Today's (Tuesday) visit with new doctor

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Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25343
   Posted 6/11/2013 10:27 PM (GMT -7)   

(This is posted both at HW PC and at HW CP, however, due to the natural interest at HW CP, will probably expand this topic there)

 

Spent about 45 minutes total “face” time, divided into two sections.  First part was going over medical history, second part physical examination and minor testing.

 

I will start with the positive I got out of the visit:

 

The doctor feels I have a serious situation on hand.

 

Further testing will be required to fully diagnose my condition.

 

He feels that the root cause is likely as the result of extreme radiation damage.

 

He said that my condition has all the earmarks of CRPS (Complex Regional Pain Syndrome), and that it seemed to be in an advanced state.

 

If it is, and left untreated, I could become completely disabled and end up in a wheelchair.

 

The negative:

 

Never saw a medical practice so obsessed with the money part, was badgered from the front desk, with the nurse, then the doctor, then even trying to check out – it was all about trying to obligate me to spend more money, and all appointments and tests have to be paid in full up front, even before being conducted.

 

Before the nurse began to take my vital signs, she was required to give me a memorized spill about how the doctor is totally opposed to the ACA, and how he refuse to see Medicare, Medicaid, and even Champus paitents, unless they will self-pay.  She said he opted out of all the government systems.  I stopped her cold turkey about 5 minutes into this spill, and told her I wasn’t interested in the doctor’s political opinions.

 

The offices were ill equipped and shabby in my opinion.  Too many pictures of the doctor every where  you turned your head and self-made ego boosting remarks about him on the walls

 

Also, the doctor made a point of saying that he didn’t believe in conventional pain medications, and won’t prescribe any regardless.  An odd view to have for a PM doctor, in all my research, most PM doctors try to limit drug use, but even in the treatment of CRPS, drugs are often used as part of the strategy.  I couldn’t help but wonder if he had lost his license to dispense drugs.  And perhaps he had been flagged out of both Medicare and Medicaid.

 

Many of his methods of treatment were identical to the approach that any Chiropractor would utilize, and to be honest, felt I was in a Chiropractic office instead of a doctor’s office.

 

He didn’t have any interest in seeing any of my recent scans, including the bone scan and CT’s done by the orthopedic doctor last year, or even of my recent PET/CT scans.

Conclusion:

 

I feel I am on the right track, my chronic pain issues are serious and on the increase and it could be leading to a more serious situation.

 

But there was nothing he talked about that a good neurologist, using conventional neurological care couldn’t take care of.

 

Since I have Medicare only, I can’t be seeing a doctor whose treatments and service have to be for in cash and advance.  Even the next visit, had I agreed to it, would cost me over 1,500 bucks up front.

 

Going to report to my oncologist, and see if he can get me referred to a top MD Anderson associated neurological practice.

 

Felt like I basically threw 200 bucks out the window.  Not giving up, if anything, I am more driven to get an answer and a solution if possible.  This just didn’t pan out to be the right answer, one doesn’t always know in advance.  There were too many red flags.

 

David in SC

 

 

 

 

 


Mossmi33
Regular Member


Date Joined Jan 2013
Total Posts : 187
   Posted 6/11/2013 10:48 PM (GMT -7)   
Hey David,

This place appears to be a scam. There a lot of dentist offices like that where you go in for a checkup and they tell you that you have 5 cavaties and all this extra stuff and your bill ends up being over a thousand dollars.

I know you have a lot of bad stuff going on but from the short time I've know you, I also know that you have a positive attitude and that means so much when it comes to cancer and CP. You remind me of my mom. She made it 5 years with Ovarian Cancer and never complained once.

I don't believe that you will be in a wheel chair. I think you have a lot of fight left in you!

Barbara Lee
Veteran Member


Date Joined Sep 2003
Total Posts : 2889
   Posted 6/11/2013 11:15 PM (GMT -7)   
David,

Gosh I hate to hear this. I mean it's good that this Dr (if you can call him one) said that you had all the earmarks for CRPS. So you know that you may be on the correct path to figuring it out.

As for the rest, I have to agree with you, there are a bunch of red flags here. I don't blame you one bit for not booking a follow up appointment with him.

I hope that your oncologist can quickly get you in to see a top notch neurologist. I hate hearing that it looks like CRPS, it's so totally unfair that the Radation treatments you received were way to much. Apparently, the Radation Oncologist didn't know what she was doing. (I think it was a she)?

