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Thread: Health Care Referral System a Joke - Driving Me to Tears

  1. #1

    Default Health Care Referral System a Joke - Driving Me to Tears

    In order to see ANY specialist, you must have a referral from a primary care doctor or another doctor. I live miles from all specialists, so scheduling an appointment with any physician is a major effort. I have to keep calling/e-mailing or then, eventually, sometimes even driving miles to my primary doctor with referral information/form in hand, and still have to keep nagging the clinic for a referral. I have also had some specialists require a referral for EACH visit, if the "reason" for the second visit is different from the reason for the previous visit. And each referral requires copies of all of your medical/hospitalization records, MRIs, etc., and my doctor doesn't have all of my records, and "forgets" to send the ones he has. I then also have to get in touch with other doctors and the hospital to get a complete set of my records, so I have to make copies of all of my paper records because I have to send them, or take them myself. (But no one gets to keep the CDs of my MRIs. because I don't want to have to keep getting more and more.) The damn doctors don't take the time to look at all of that information you send/bring to them, anyway. Every doctor comes in to the appointment like their butt is on fire, just makes one easy assumption in about 5 minutes, and expects to be reimbursed from your insurance for the cost of a full exam.

    This whole health care system that requires a referral for every doctor's visit is a joke. My primary care doctor wants me to visit him first (and pay him the cost of an office visit) as if I have to bribe him to let me go to another doctor, and then have to pay that doctor for another office visit there. And the time it takes for this whole process from beginning to end until the day you finally go to your appointment will usually take 3-4 MONTHS IF YOU'RE LUCKY.

    I had two friends who were ill and kept trying over and over to find and get in to see doctors (all requiring referrals) over the course of a couple of years. Both of them did not get their diagnoses until their autopsies. They died not knowing why they were dying. I was diagnosed with MS, but am having unrelated health issues. But every doctor just wants to blame everything on my MS or, as a female, "It's just depression." I have all of the health insurance I need, but it isn't doing me any good. It's just a lot of payments going out to doctors I have to wait for months to see after going through a lot of hoops to get to, and then, in the end, just being dismissed as if I was just wasting their overpriced 5 minutes of time. The American health care system is broken.


  2. #2
    Distinguished Community Member Lazarus's Avatar
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    Nice to see you posting. Sorry things are so tough.

    When you post again, try to break up those long paragraphs into small ones. Many people here have eye problems and we can not read huge blocks of print.

    I did not see a question in your post so it seemed you were looking for people who understood.?? If I missed the question point it out . If you needed to vent, I hope it feels better.
    Linda~~~~

    Be the kind of woman that when your feet hit the floor each morning the devil says:"Oh Crap, She's up!"

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  4. #3
    Distinguished Community Member agate's Avatar
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    Quote Originally Posted by Page.One View Post
    This quote is hidden because you are ignoring this member. Show Quote
    In order to see ANY specialist, you must have a referral from a primary care doctor or another doctor. I live miles from all specialists, so scheduling an appointment with any physician is a major effort. I have to keep calling/e-mailing or then, eventually, sometimes even driving miles to my primary doctor with referral information/form in hand, and still have to keep nagging the clinic for a referral. I have also had some specialists require a referral for EACH visit, if the "reason" for the second visit is different from the reason for the previous visit. And each referral requires copies of all of your medical/hospitalization records, MRIs, etc., and my doctor doesn't have all of my records, and "forgets" to send the ones he has. I then also have to get in touch with other doctors and the hospital to get a complete set of my records, so I have to make copies of all of my paper records because I have to send them, or take them myself. (But no one gets to keep the CDs of my MRIs. because I don't want to have to keep getting more and more.) The damn doctors don't take the time to look at all of that information you send/bring to them, anyway. Every doctor comes in to the appointment like their butt is on fire, just makes one easy assumption in about 5 minutes, and expects to be reimbursed from your insurance for the cost of a full exam.

    This whole health care system that requires a referral for every doctor's visit is a joke. My primary care doctor wants me to visit him first (and pay him the cost of an office visit) as if I have to bribe him to let me go to another doctor, and then have to pay that doctor for another office visit there. And the time it takes for this whole process from beginning to end until the day you finally go to your appointment will usually take 3-4 MONTHS IF YOU'RE LUCKY.

    I had two friends who were ill and kept trying over and over to find and get in to see doctors (all requiring referrals) over the course of a couple of years. Both of them did not get their diagnoses until their autopsies. They died not knowing why they were dying. I was diagnosed with MS, but am having unrelated health issues. But every doctor just wants to blame everything on my MS or, as a female, "It's just depression." I have all of the health insurance I need, but it isn't doing me any good. It's just a lot of payments going out to doctors I have to wait for months to see after going through a lot of hoops to get to, and then, in the end, just being dismissed as if I was just wasting their overpriced 5 minutes of time. The American health care system is broken.

