Wellness

[LilacTree]

I called my gastroenterologist's office last week and spoke to my doc's admin.  I asked her to ask the doc to refer me to a hepatologist.  She had me spell it because she didn't know what a hepatologist was.  Many gastroenterologists have hepatologists on their staff to deal with liver issues, since gastro docs do not.  However, the two specialties have a lot of medical issues in common.

When she finally called me back almost a week later, she referred me to two docs who work out of U of P in Philly.  I called that number and the two docs did not have offices in my state even though U of P and our local conglomerate have merged.  One doc worked in Lancaster, PA, a couple of hundred miles away. 

I was finally transferred to someone at U of P who referred me to two hepatologists whose offices are right in the next town.  Obviously my gastro doc's office did not know that.  My gastro doc is the one I have always trusted the most.  Now I'm not so sure.  He probably told the admin to look it up and she obviously didn't know what she was looking for.

This is not the first time this has happened to me in several doctors' offices either.  Maybe I expect too much?

[millieshops]

I wouldn't be upset at her not knowing the name of the specialty -  those who answer the phones are not necessarily medically trained and if that person just happened to have been working there for less than 6 months -- I'd guess they know very little outside of their own cubicle.

I do wonder why the more local doctors weren't given to you although I will admit I rarely ask in my own doctors' offices until after I've gone online to my insurance company list of doctors.  Then I ask my doctor if he actually knows any of those I can use without leaving my network. 

Hoping one of the names you finally found will help you.

[Peaches McPhee]

Wow, that is pretty poor.   A good example of someone who is poorly trained and doesn't know what to do other than the basics of her job.  And, apparently is poorly supported by the others in the office -- if she did not know, she should have asked someone to assist her.  Sad coming from a health provider's office. 

[Gram W]

I also do my home work before consulting with my family physician as he is the one to make referrals.   I check my insurance companies formulary to see what and where the needed doctors are located who accept my insurance,  Not everyone in  my area accepts but my insurance is a large company accepted by most here including our hospital.  When I retired it was recommended by our local senior center [run by many professionals] as the insurance company used by most in my area.   I travel 1 hour to get to a specialist that handles my lupus,etc.  I chose him because he has a large practice and specializes. I also checked his background and training.  He is well respected and his requests for test, etc are always honored and paid for by my insurance. It is worth the trip and he does accept my insurance.   My health is my responsibility.  I have learned that if I do not get answers from the docotrs desk I ask for a nurse or someone with more knowledge.  I am  not rude as I understand that often the person on the phone has little medical knowledge unless they have been there a long time.  Good luck.  Don't give up or get discouraged.  You are worth the effort.

[sophiamarie]

Be thankful that she didn't refer you to a "herpetologist".........

[151949]

I would think that if a person needed a liver specialist their doctor would take the initiave and refer them to one. Honestly, in all my 42 years as an RN I have never run into a liver specialist - and I worked in a major university medical center in medical ICU.

[Melania]

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@151949 wrote:

I would think that if a person needed a liver specialist their doctor would take the initiave and refer them to one.

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My thoughts exactly. Who exactly is recommending this?

It's a shame OP is always looking for fault with her care team. 

[151949]

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@Melania wrote:

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@151949 wrote:

I would think that if a person needed a liver specialist their doctor would take the initiave and refer them to one.

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My thoughts exactly. Who exactly is recommending this?

It's a shame OP is always looking for fault with her care team. 

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Yes, she seems to have a zillipon doctors and never likes any of them.

[Havarti]

@LilacTree  I really relate to your expereince and am left wondering the same thing you are!