You have come through so much David, I truly believe that you won't end up in a wheelchair. I know you are sick and tired of being sick and tired. I also know that dealing with the amount of pain you deal with is a HUGE part of making you feel like giving up. From the short time I've been reading your story and shaing posts with you I've learned something about you.

You are a true FIGHTER, you DON'T give up no matter what seems to be thrown at you. Do you FEEL like giving up, YOU BET YOU DO. However, YOU have an INNER STRENGTH that propels you to keep fighting. I believe that IF you didn't have that INNER STRENGTH you'd have stopped fighting a long time ago.

I'll continue to pray and be there for you if you need. I hope that you are seen very very soon. Try to rest some today and I hope your pain levels are much lower than they have been.

Hugs,
Barbara

nvrthesame98
Forum Moderator


Date Joined Jun 2008
Total Posts : 6706
   Posted 6/11/2013 11:46 PM (GMT -7)   
Sorry to hear this David since you had high hopes for this guy. I understand they like to make money but I personally wouldn't think of putting my life in the hands of a physician whose only values are the Almighty dollar.

Its certainly easy enough to check on his standing with the AMA and if he has ever been sanctioned by anyone.

Im positive you've seen enough Drs to detect something hinky I.in one. So like you I believe a board certified Neurologist can probably help you more then this guy. Keep plugging along you know the drill to finding a Dr that suits your needs and will play nicely with your other Drs.
" Don't give up God gives his hardest battles to his strongest soldiers.

Vickie
Moderator chronic pain

Disabled since 1998 on SSD
DX: lft knee TKR. 6 rt knee surgeries for meniscus repair. Pars defect,ddd at L3-4 S1. disc collapse at L-3 with nerve impinge,legally deaf, shoulder repair,post encephalitis/mig
Meds(Methadone, lyrica, K+,Indocin,Zantac,Zanaflex,Inderal,HRT

rjbeck
Regular Member


Date Joined Feb 2008
Total Posts : 253
   Posted 6/12/2013 2:49 AM (GMT -7)   
RUN AS FAST AS YOU CAN FROM THIS QUACK.. A PM DOCTOR NOT ACCEPTING ANY FORM OF GOV'T INSURANCE IS BIG RED FLAG THAT SOMETHING IS REALLY WRONG.
OF course this doctor found some serious signs of CRPS and he did this without looking at one of your scans or x-rays and lots of testing is needed.. If I was in your situation I would put a stop to your $200 payment these people did nothing for you but try and sell you some more expensive tests.
 
How does radiation cause anybody to have CRPS
 Complex regional pain syndrome typically develops after an injury, surgery, stroke or heart attack, but the pain is out of proportion to the severity of the initial injury, if any.
Hope you feel better and I am sorry you had to experience a visit with someone like that.

Post Edited (rjbeck) : 6/12/2013 4:04:03 AM (GMT-6)


nvrthesame98
Forum Moderator


Date Joined Jun 2008
Total Posts : 6706
   Posted 6/12/2013 4:00 AM (GMT -7)   
Hi R and where have you been keeping yourself? How are things with you? Sorry David just wanted to say hi and that I agree with R totally on the run(well probably not literally run)but you get it.
Also,R, David has accumulation of various scar tissue from the radiation and surgeries which could be the direct link causing Crps.

Hope you didnt mind me throwing that out there David.
" Don't give up God gives his hardest battles to his strongest soldiers.

Vickie
Moderator chronic pain

Disabled since 1998 on SSD
DX: lft knee TKR. 6 rt knee surgeries for meniscus repair. Pars defect,ddd at L3-4 S1. disc collapse at L-3 with nerve impinge,legally deaf, shoulder repair,post encephalitis/mig
Meds(Methadone, lyrica, K+,Indocin,Zantac,Zanaflex,Inderal,HRT

CRPSpatient
Forum Moderator


Date Joined Mar 2011
Total Posts : 1276
   Posted 6/12/2013 4:15 AM (GMT -7)   
David, I'm sorry this appointment didn't go as you hoped.

I'd agree with the others - if you do have CRPS, a neurologist would probably help you more than this doctor. .

Far too many red flags for me too - bone scans and CT won't necessarily help with CRPS diagnosis... but things like patchy bone loss and muscle atrophy can add weight to a suspect case if they're present. That this doctor wasn't interested in any of your prior records or work-up would make me run - and fast.

I hope your oncologist can find you a decent doc to see.

rjbeck - my understanding is that -any- tissue damage has the potential to trigger CRPS, not necessarily an injury in the typical sense. I've read cases of CRPS, or CRPS-like conditions (the very severe pain, though the vasomotor changes you see in the limbs aren't so consistent) developing in the breast following radiation therapy.


