RANT...My 80 year old Mom's doctor won't see her

Please bear with me as I rant.  I am so damned angry that I could spit.  My Mom is amazing, some of you have met her...she rocks.

She is also 80.  She pays alot of money each month for supplemental insurance because our healthcare SUCKS.

So she calls her doctor's office today and tells the 'scheduler' that she needs to get into the doctor today because she's having congestion, coughing alot and having some breathing issues. In November 2006, this happened and she developed pnuemonia and was putt in the hospital.  Follow me here folks.

So the scheduler PUTS HER ON HOLD...comes back a couple of minutes later and said the DOCTOR TOLD THE SCHEDULER TO TELL MY MOM TO GO TO URGENT CARE, she COULDN'T SEE HER....(this doctor has been Mom's doctor for 3 years and is 1/2 mile from her apartment)

I'm beginning to think that these schedulers do this, they allege they spoke with the doctor/nurse and use this response. (I received it from them one time as well...the ONLY time I EVER dealt with SHARP)

URGENT CARE SUCKS.... SHARP Urgent Care here in California is horrific.

So now my TOO SICK TO DRIVE 80 YEAR OLD MOM has to drive 10 miles to the flipping urgent care (I found all this out on my way home from work when I called to see how she was feeling)...so a friend from her complex went with her and a good friend of mine took care of her dog.

Folks, this UNACCEPTABLE, this is AMERICA for God sakes.

We have all these damned presidential candidates blowing smoke up our asses thinking we are getting orgasmic from it and loving them bigger then life, and they don't know SHIT.

This isn't the worse case of someone not receiving care that they need...but it hits too close to home.

Mom had this same shit about 15 months ago, a couple of weeks after my sister passed away and I took her to the Urgent Care, when they started dicking her around I requested an ambulance and we went to the hospital, she was admitted with pnuemonia.

Our country is broken.  Our country is BROKE.  WE AMERICANS ARE SUFFERING.

My Mom DESERVES better, we ALL do, yet what the hell can we do.

For those of you that want to rant/rave politics and which candidate will do something...not just talk, here is what I say:  Don't Obama me, surely don't Billary me.  I like Edwards, I want him to win, I truly in my heart and soul think he's the ONLY candidate that GIVES A DAMN.

So as angry as I am, noting will change, I need to see if Mom has gotten in to see the doctor yet, it has been FOUR HOURS so far.  God help all of us.

•  Your mom does deserve better

  I am so sorry.

  by crazyshirley2100 on Wed Jan 23, 2008 at 07:30:39 PM PDT

  •  We all do! (n/t)

    by LordMike on Wed Jan 23, 2008 at 07:34:22 PM PDT

  •  She's tough, but she isn't young anymore

    and this bullshit just isn't right...they are opening her up to alot of other potential infections.

    by Barbara on Wed Jan 23, 2008 at 07:37:06 PM PDT

    •  Sorry to hear about your Mother

      Sorry to hear about the troubles your Mother had to go through today.

      Agree with you wholeheartedly that Urgent Care in CA is.... "subpar."  SUCKS is quite accurate.

      Welcome to the middle second class!

      Bah!  After a bunch of the diaries I've read tonight I need a beer.

      by fresburger on Wed Jan 23, 2008 at 07:42:59 PM PDT

  •  MOM was finally seen...

    they gave her a breathing treatment (the machine kind)...gave her the prescriptions that she had 14 months ago and told her she needed to be VERY careful.

    Amazing...she was out in shitty weather, sitting in a waiting area, blah, blah for a total of 6 hours to get the drugs that she basically knew she would need given her HISTORY...and her DOCTOR could have saved her from all this shit.

    FYI, our weather here is pouring rain and about 42 degrees...

    But she JUST got home, sounding wiped out.  

    Hopefully she'll be okay and she wont get worse due to this weather and crap...

    LIFE

    Thanks everyone....this rant felt good.  For all of you who have loved ones going through difficult times, I will keep them in my thoughts and prayers....we just need to help each other.

    Be well and stay safe.  B

    by Barbara on Wed Jan 23, 2008 at 08:52:56 PM PDT

    •  Barbara, got here late.

      But wanted to give my support.

      It's amazing what the insurance companies are doing and GETTING away with.  My parents are mid 60's, and have good insurance, but for HOW LONG?

      I'm early 40's, just layed off, got strep throat, by the time I paid for my doc visit, meds, and a refill for my high blood pressure, I was out 160 bucks....and I'm unemployed.

