It is IMPOSSIBLE to find PM in this area!!

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Retired Mom
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   Posted 2/9/2012 4:40 PM (GMT -6)   
Ok, so I'm venting and I'm sure it's not completely impossible, but many of you know that I have been struggling to find really good PM for a while.  I've been working with the one I have and I am grateful for the help they give me!! 
The main reason I finally started the "big search" was because I heard of the new laser RFA they are using in a larger city within driving distance for procedures.  Amazingly, one of the physicians who uses the laser comes to this tiny town a day or two a month and I have been trying to find a way to get more info on the practice.  It's a VERY large group of Dr's of many specialites and they have some seriously strange referral practices.
Basically what I found out today is that I have seen two of the Dr's in the group before.  One gave me a "second opinion" on my back a few years back....I LOVED him, but I don't want more surgery and he is a surgeon.  The other did my bi-lateral carpel tunnel surgery a little while back.  The surgery was quite painful, but I honestly can say that he did a very good job and, although I do have some trigger finger issues, it was a good surgical procedure.  Both were very good surgeons and I would work with either one again if ever needed. 
On to the PM issue....So I have to get a REFERRAL from the Surgeon who gave the second opinion a few years ago to even get a CHANCE to see the PM in the group.  I only saw him twice and it was honestly just a second opinion.  Then I have to have all of my records sent from my current PM directly to the Dr and have him review all of the records before they will set an appointment for me to meet with him and discuss whether or not he would be a positive change.  For real????  HELLO????  Does this sound a little crazy to you guys? 
So I asked if I could just get a copy of my records myself and bring them to a consult and they told me no.  They said they have to give my records to the Dr for him to review to decide if he would even accept a referral on me and allow me to change to his practice for care. 
This is the ONLY other group of PM physicians that comes within 70 miles of my home at all.  I don't mind having someone drive me to the procedures...even that far, but I can't expect my husband to take off of work constantly to go in for med checks and standard things. 
I guess I'm stuck where I am and will have to basically take what I can get since there is no way I'm throwing away a Dr for the "possibility" of getting another.  What if he were to say no?  There are only three PM dr's in the whole group and I have found out for sure that one does not prescribe meds.  That leaves two that do, but I don't know anything about them and I can't see either one without all of this hooplaaa. 
Frustration, vent, complain, whine, vent, vent, vent, vent!!!!  I guess that makes me feel some better.  I just wanted a more up to date treatment option for the RFA.  UGH!!!
Failed TLIF L5-S1, Miltiple Bulges/Herniations, Scoliosis, Pituatary Disorder, Fibro, Failed Bladder Surgery, Failed Nissen, GERD, OCPD, GAD, MDD, CFS, TMJ, Migraines, HBP, Idiopatic Reactive Hypoglycemia w/Diabetic reaction to HGH, Bi-lateral CTS (now trigger finger), Edema, Tarsal Tunnel Syndrome, Peripheral Neuropathy, Plantar Fascitis, Tibular Tendonitis, Adult Onset Flat Feet, & Vision Issues

Post Edited (RetiredMom) : 2/9/2012 2:53:50 PM (GMT-7)

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Date Joined Jan 2010
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   Posted 2/9/2012 7:51 PM (GMT -6)   
Hi there,

Sorry for your frustrations:(

To the part about it being odd that they want to review all your records first...this isn't strange at all..Most Dr.s will want this to see if there is anything different they can do that isn't being done now...

The reason they won't allow you to bring the records is unfortunately people could easily remove anything that was a red flag, like if they failed a drug test or got caught Dr. shopping, etc....

So it's between Dr. to can certainly (and should do this) just request copies for yourself from your DR...just to have so you know what is in there...It does cost a bit as they charge for each copy but you can work that out with them..

I'm not sure why you think you would have to throwaway your Dr. now by asking them to possibly see someone else that does a procedure that he doesn't do....Any good Dr. should not mind this at all...

Also, many Dr.s will also say they "don't do meds" up front because people call and only ask about this and it seems to them as if someone only cares about narcotics...The key is asking them if they are comprehensive Pain Mgmt. specialists...Ask if they do everything from injections to PT to medicine....If you say it that way it always comes off better that you are not being a pill seeker...(not saying you are at all....just in general)..

I know this is a hard decision...but maybe talk it over with your husband and really think about whether it's worth going forward to get better care than you are now...

Sending you some hugs tonight!! (( ))
SB and "the pup who snores loudly" 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006

Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 2/9/2012 8:22 PM (GMT -6)   
Wow Snowbunny, I had never thought about it quite that way. I guess I just never thought about people pulling the bad records out and things like that. You would never even believe my previous life was so tied in to law (can't go in to that though for privacy reasons). I should have thought that out more :)

I honestly do understand about the meds question too and I did phrase it something like that. Two of the three in the practice do prescribe meds as part of the treatment plan...only one does not do meds at all. He's not the one I was going to try to get in with anyway. But, there would be two or three main reasons I honestly wanted someone new. One was the Laser RFA (as opposed to the one I scream through...but get anyway because it is honestly the best treatment for me), the second was the flip/flop attitude of my current PM. They often don't remember what they told you and don't have it charted fully from one apt to the next. It's also difficult to get anything stronger no matter how long it has been and how bad the test show deterrioration. They don't order their own testing either and depend on the MRI's, CT's, and X-rays ordered by my PCP. Lastly, this guy comes to my little town for the routine visits and it would make it a lot easier than driving the distance (even though it is on 20-25 miles each way to my current office). Sometimes it can be hard to do that. I'm sure you understand.