Laura
Moderator - Chronic Pain Forum

Full body CRPS, Dystonia, EDS, Dysautonomia (multiple issues) Osteoporosis, Fibromyalgia

SCS, Intrathecal Baclofen/Morphine pump, multiple oral meds - feel free to ask.

Sophia A
Regular Member


Date Joined May 2013
Total Posts : 156
   Posted 6/12/2013 6:04 AM (GMT -7)   
Wow not the update I was looking for. Im sorry that you had to experience that. Sounds like you know exactly what to do though...get your oncologist to refer the neuro.

Im so glad that you are not discouraged and will continue to fuel that drive and totally know you will get up this hill!!!

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9657
   Posted 6/12/2013 6:32 AM (GMT -7)   
Thanks for keeping us posted David, I hate hearing about doctors like this and this doctor should have his license yanked. Only thing he told you that help is he thinks its serious which is what the other doctors you saw should've said.
So very sorry about this visit. Sure hope your onco can help you with the next step for the neurologists. Hope your not in to much pain after this appointment. Many well wishes to you.
**********************************************
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...
********>^..^<********>^..^<*******

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25343
   Posted 6/12/2013 6:51 AM (GMT -7)   
moss - not sure if it was a scam outfit, but something really wasn't right. and trust me, I so wanted this visit to be the start of a good thing, my "gut feeling" meter went off even a couple of weeks ago when I had to go there and pre-pay for this visit. just not normal to do so.

barb - if anything, this episode makes me want to fight harder. I need answers, I need help, I need real solutions, but I am too smart to get sucked into something like this. I looked over all the walls that I could see, and never saw any medical certificates or degrees. not saying he wasn't a doctor, but hey, usually you see hung degrees somewhere

Vickie - my wife bought up a couple of good points, as a very experienced nurse, who at one time spent years working for doctor offices. she said, he might have gotten thrown out of Medicare/Medicaid because of not following their rigid standards, and perhaps he lost the right to dispense pain medications due to "problems". something to think about, plus about him being so against "Obama care", it was passed in 2010 and his paperwork showed that he was not taking Medicare back in 2008, 2 years before there was even any ACA, so something isn't jiving there.

rjbeck - when I stopped his nurse from her spill, I even said to her, that many of his patients would have to be on Medicare or Medicaid if they were disabled, so I told her it would be odd, since many would also be on some form of disability. She refused to answer me. Yes, CRPS could be triggered from major radiation, I underwent major radiation twice in a little over 10 years, and the 2nd time it was administered wrong and I was burned by it bad enough to destroy my bladder. From what I read, CRPS can be caused from trauma introduced by surgery and even radiation.
Age: 60, 56 at PC dx, PSA 16.3
3rd Biopsy: 9/8 7 of 7 Positive, 40-90%, 4+3
open RP: 11/8, Catheter in 63 days
Path Rpt: 3+4, pT2c, 42g, 20% tumor, 1 pos margin
Incontinence & ED: None
Surgery Failed, recurrence within 9 months
Salvage Radiation 10/9-11/9, SRT failed within 9 months, PSA 12/12 = 40.x
Spent total of 1 ½ years on 21 catheters, Ileal Conduit Surgery 9/10,
7 other PC-related surgeries 2009-2012
Severe Chronic Pain, Severe Fatigue, & Urostomy
Member of Prostate Cancer & Chronic Pain HW Communities since 10/2008
“I live in the weak and the wounded” – Session Nine (Movie)

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25343
   Posted 6/12/2013 7:05 AM (GMT -7)   
Vickie - thanks for the input, I agree with you. I have lots of radiation scarring. when dr. "K" at MUSC inspected my scans when I visited him, he said "I have never seen anyone whose lower insides were so damaged by radiation". The trauma of that even alone, from what I understand, could turn regular chronic pain into CRPS. Even this new "doctor" said that the pain had spread very fast (in the bigger picture of things) from my hip where it originally started, to as much of my lower body as it is currently covered.

laura - thank for you input, I agree 100%. I have developed a lot of atrophy in both of my lower legs, in fact from my hips down on both sides, despite being in oncology rehab for over 2 years now. Getting more and more weakness in my legs, but mostly the right side.

thank, Sophia, trust me, I am moving quickly forward to find a top quality neurologist before this gets out of hand

chart - to say it was an eye opener would be an understatement, but it does give me a sense of real direction now, so in an odd way, he helped me. while he posts many glowing reports about himself from aledged patients, I wonder how many people like me simply walked away after one visit

David

To answer all so far - yes, I am running as fast as I can from this "doctor". I think any of you, would have done the same thing. And in my report here, I just quickly put down the major points of this visit. As I remember more, I will post more. He did get 200 out of me, but that will be the only money.