I went to the same GP for 30+ years.  He was great initially, although he missed diagnosing melanoma from a mole I asked about for 2 years.   That is significant because my father died from melanoma.  Fortunately I eventually went to a dermatologist and it was correctly diagnosed and treated.  I am now on BP meds so I need to go to the GP more frequently than just an annual check-up.  Last fall I went and he ordered some blood work and then asked me to come back in 4 weeks.  The lab did the blood work and urinalysis, most results were normal and two were slightly high.  In the meantime I had my annual mammogram and the results came back normal.  I returned to the GP a month later as instructed and he wrote me a new Rx for BP meds (he sent it electronically to the wrong pharmacy) then hand wrote and RX for me to carry to the correct pharmacy.  I left and his chief nurse called me later that day telling me it was urgent that I get come back to the lab had have blood work (she named which tests – oddly, it did not include testing where I was slightly high – only where I had been normal) and a urinalysis…I need to come in that very day.  I told her the next day would be the soonest but I wanted to know why I had to redo the very same blood work and urinalysis that had been done a month before and all come back normal.  I said I did not think that insurance would cover the repeat of normal tests a month later and that I wanted to know what problem required the retesting.  She was irritated that I wasn’t going to rush right back stating the doctor ordered it immediately and I better get right in and have it done.  The next day I reported to the lab and asked the lady there why I would need to have it repeated a month later when the results had been normal.  She looked it up and was perplexed, too, so she called the doctor directly.  I heard her give him the “order” number for the lab work & urinalysis  he had requested the previous month and tell him it was all normal, there was a long pause (I presume he looked it up on his computer) and then she hung up.  She said his response as “never mind, she can go home”.  Between not knowing I had the mammogram, sending the RX to the wrong place and ordering repeat tests, it became clear to me that the doctor was not even looking at my chart/history.  For me, it was time to find a new doctor.  I thought it would be easy.

I did a lot of research and found a doctor (an internist) I was excited about, one that specializes in helping people with BP issues.  He was in a completely different “hospital group” .  His hospital is considered the top in the area, but is a downtown hospital and I am a suburban person.  I figured if I am actually IN the hospital, I won’t care where it is located and fortunately this doctor has a suburban office.  I made an appointment and they told me they would send out the paperwork shortly before the appointment.  I waited…no paperwork.  I called, they said they sent it.  I waited, no paperwork.  I called and asked them to e-mail it….NO, they have policies and can’t e-mail (it is blank paperwork…no person information included).   I drove to the office to pick it up.  When I showed up to my first appointment with my paperwork in hand, they had 30 minutes worth of additional paperwork to be completed…many questions I could not answer off the top of my memory.  Frustrating. 

I liked the doctor and he spent quality time with me and I felt he truly listened.  He ordered blood work for that day, told me to schedule an appointment for further lab work in 2 weeks (he would place the request in the system so it would be ready).  I was to come back to him in 6 weeks. They requested I set up an account on their e-chart system for better communication.  I registered and received notice it could take a week….over 2 months later and it still is not set up…I just “need to be patient”. 

 It took over a week to receive the results from the first blood work – over the phone the doctors nurse said it all looks good and when I received the paper copy some were high.  I was confused.  Then when I tried to schedule the 2nd set of blood work he had never entered the order for it.  The office said “he forgot” and got him to enter it.  They also told me they had lost my initial paperwork and I would need to fill it all out again.  I waited nearly month and never received the results or a call about the second blood work.  I went into the office to pick up a copy and asked if this was normal and they said the doctor’s mailbox has been full for a while and so that means he has not had time to review the lab work yet.  Why even have the blood work done in two weeks if the results aren’t important enough to read?  The only things listed on the paperwork for the 2nd blood work were things that were normal two weeks before – he didn’t retest anything that was high.  I never made the follow-up appointment to meet with the doctor, but friends have said I should and tell him about my experience.  I am left wondering what has happened to medicine…is this really normal for the medical world today?   Should I keep looking for a better situation…is there better or is this the new normal?  If there is better, how do I find it?  Do I go back and address this with the doctor?  Neither of the doctor experiences is acceptable to me as good or safe medical practice.  Am I being unrealistic…am I asking too much?

Sorry for the length and thanks in advance for anyone who even skimmed this and was willing to post thoughts. 

[LilacTree]

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@millieshops wrote:

I wouldn't be upset at her not knowing the name of the specialty -  those who answer the phones are not necessarily medically trained and if that person just happened to have been working there for less than 6 months -- I'd guess they know very little outside of their own cubicle.

I do wonder why the more local doctors weren't given to you although I will admit I rarely ask in my own doctors' offices until after I've gone online to my insurance company list of doctors.  Then I ask my doctor if he actually knows any of those I can use without leaving my network. 

Hoping one of the names you finally found will help you.

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I don't need referrals to specialists because I am on Medicare.  However, I assumed a gastroenterologist would know what a hepatologist was.  And I have had this doc for over 30 years and this admin has been working for him for at least 20 years.  What . . . no one out of the hundreds of patients he sees per week has ever needed the services of a hepatologist?

Thank you for your kind post, BTW.