I do have to admit that I'm still confused about having to get a referral from someone I've only seen twice (once before testing and once after) for a second opinion on why I was still hurting so badly after my fusion. He was a GREAT guy and I have no doubt he would recommend me (especially since he put in his report that I should continue to see PM until I couldn't stand the pain anymore and then have the surgery done to repair the fusion). He wanted to go in through the front and basically change everything that was done, but was restricted by the way the previous surgery was done. He also wanted to put in a modified cage, but would have to work around the rods/screws that are already there. He was NOT pleased with my original surgery and didn't hesistate to say it in his report. Again, I like him soooo much, but he's an ortho and I am scared to use someone not a Neuro when dealing with this type of situation. I also simply don't want any more surgery if I don't have to have it. Recovery is too bad.

Again, I appreciate your insight Snowbunny. It made me feel a bit silly for getting so upset. I still feel like I will be loosing the one I have completely if I seek another PM for any procedures. He was not pleased at all when the neurosurgeon wanted to do the SCS since he does this procedure too. I decided against it, but I could tell that I would be burning bridges if I went to someone else for something he could do. Perhaps it's ego or perhaps he feels like you would be Dr shopping. I don't know. I just don't want to loose out in the long run for the possibility of a less painful procedure. I guess it will just be time to grit my teeth and deal with the pain for the next RFA in March.

Have a wonderful evening!
Failed TLIF L5-S1, Miltiple Bulges/Herniations, Scoliosis, Pituatary Disorder, Fibro, Failed Bladder Surgery, Failed Nissen, GERD, OCPD, GAD, MDD, CFS, TMJ, Migraines, HBP, Idiopatic Reactive Hypoglycemia w/Diabetic reaction to HGH, Bi-lateral CTS (now trigger finger), Edema, Tarsal Tunnel Syndrome, Peripheral Neuropathy, Plantar Fascitis, Tibular Tendonitis, Adult Onset Flat Feet, & Vision Issues

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Date Joined Mar 2011
Total Posts : 816
   Posted 2/9/2012 8:59 PM (GMT -6)   
Hi, I also was asked to mail my records to one doctor (pm) before he decided if he would accept me as a patient.  Be very careful, before I found the pm doctor I have now, I really disliked the doctors I was seeing, they are a husband and wife team.  I asked for my records and saw about 3 doctors, I did not get meds from any one them as I was only looking for another doctor.  When I went back to the husband and wife team, I saw them about three more times, they then bumped me off there pm clinic, accusing me of "doctor shopping".
I began to explain that I did not get meds from any of the doctors I saw, but there minds (if they had any) were made up.  I will say they bumped me after doing an expensive and painful test to see if I had neuropathy, which I did.  After she told me not to come back, I returned for my records, she told me she was charging Medicare as if it was a real visit.  I reported them to medicare, and low and behold, they had many complaints against them.
Its very difficult, this I know, I finally found a wonderful pm doctor, who also has a wonderful pa, I havent seen the doctor in a year, I see her every visit, and she is great.  She upped my meds when I asked without a blink.  I take 2 buses, 3 trains (subway) and another bus to get there, and its all worth it.
good luck, take care,
degenerative disc disease, fibromyalgia, osteoarthritis, neuropathy, lumbar laminectomy july 1998 no help, rechargeable neurostimulator unit low right back w/lead wires to left side and right leg unit not working just sitting there.i am 57 years young in may will turn 58. i have 2 grown daughters, 25 and 29. i have 2 grandchildren, 9 year old grandaughter and 5 yr. old grandson

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Date Joined Nov 2011
Total Posts : 615
   Posted 2/9/2012 9:26 PM (GMT -6)   
nono  Holy it just should not be so hard...suffering like most of us do on a day to day basis and now they throw all these rules and regulations.  I have worked for the healthcare for 23yrs. so there are things I understand that have to be done, but seriously it is like they have to interview you like they are hiring you for a job....some are so darn arrogant and if your chart is to big and complicated they will not want to take you on as a patient.  Seriously some times it is just that they go to far.  Really all the extra stress causes cp patients more pain maybe they should start taking that into concideration. shakehead
Sorry I guess I got into venting and rambling...just get frustrated with some of these procedures!

Take care all!!! turn

Post Edited (sos007) : 2/9/2012 7:29:37 PM (GMT-7)

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Date Joined Feb 2003
Total Posts : 16789
   Posted 2/9/2012 9:37 PM (GMT -6)   
Sos007, I deleted your duplicate post, the only difference is the 2nd one above has icons in the body of the post-please do not duplicate your post, thanks...Susie
Moderator-Chronic Pain Forum

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Date Joined Feb 2003
Total Posts : 16789
   Posted 2/9/2012 9:59 PM (GMT -6)   
RM, I have a bad feeling this situation is only going to get worse instead of better. I think we are going to see it become more difficult to become a new patient with PM drs, especially if we have been treated by one in the past.

I know my dr does not see a new patient until she has reviewed the previous years medical records. After reviewing them she will make a decision on whether or not she accepts the person as a new patient. That is how a lot of PM drs handle the new patient thing here. It can really make it tough for the person looking for a new dr. I also realize this does help them weed out the undesirables too.

Slowly but surely over time the war on drugs has helped push these drs in this direction. It just stinks. Patients are the one affected and feel the impact.

Take care.
Moderator-Chronic Pain Forum
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