Even as I was getting dressed, the doctor started pushing, why don't you let me give you this first nerve test, you can have it for 500 dollars, you are already here. I said, no, I was only here for a consult. Then he pushed for injections. I said what are you injecting, steroids? He said instead, I use various medications, the shots range from 69 to 1500 a piece. I said, how long do they last. Oh, sometimes a few weeks to a month, usually the patients have to have them twice a month. I said, and where would you inject me when you don't even know where the pain is primarily coming from?

Tell me that's not a red flag. When I checked out, that woman kept it up, are you sure you don't want the doctor to do something for you today before you leave? I was getting mad by then, and I reminded her that I was only there for an initial consultation.
Age: 60, 56 at PC dx, PSA 16.3
3rd Biopsy: 9/8 7 of 7 Positive, 40-90%, 4+3
open RP: 11/8, Catheter in 63 days
Path Rpt: 3+4, pT2c, 42g, 20% tumor, 1 pos margin
Incontinence & ED: None
Surgery Failed, recurrence within 9 months
Salvage Radiation 10/9-11/9, SRT failed within 9 months, PSA 12/12 = 40.x
Spent total of 1 ½ years on 21 catheters, Ileal Conduit Surgery 9/10,
7 other PC-related surgeries 2009-2012
Severe Chronic Pain, Severe Fatigue, & Urostomy
Member of Prostate Cancer & Chronic Pain HW Communities since 10/2008
“I live in the weak and the wounded” – Session Nine (Movie)

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25343
   Posted 6/12/2013 7:08 AM (GMT -7)   
A question for all of you here, based on what I was told:

Is it possible for a legitimate PM office, to totally be against the use of all narcotic pain meds, no matter what the circumstances or condition of the patient?

david
Age: 60, 56 at PC dx, PSA 16.3
3rd Biopsy: 9/8 7 of 7 Positive, 40-90%, 4+3
open RP: 11/8, Catheter in 63 days
Path Rpt: 3+4, pT2c, 42g, 20% tumor, 1 pos margin
Incontinence & ED: None
Surgery Failed, recurrence within 9 months
Salvage Radiation 10/9-11/9, SRT failed within 9 months, PSA 12/12 = 40.x
Spent total of 1 ½ years on 21 catheters, Ileal Conduit Surgery 9/10,
7 other PC-related surgeries 2009-2012
Severe Chronic Pain, Severe Fatigue, & Urostomy
Member of Prostate Cancer & Chronic Pain HW Communities since 10/2008
“I live in the weak and the wounded” – Session Nine (Movie)

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 6/12/2013 7:12 AM (GMT -7)   
Interesting...Dr. S's website explains why he opted out of Medicare in 1998.

Medicare Opt Out: Why Doctor Opted Out Of Medicare

I am a Greenville physician who specializes in physical medicine and rehabilitation, or complex chronic pain, and serve on the medical staffs of Bon Secour’s St. Francis Community Hospital and Greenville Memorial Hospital.

Part and parcel of a physician's soul is caring for the sick. It's what motivates one to enter the medical profession. Yet, most citizens who have Medicare coverage today are finding fewer physicians who will accept Medicare patients. In fact, many physicians, including myself, are dropping out of the Medicare program altogether.

Why would a physician who has treated Medicare patients for over 15 years suddenly decide to opt out of the Medicare program?

The federal government, while possibly well intentioned, has now created such a complex maze of Medicare rules and regulations that compliance is practically impossible. By the time the physician figures them out, they have changed. By the time on realizes that they are not in compliance, they are audited.

At this point, the federal government is not concerned that the doctor was not aware of the dynamic rules and regulations. To them, the doctor is committing fraud and will be fined up to $10,000 per line item error.

To add to the frustration of keeping abreast of ever-changing rules and regulations, when a physician has a problem with Medicare, he does not know where to turn for help. Medicare is run by the Center For Medicare & Medicaid Services (CMS), also formally known as the Health Care Financing Administration (HCFA). Their main office is in Washington, D. C., but they have regional offices all over the United States. For example, South Carolina's regional CMS office is in Atlanta.

The South Carolina Medicare program has, however, decided that due to their absence of nerve injury, the service is unnecessary. Just a year earlier, when she had private insurance, the procedure would have been covered. Even if by some chance it was not, at least she could choose to pay for it herself. Now that she is on Medicare, however, she has no choice at all.