      It's just crazy that this is how it is, and I consider myself lucky that I can afford the meds out of pocket for last month, next month, not looking so good.

      by buckeyekarl on Wed Jan 23, 2008 at 09:46:04 PM PDT

•  Four hours

  and she still hasn't seen a doctor?  AND SHE HAS INSURANCE!  She's 80 years old for Christ's sake!

  by TXsharon on Wed Jan 23, 2008 at 07:31:47 PM PDT

  •  She has the wrong doctor

    Tell me more, is this an HMO she belongs to? If so get her the hell out of it. They should have your Mom's history, and with her coughing, not being able to breath, she shouldn't have been directed to urgent care without even seeing her. I don't want to get political here, I know you are concerned and really pissed off over what happened to your Mom today. I just want to say, John Edwards' defense of trial attorneys the other night could not be more on point. The trial lawyers are all we have when we fight against corporate interests that do not do the right thing. Corporate interests, like insurance companies, HMO's and all the rest. I hope your Mom will be fine, but if she isn't, fight them, and fight them hard. No one should be treated like this, most especially an 80 year old woman who is complaining of feeling ill. You Mom and others of her generation have contributed so much to this country, to have those who now take advantage of those contributions, ignore her, is more than wrong, it is totally outrageous.

    by Vera Lofaro on Wed Jan 23, 2008 at 07:44:05 PM PDT

    •  It is an HMO...

      and it sucks.  She is hooked into Sharp Healthcare with it and has alot of problems.  The supplement insurance is through AARP.

      I will be contacting her doctor personally tomorrow.  

      Thanks for your kind words.  Mom is going to be fine...she has to be.

      by Barbara on Wed Jan 23, 2008 at 07:56:42 PM PDT

      •  FIND A WAY OUT OF IT

        She is getting ripped off.

        HMOs, with a few notable exceptions, are rotten to the core. This one obviously is because they effectively denied her care when she needed it.

        by FishOutofWater on Wed Jan 23, 2008 at 08:03:22 PM PDT

      •  If she has AARP Supplemental

        get her the hell out of Sharp, or any HMO for that matter. We did that with my Mom 14 years ago, and it gave her 14 more years of life. When you belong to HMO's, and some are better than others, I don't know much about Sharp, but they are basically all the same. It is always the bottom line, and to be brutally honest, at 80 years old, it is just more cost effective to them if your Mom dies rather than them treating her in the future. After 80 years old the chances are your Mom's health will gradually fail, and she will need more and more care. They simply don't want to make that investment, at a certain point, what they get from Medicare gets eaten up by any treatment.
        I don't even want to go into the horror story of a certian HMO killing my Dad, and rendering my Mom a handicap fourteen years ago, but trust me, I am not exaggerating. When we realized it was neglect, intentional neglect that took my Dad's life, we as quickly as we could get my Mom out of that HMO, and as I said before she had 14 more years of a quality life. She died the week before Christmas, and in her final two weeks of life she received extraordinary care, because of her Medicare benefits along with her AARP supplemental coverage. It was not Hospice care, it was constant extraordinary, medical care with palliative treatments to make her final days the most comfortable they could be, along with helping us all through a very difficult time. Not so with my Dad and the HMO he belonged to at the time of his death.
        As I said before some HMO's are better than others, but even with the better ones, you, as the patient, have got to be proactive with your care. Unfortunately many of our senior citizens are not as proactive as they should be, they hold Doctors in such reverence and are afraid to question any treatment and are also unable to research treatments and demand such treatments as well as diagnostic tests. The fact are, they don't demand the treatments or diagnostic tests they are entitled to, and the HMO benefits, which means the patient, in this case your Mom loses. This is the reason HMO's market Medicare, or Senior Citizens as patients in their organization. This is not the fault of the Senior, or the patient, they matured in a time when Doctors looked out for each one of their patients, and it was rare when they would not do all they could to save a life or make the patient more comfortable. This is what is wrong with Medicine today, it is always the bottom line, and most especially with HMO's which in most cases are nothing but profit driven organizations, when the needs for profits override the need to save lives that is when we are all in trouble.
        I know this was a lengthy response, but if it at all convinced you to seek better care for your Mom, then I will feel as though my two cents  helped someone.

        by Vera Lofaro on Thu Jan 24, 2008 at 07:15:30 AM PDT

  •  are you serious?

    she has some congestion.  I saw 4 MIs today and a few strokes.  Converted torades rythm in my last 5 minutes at work.  