    Hi Page.One, and


    You registered here in 2006 but this is your first post. Might you be a returning former member?

    Nobody can tell you how to post or what to post here but new members are sometimes asked to break up their posts into smaller paragraphs as a courtesy to those here who have vision problems and find it hard to follow dense blocks of text.

    It's tragic that you've lost two friends who never had a chance to see the specialists they needed. The system has many many flaws, and the long waits for specialists are among the most glaring defects.

    A specialist usually isn't the person you'd go to in an emergency, though the specialist might soon be called in on the case once you'd been seen as an emergency. That is how the long waits are justified.

    It makes some sense to run a case past a primary care doc first even if the visit seems to you to be routine and unnecessary.

    A specialist is just that--a specialist. That person's time is so valuable that he/she has to have many ways of screening out patients who might not really need to see that specialist--but might need some different specialist.

    Or might need no specialist. In many instances the primary care doc is able to tend to the problem.

    I'm afraid having to remind doctors' offices of the need for appointments and the need to get rx refills and the need for you to have copies of your medical records is par for the course.

    Doctors seem to be badly overloaded. The number of patients a typical doctor sees in a typical day is staggering. I'm not sure that some of this isn't the doctors' own doing--maybe just by having hired incompetent office staff--but office management isn't at all like practicing medicine, as I think any doctor would tell you.

    I'm not making excuses for them. You're absolutely right about how discouraging it can be to have medical problems that need to be addressed and to be caught up in systems that aren't working well for you.


    Looking forward to getting to know you better--
    Last edited by agate; 02-11-2016 at 10:25 PM.
    MS diagnosed 1980. Avonex 2002-2005. Copaxone 6/07 - 5/10.
    Member of this MS board since 2001.

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  6. #4
    Distinguished Community Member Sunshine's Avatar
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    You have to get a referrals? Hm. My insurance doesn't require that. Sounds very annoying.

    Doc's do play the depression or stress card when they're stumped. I would rather they just say, I don't know

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  8. #5
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    I've never had insurance that requires me to have referrals, Page, and I realize I am lucky.

    I am sorry for your run around. A person w MS (actually most sick people) doesn't have energy to run around like that! You are smart to keep copies of your records.

    See you around the board.
    ANN
    There comes a time when silence is betrayal.- MLK

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  10. #6
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    Hi Page, welcome

    Sorry about all the problems you are having with the paper work and referrals and seeing Doctors. Many on here can relate to what you are saying. I spent much of my day today trying to get a problem ironed out between a pharmacy and the insurance company. I didn't even know I had the problem, but the insurance company is saying that I owe them $2,257.00 for an MS drug that was shipped to me in January. I thought it had been taken care of.

    Like you, I feel frustrated, but I am trying to not let it get to me too much. I know that I need Doctors and Insurance, but dealing with everything is sometime just too much. I feel your frustration and irritation at the whole situation. No one who is already sick feels like going through what you are having to deal with.

    Our health care system needs something to get it back on the right track, but I am not sure what it is.

    Good luck in getting to see the right Doctor.
    Virginia

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  12. #7
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    Yes, it's challenging to have to be your own advocate. Finding a good primary care doctor is essential, as that doctor is the one many insurance companies look too to make those referrals. I've been fortunate that most of my records have now been computerized so now, even though I live in rural America, my records are available with just a few taps n the keyboard.

    Doctors are allotted just 15 minutes per patient, that's all that Medicare and most insurance companies will pat them. So it's important to prioritize your symptoms, know exactly why you're needing to get medical care, before stepping foot into their office. And specialists indeed specialise in just one thing, so if you have a bunch of different things going on that your primary care doctor can't take care of, then you do need to travel to a lot of different doctors.

    I'm sorry about your friends. I hope you find the care you need.

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  14. #8
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    Welcome,
    I can understand your frustration. Please come here and vent anytime that is what we are here for.

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    Distinguished Community Member SalpalSally's Avatar
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    Welcome and good wishes!

    I remember having to get referrals for specialist as well,
    with private insurance. In the nursing home getting a specialist
    is a joke!l
    Love, Sally


    "The best way out is always through". Robert Frost







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  18. #10
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    Page.One,

    Obviously you're frustrated. Understood.
    Some regions are better than others concerning doctors and availability. And the paths in getting care can be different. Sounds like you live in a really remote area of the U.S.

    We'll be here when you need to post again. Or if you just want to talk.
    Feel free to join us at anytime. Share a joke or two.
    Last edited by Parsi; 02-16-2016 at 02:01 PM.

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