Physicians are very cautious about patient care in this atmosphere. I, for one, am tired of honoring the Medicare system more than my patients' needs. I welcome the possibility of establishing and renewing physician-patient relationships that are invaded by federal rules and regulations which cannot be followed and appear only to prevent the delivery of care.

This year, U.S. Sen. Kyl introduced a bill, which would allow citizens with Medicare to pay for their own health care (this option was taken away from Medicare patients years ago). If individuals were allowed the opportunity to privately pay for their health care, costs to the government and taxpayers would go down. The bill became law, but before it did CMS and President Clinton attached the following stipulation: If the physician contracted with one Medicare patient who decided to pay for his/her own health care, then the physician could not bill Medicare for any other Medicare patient for two years.

There was an attempt in Congress to remove the two-year exclusion from the new law. HCFA lobbied extensively against this change, arguing that it undermines their ability to control the delivery of health care, and the stipulation remains.

Medicare has become the single largest payer of health care services, and opting out to the Medicare program under the Kyl bill surely will mean lost opportunities for the physician. It is not an easy decision to make.

There are, however, few basic truths more fundamental than the belief that preservation of life and liberty also includes the right to unrestricted freedom when it comes to one's own health care. Opting out allows the physician to place patient care ahead of federal rules and regulations. It empowers him to practice proactive medicine once again. I am a Greenville physician who specializes in physical medicine and rehabilitation, or complex chronic pain, and serve on the medical staffs of Bon Secour’s St. Francis Community Hospital and Greenville Memorial Hospital.

Part and parcel of a physician's soul is caring for the sick. It's what motivates one to enter the medical profession. Yet, most citizens who have Medicare coverage today are finding fewer physicians who will accept Medicare patients. In fact, many physicians, including myself, are dropping out of the Medicare program altogether.

Why would a physician who has treated Medicare patients for over 15 years suddenly decide to opt out of the Medicare program?

The federal government, while possibly well intentioned, has now created such a complex maze of Medicare rules and regulations that compliance is practically impossible. By the time the physician figures them out, they have changed. By the time on realizes that they are not in compliance, they are audited.

At this point, the federal government is not concerned that the doctor was not aware of the dynamic rules and regulations. To them, the doctor is committing fraud and will be fined up to $10,000 per line item error.

To add to the frustration of keeping abreast of ever-changing rules and regulations, when a physician has a problem with Medicare, he does not know where to turn for help. Medicare is run by the Center For Medicare & Medicaid Services (CMS), also formally known as the Health Care Financing Administration (HCFA). Their main office is in Washington, D. C., but they have regional offices all over the United States. For example, South Carolina's regional CMS office is in Atlanta.

Since the Medicare program is so large, CMS contracts with other companies to actually run the program. CMS calls these companies the Intermediary. In South Carolina, the Medicare Intermediary is a subsidiary of Blue Cross Blue Shield, called Palmetto Government Benefits Administrators.

Even the Intermediary admits that it has a hard time keeping abreast with all of rules and regulations of CMS. They may make rulings against what would otherwise seem to be obvious CMS policy. If pointed out to them, don't be surprised if they are deaf to the complaint.

If a physician provides care that they believe to be medically necessary and Medicare pays for it, but then Medicare later decides during an audit that is was unnecessary, the physician will be penalized. The most common and on-going disagreement between physicians and Medicare federal regulations revolves around the issue of was the care medically necessary?

Every patient contact becomes an encounter with choice: think first of the patient? Or of the system? It has gotten to the point where only in a minority of cases can the two needs be met simultaneously.

Mrs. Gray, a 65-year-old woman from Greenville, is a good example. She is a kind soul who suffers from chronic low back pain. Her X-rays reveal degenerative arthritis, and her neurologic studies show no evidence of nerve damage. Having not done well with treatments such as medicine by mouth or physical therapy, she is a very good candidate for an epidural steroid injection.

Hardly a day goes by without some form of the media reporting how the government has further eroded the personal choice of American citizens. All too frequently, the deepest erosion of personal choice is an intensely important one—Americans' health care.

With legislative initiatives like the False Claims Act, the Kennedy Kassembaum Bill, and the Patient Privacy Act, Americans are told they will be taken care of by the government. All is well. Our rights are preserved. When they go to the doctor, however, they find out that just the opposite is true. Medicare participants are confronted with a list of services no longer available to them simply because they are in the Medicare system. Even if they want to privately contract for their own care, they cannot. Doctors are required to file affidavits with Washington stating that they will never file a Medicare claim in order to participate in a private contract, and only a few doctors can afford this.