    If you think having insurance makes you be seen faster in ANY emergency department in the US you are under SERIOUSLY MISGUIDED.  I have been a travel RN all over the country almost exclusively in ERs.  Never has that ONCE been a concern when doing triage for a patient.  NEVER ONCE.  

    by Hind2 on Wed Jan 23, 2008 at 07:53:02 PM PDT

    •  Yeah and my brother is an ER Pharmcist...

      your point is what?

      He's seen worse then you probably have and he's pretty pissed.

      I grew up in a medical family...my Mom is certainly NOT an alarmist and if she needs to see a doctor, she needs to do it now generally as she very, very seldom has to...

      Your lack of compassion must make your patients love you.

      by Barbara on Wed Jan 23, 2008 at 08:00:26 PM PDT

      •  how has a pharmacist seen worse...

        than someone who is bedside?  I see people die a few days a week.

        I am not saying she is an alarmist.  I dont have a lack of compasion.  But my comment was in direct response to the poster that said "she even has insurance".  

        Your personal attacks on me are not appreciated.  I work incredibly hard for my patients and give all of them great care.  I expect an apology but like most on this site I am sure you are too "right" to know any better.

        by Hind2 on Thu Jan 24, 2008 at 03:19:33 AM PDT

    •  Huh? This isn't about an ER, it's HMO UC

      You must need some rest.

      This dairy makes no mention of going to the Emergency Department of a hospital.

      You are the one who is seriously misguided.

      by FishOutofWater on Wed Jan 23, 2008 at 08:08:29 PM PDT

    •  All the more reason her GP should have seen her

      I think the point here is that this elderly woman clearly trying to KEEP from being an emergency shouldn't have had to go to the emergency room at all.  Her regular physician - or even her doctor's PA - should have seen her, listened to her chest, and treated her appropriately.

      And this isn't just an HMO problem - I and my teaching colleagues all have good insurance without HMO's, and we still have trouble getting in to see doctors at all.  It's a mystery to me.

      by geordie on Wed Jan 23, 2008 at 08:09:14 PM PDT

      •  My Mom is VERY HEALTHY overall...

        at 80, she is a 18 year breast cancer survivor, she has buried her husband and my sister.

        She hates going to doctors and when she does, it is because she is VERY sick...

        Her GP knows her history and knew that due to the pnuemonia from 14 or 15 months ago, that she had to be monitored close whenever she started getting considerable congestion, etc....so this happens and the GP for whatever reason can't get her in, or WONT get her in to check her lungs, give her a breathing treatment and give her the 'scripts' she needs.

        Mom is a senior that takes only 2 daily medications...

        by Barbara on Wed Jan 23, 2008 at 08:13:39 PM PDT

        •  Confused

          Are you agreeing with me or disagreeing with me?  Not sure from your post - I think we're on the same page - I just think it's inexcusable for your mother's doctor, knowing her history, to not make time to squeeze her in.  That's just negligent practice, IMO.

          by geordie on Wed Jan 23, 2008 at 08:15:51 PM PDT

          •  I agree...

            by Barbara on Wed Jan 23, 2008 at 08:19:30 PM PDT

            •  Barb

              find out if your mom's doctor REALLY said she couldnt see her, or if, as you suggested, it was the scheduler making that decision. If your mom's doctor has been good up to now, it doesnt make sense that she would all of a sudden refuse to see her.
              This happened to me...I would call my doctor with questions and she would never call me back. I finally would have to make an appointment and I would ask the doctor why she never returned my calls..she said she never got any of the messages, and then she smiled and said "My office girls like to protect me from getting too busy." That was the last time I went to that doctor.

              Within your moms coverage area, is there a doctor who specializes in geriatric care? Someone who LIKES to work with the elderly???

              Good luck and a hug for you. I hope your mom is back on her feet soon.

              by fireflynw on Wed Jan 23, 2008 at 08:39:08 PM PDT

              •  fireflynw...thanks...

                I'm going to investigate this starting tomorrow and see what I find out.  If her doctor has that type of attitude, then yes, it is time to find Mom a new one...

                by Barbara on Wed Jan 23, 2008 at 08:46:02 PM PDT

        •  I agree with this as well...

          but once the GP sends her to any acute treatment place its inevitable in most places that anything not critical will end up waiting.  That was my only point above and you pretty much attacked me and insinuated that I give shitty patient care.....  Why people are so ugly on this site is beyond me.

          by Hind2 on Thu Jan 24, 2008 at 03:22:26 AM PDT

          •  Get A New Doc

            This has happened to me so many times with my 95 year old mother.  ER care is SO much more expensive but the specialists are running such busy practices ,trying to suck so many dollars out of each and every day that there is no time, no wiggle room in the schedule for a patient who may or may not need emergency care(which is different than urgent care). They cannot be bothered with fitting your mom in.  There's big money to be made on the quick in and out and your mom, being in urgent distress, would take a longer chunk of time for a patient visit.  It is economics.  And it sucks, not just in California but everywhere. So if it looks "urgent" off you go to an ER for a long wait and VERY expensive care.  

