Chinese restaurant, the Oncologist's office calls to tell me that my new insurance, the one I so carefully chose, would not be accepted by them for the new year. Doctor is not on my plan. Oh yes he is! I insisted.

This is where it gets bad, and I haven't sufficiently stewed to be able to tell this part of the story without sending myself back to the sobs in which I spent the rest of Friday.

I have involved my broker, but it is looking like my doctor had a last minute dispute with this carrier and pulled out...AFTER the open enrollment period. (Dirty Pool! Foul! NOT Cool!) They have been messing with patients lives for a year now, ever since the merger.

SEVEN years I've been with this man. That's longer than my marriage lasted. Seven years I've adored him and depended upon him. In those seven years, I think the longest that I've gone without seeing him was 4 months, when we had just barely started lengthening out the period of time between exams, before my Stage IV diagnosis when I started seeing him monthly again.

And now it looks like I will indeed be interviewing new Oncologists. Something I've dreaded and never wanted to have to do, thinking I would be with this doctor to the end of my days. I made an appointment to see my Primary Care Physician next Monday to try and sort some of this out.

Goal for now? Not to fall into the sobbing dark place again.


Rosina said...

Talk to your family doctor. Maybe she/he would be willing to do your weekly blood work via your port. Even if she does it and you deliver it to the lab. It is such a shame that most doctor's offices have become a business without the human decency to treat a patient with honesty and compassion. You know the insurance companies dictate who can and cannot have treatment and they have ruined healthcare. I'm so sorry you are going through this. All of it. Cancer sucks, healthcare sucks. Hugs to you. :*(

Anonymous said...

I always hate the way doctors abdicate any responsibility or knowledge of the financial aspect of their own practices. This way they can be the good guys vs. the business office or insurance company. It's such disingenuous bullshit and I'm so sorry they've left you caught in the mire of it.


Scorchy Barrington said...

Fuckity fuck fuck fuck! I know it's got to be a fine line for the docs to walk in this day and age. But you had an established relationship--why isn't he helping you problem solve? Dammit to hell. He acted like a tool when what he needed to do was just see how he could facilitate.

Carolyn said...

I can't wrap my head around your health care system Shelli. This is disgusting. I'm sorry you have to deal with this, like it's not bloody hard enough. I figure the sobbing dark place is a place of reality that can help clean out the crap sometimes, glad you are strong enough to climb out when you're done with it. Gentle hugs...

Meg said...

Hearing about these 'situations' makes me sad and angry. As a nurse I have been taught to critically think. No one in this mess thought about anything except money. Whatever happened to patient CARE. I'd send tissues for your tears if I could.

AnneMarie Ciccarella said...

DAMN IT TO HELL..... I can NOT believe what seems to be going on. We need a exorcism of sorts because what is happening every where I turn is making me crazy. I can't be a Fearless Friend when I'm ready to go punch the shit out of people.... Right now? I'm coming out swinging....


Anonymous said...

i am so, so sorry for the grief you are going through. for medical politics and profit to render such awful results and consequences to patients is so abhorrent. this scenario is one i have seen when i was a practicing hospice RN, and now as a ST IV BC patient it scares the hell out of me. i have a porta cath, and veins of an infant, and have informed all my doctors and nurses that it is NEVER to be removed. they agreed. but what the fuck good will that do if labs we use have no one proficient to do the blood draws through the port???

as to losing your oncologist of seven years - crickey, what a shitty deal that was - pulling out after the done deal with insurance. you have defintely had insult added to injury.

i will BELIEVE for you that you find a new doctor/practice that will be sensitive to your situation and needs. please know i will keep you close to my heart during your quest. if you feel like having a sobbing cry, do it - it's a cryable event, for christ's sake, and you deserve any outlet available to give yourself relief.

love, XOXO

karen, TC

The Accidental Amazon said...

Crap, crap, crap....I'm going to read your update now. Sending hugs & outrage in the meantime.

Nancy's Point said...

Good Lord. This is awful. I'm very sorry about the crap you are enduring. And I'm sorry for being so slow to read and comment. Hugs.