A lack of accessibility for coverage has also infiltrated itself into non-government sponsored programs. Every day Americans find out that an insurance company clerk (who may have no medical training) determines which health care services are eligible. When coverage for a claim is denied, it has a distinctly detrimental impact on the physician-patient relationship.

In a free market, changing insurance policies seems like an obvious answer. However, acceptance by a new carrier is often difficult due to coverage exclusions for pre-existing health problems. Frequently, these alleged problems concern health care issues of which the individual was not even aware.

A few savvy Americans may recall that it is illegal for an insurance company to deny coverage on the basis of pre-existing conditions. That was the carrot that was dangled when the Kennedy Kassembaum bill finally enacted the vast majority of the Clinton Health Care Plan.

Yet when people question the insurance carrier about this exclusion, they find out that this provision of the law is not enforced. In fact, none of the provisions that protect personal rights are. Only punishments are enforced.

The FBI spends its time sleuthing down health care providers, who are, according to the Attorney General's Office, the country's greatest menace. Declaring physicians as its number-one target, it is no wonder that doctors no longer want to work for themselves.

Consumers and providers of health care find that they are faced with such a complex web of medical laws that it is difficult to determine if they have violated one or not. Being part of the system means playing the role of the abused or of the victim. Just pay the premiums. Expect restrictions. Payer-centered and government-controlled care, which is the name of the game in today's market.

Rather then unifying as a team to protect health care freedom rights, the doctor-patient relationship has deteriorated. The doctor is forgetting how to deliver, and the consumer is forgetting how to receive patient-centered care.

It's no surprise this has happened. What is a surprise is why so few know what to do about it. Individuals in all walks of life need to begin to take more ownership in their health care. They need to go into a doctor's appointment prepared for the visit, and prepared to take responsibility for the entanglements that their third-party payer may bring with that visit.

Doctors need to remember that their first responsibility is to their patient. They need to demonstrate both empathy and decisiveness that reassures patients of their commitment to the patient's well being.

The doctor and the patient have to work together to fight against third-party interference with their relationship. They have to stop any further dismantling of this doctor-patient trust. It is important to repeal legislative provisions that serve to degrade that relationship and instead enhance opportunities that promote responsible choice.

It's all about responsible choice. Both the doctor and the patient have to demonstrate the courage to commit to responsible choice, and to follow through with that commitment. Only then will the health care system function as it should.

A version of this article appeared in the Greenville News, Greenville, SC, January 8th, 1998

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25343
   Posted 6/12/2013 7:19 AM (GMT -7)   
Wow, Sephie. That is quite a piece there, and very political. Good searching, as I hadn't seen his full statement on the subject, but again, wasn't looking for it.

So what is your take on his position? And why would his nurse(s) be required to give the anti-ACA spill even before doing my vital signs?

May be hard to answer on HW, since much of that aspect is political in nature

david
Age: 60, 56 at PC dx, PSA 16.3
3rd Biopsy: 9/8 7 of 7 Positive, 40-90%, 4+3
open RP: 11/8, Catheter in 63 days
Path Rpt: 3+4, pT2c, 42g, 20% tumor, 1 pos margin
Incontinence & ED: None
Surgery Failed, recurrence within 9 months
Salvage Radiation 10/9-11/9, SRT failed within 9 months, PSA 12/12 = 40.x
Spent total of 1 ½ years on 21 catheters, Ileal Conduit Surgery 9/10,
7 other PC-related surgeries 2009-2012
Severe Chronic Pain, Severe Fatigue, & Urostomy
Member of Prostate Cancer & Chronic Pain HW Communities since 10/2008
“I live in the weak and the wounded” – Session Nine (Movie)

alsoinpain
Regular Member


Date Joined Jun 2012
Total Posts : 353
   Posted 6/12/2013 7:55 AM (GMT -7)   
David, I'm glad you're on the right track with getting diagnosed, but I have to agree that this doctor just isn't right. Just in my own opinion, I have to wonder what kind of compassion a doctor has when he opts out of medicare, using the excuse that it's the government's fault with all of their regulations and such. It just makes me personally think that he's greedy. Granted that very well could be farthest from the truth, but that's just my take on it. I think things will be better with the Neuro that you will see next.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25343
   Posted 6/12/2013 8:06 AM (GMT -7)   
also, It would be hard not to evaluate this doctor that way. it was all about money at every turn, with my other doctors, money is never a subject and its never brought up. let alone be flaunted like at this doctor's office. its just not going to happen with me, going with my gut feeling this time

thanks,

david
Age: 60, 56 at PC dx, PSA 16.3
3rd Biopsy: 9/8 7 of 7 Positive, 40-90%, 4+3
open RP: 11/8, Catheter in 63 days
Path Rpt: 3+4, pT2c, 42g, 20% tumor, 1 pos margin
Incontinence & ED: None
Surgery Failed, recurrence within 9 months
Salvage Radiation 10/9-11/9, SRT failed within 9 months, PSA 12/12 = 40.x
Spent total of 1 ½ years on 21 catheters, Ileal Conduit Surgery 9/10,
7 other PC-related surgeries 2009-2012
Severe Chronic Pain, Severe Fatigue, & Urostomy
Member of Prostate Cancer & Chronic Pain HW Communities since 10/2008
“I live in the weak and the wounded” – Session Nine (Movie)

DianeB
Veteran Member


Date Joined May 2013
Total Posts : 1342
   Posted 6/12/2013 9:11 AM (GMT -7)   
David

Re:reason for questioning by nurse.. Perhaps already-anti-ACA people are the (only) target patients for this 'doctor' ??

Impossible to determine why that practice is the way it is.. some folks obviously use it or it would not be viable.

Regulations are apparently quiet complex & this practice has decided to not want to have any outside rules?? !!

Aside from that, you saw the obvious red flags re: not looking at your test results & high pressure to commit to (& pay upfront) for various tests & procedures. Seems only ill-informed or desperate people use this doctor.

Prayers continue for you David
Diane

Herniated cervical discs & other assorted disc / spine issues, Arthritis
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Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 6/12/2013 9:15 AM (GMT -7)   
David, you ask good questions, and ones that I don't know the answers to. If I had to hazard a guess, I imagine that Dr. S is very involved with hospital boards, etc. and it would seem that they would be the ones to push back on the ACA. Not trying to turn this into a political discussion but I must comment at this point that I'm not a fan of the law either. With that said, it seems like professional suicide to opt out of the largest health insurance program in the nation (Medicare) especially with ACA getting ready to kick in come 2014. His website says he accepts most major insurances (yeah, except Medicare) so I wonder what kind of tune he's gonna sing come January and he gets to deal with state-run insurance exchanges. Hmmm...

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 15331
   Posted 6/12/2013 9:25 AM (GMT -7)   
I think David said this dr is connected with some hospital there in Greenville, I cannot recall the name of it right now. My PmMdr told me any dr can decide not to file Medicare, it is not written in blood they have to file it.

That was some interesting reading and there is quite a bit of truth to it too.
Moderator, Chronic Pain Forum & Psoriasis Forum

alsoinpain
Regular Member


Date Joined Jun 2012
Total Posts : 353
   Posted 6/12/2013 9:26 AM (GMT -7)   
I just thought of another question, what kind of tests would he be doing if he required you to pay him for them upfront? I mean, when I get an x-ray or blood tests, the bill comes from the lab, not the doctor that ordered them.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25343
   Posted 6/12/2013 9:32 AM (GMT -7)   
Stray, of course doctors don't have to opt to be in Medicare/Medicaid, its their choice. I answered your other questions on the HW PC side, so won't repeat it here.

I don't want to politicize this thread, but so there is no misunderstanding, I fully support the ACA, and look forward to its implementation. That's all I will ever say on it.

The connection to my preferred hospital system was much less formal than I was led to believe. Starting to believe it only has to do with renting office space in one of the hospitals many medical buildings. I saw no other open connection to the actual hospital systems, like I have with some of their other practices.
------------------------------------------------

Sephie,

It would still seem like many of his patients would typically be on Medicare or Medicaid. Would look like he's cutting off a major source of income in his specialty field. Lots of people on disability would hardly have the resources to pay all these visits and tests out of pocket.

david
Age: 60, 56 at PC dx, PSA 16.3
3rd Biopsy: 9/8 7 of 7 Positive, 40-90%, 4+3
open RP: 11/8, Catheter in 63 days
Path Rpt: 3+4, pT2c, 42g, 20% tumor, 1 pos margin
Incontinence & ED: None
Surgery Failed, recurrence within 9 months
Salvage Radiation 10/9-11/9, SRT failed within 9 months, PSA 12/12 = 40.x
Spent total of 1 ½ years on 21 catheters, Ileal Conduit Surgery 9/10,
7 other PC-related surgeries 2009-2012
Severe Chronic Pain, Severe Fatigue, & Urostomy
Member of Prostate Cancer & Chronic Pain HW Communities since 10/2008
“I live in the weak and the wounded” – Session Nine (Movie)

nvrthesame98
Forum Moderator


Date Joined Jun 2008
Total Posts : 6706
   Posted 6/12/2013 12:06 PM (GMT -7)   
He seems more paranoid over audits and investigation then normal. He has a real problem with anyone being in his business and that rings all kinds of bells for me since every aspect of healthcare professionals are use to and become comfortable with the many agencies and and organizations that peruse our choices of treatment, the scope of how we perform within a variety of guidelines and individual professional associations that strive to assure patients that their healthcare professionals are in fact acting in the best interest of patients and to the best and highest scope of the professionals ability.

Can you even imagine a system of healthcare with no one monitoring? Drs,Dentist, nurses,therapist just do whatever. Scary!

Drs that have a problem with being monitored probably doing or not doing something they should.

We all as healthcare workers have to always make sure every word we chart every Med we sign out every single aspect of care we provide must pass the scrutiny of many including the law. Never seen a healthcare worker have a problem unless they were slack at what they do,breaking some law of land or morality or just plain con artists.
" Don't give up God gives his hardest battles to his strongest soldiers.

Vickie
Moderator chronic pain

Disabled since 1998 on SSD
DX: lft knee TKR. 6 rt knee surgeries for meniscus repair. Pars defect,ddd at L3-4 S1. disc collapse at L-3 with nerve impinge,legally deaf, shoulder repair,post encephalitis/mig
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UserANONYMOUS
Forum Moderator


Date Joined May 2011
Total Posts : 4428
   Posted 6/12/2013 12:14 PM (GMT -7)   
David, sorry to hear this. He really sounds like a quack. Glad you're staying far from this doctor as it doesn't sound right. Your wife did make some good observations.
I'm not familiar with health-care in the US so I'm sorry I can be of any help with your questions.
Thanks for the update.

UA
Chronic Pain, Depression, Borderline Personality Disorder.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25343
   Posted 6/12/2013 12:15 PM (GMT -7)   
Vickie:

My wife (nurse) brought up that very point. She said the Medicare and Medicaid standard of care regulations are essential to protect patients from questionable treatments, that it is a safety net in place for the patients. Makes sense to me.

My wife as a nurse, and her facility, are under constant audit and scrutiny. Right now they are going through peer reviews, the facility's yearly DHEC window is about to open, and when they come to inspect, they get into every nitty gritty detail, and its hard for even a great place not to get flagged for something.

The idea of a medical practice or a doctor practicing without any safeguards, makes me feel a bit creepy and suspicious. Or perhaps its just me.

david
Age: 60, 56 at PC dx, PSA 16.3
3rd Biopsy: 9/8 7 of 7 Positive, 40-90%, 4+3
open RP: 11/8, Catheter in 63 days
Path Rpt: 3+4, pT2c, 42g, 20% tumor, 1 pos margin
Incontinence & ED: None
Surgery Failed, recurrence within 9 months
Salvage Radiation 10/9-11/9, SRT failed within 9 months, PSA 12/12 = 40.x
Spent total of 1 ½ years on 21 catheters, Ileal Conduit Surgery 9/10,
7 other PC-related surgeries 2009-2012
Severe Chronic Pain, Severe Fatigue, & Urostomy
Member of Prostate Cancer & Chronic Pain HW Communities since 10/2008
“I live in the weak and the wounded” – Session Nine (Movie)

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25343
   Posted 6/12/2013 12:16 PM (GMT -7)   
thanks UA, didn't see your post. I am ok with this, just will move on to the next step.
Age: 60, 56 at PC dx, PSA 16.3
3rd Biopsy: 9/8 7 of 7 Positive, 40-90%, 4+3
open RP: 11/8, Catheter in 63 days
Path Rpt: 3+4, pT2c, 42g, 20% tumor, 1 pos margin
Incontinence & ED: None
Surgery Failed, recurrence within 9 months
Salvage Radiation 10/9-11/9, SRT failed within 9 months, PSA 12/12 = 40.x
Spent total of 1 ½ years on 21 catheters, Ileal Conduit Surgery 9/10,
7 other PC-related surgeries 2009-2012
Severe Chronic Pain, Severe Fatigue, & Urostomy
Member of Prostate Cancer & Chronic Pain HW Communities since 10/2008
“I live in the weak and the wounded” – Session Nine (Movie)
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