            I finally got a new internist a few years ago for her who knows her case very well, knows me and trusts me as her caregiver, and will see her immediately when she goes into a respiratory crisis. He is an amazing man, a Dem I might note which is something of a rarity among docs, who touches her gently as a son might do, looks her in the eye and compliments her hair--in addition to being a brilliant diagnostician and doc.  Love him.

            Hind, I will apologize for the rudeness on this site.  Your comments and viewpoint add a lot to the discussion.  The emotions are running so high because the world is turbulent right now and people are afraid, of economic meltdown, of rampant racism, sexism, ubiquitous mental instability and the breakdown of logical discourse etc etc.  It is a mad world.  Sorry, kiddo.  And thanks for being a caregiver to both Barb and Hind, we rarely get thanks for what we do.

            by DEFuning on Thu Jan 24, 2008 at 05:14:38 AM PDT

          •  This is why you were criticized

            You said this:

            how many other countries would a 79 year old get heart surgery?  When is ones life complete?  How old is old enough to be content?  The only thing I fear is getting TOO much care at that point in my life

            This sounded like you didn't think an 80-year old woman should get any particular treatment at all.  I didn't say this - you did.  Don't act surprised when you say something that is cruel, under the circumstances, for Barbara, and for all of us caring for elderly parents, and pretty blatantly ageist.  

            by geordie on Thu Jan 24, 2008 at 05:46:31 AM PDT

          •  WHy YOU were so ugly

            is beyond me. My husband was a CNA and is a nursing student. He dealt with geriatrics. He'd love to give you a piece of his mind.  I wish I knew where you worked so id Dad who is 87, with his brain workin' better than yours and a living will to make sure he doesnt' get heroic measures, shoudl ever need ER care--because I'd throw your unpleasant ass out of the room if you came in.

            by irishwitch on Thu Jan 24, 2008 at 01:16:06 PM PDT

      •  It's no mystery. Office visits don't pay.

        Medical students chose to specialize in areas where they can make a decent living and pay back their debts. They want to do procedures because that's where the money is.

        The cost of running a medical practice today is so high that doctors don't want to do family practice of internal medicine. We now have  a shortage of those doctors in many parts of the country.

        HMOs have made the situation worse because doctors get overworked and lose control of their practice. Areas with high HMO penetration often have doctor shortages.

        by FishOutofWater on Wed Jan 23, 2008 at 08:20:45 PM PDT

      •  I agree with that....

        by Hind2 on Thu Jan 24, 2008 at 03:20:15 AM PDT

    •  This is a UC

      As far as I know, they operate on first-come, first-served.  If they think you are in bad enough shape to need expedited treatment, they direct you to a hospital.

      "Urgent" is pretty much a misnomer.  Should be called "Can't Wait Three Days To Get In To See My Regular Doctor" Care Centers.

      by Free Spirit on Wed Jan 23, 2008 at 08:13:17 PM PDT

    •  Hind2, I don't really care what your opinion is

      here. You're a travel RN, you work ERs, you don't handle urgent care patients, you obviously didn't pay attention to the history given on this patient.

      So.

      Your ranting reply in defense of an irrelevant aspect of a thoroughly fractured medical industry impresses me zero.

      Just so we're clear.

      by BlackSheep1 on Wed Jan 23, 2008 at 08:19:30 PM PDT

•  Canada has Waiting Lines

  Isn't that what the wingnut assholes say? I think a waiting line would be better than the No care that we get

  by barbybuddy on Wed Jan 23, 2008 at 07:32:58 PM PDT

  •  what care are you not getting?

    by Hind2 on Wed Jan 23, 2008 at 07:53:32 PM PDT

  •  Canada also has good triage system, eom

    by WSComn on Wed Jan 23, 2008 at 08:09:15 PM PDT

  •  Yesterday I scraped my leg.

    Stupid injury -- had my foot a fraction of an inch too close to the corner of the car door when I closed it. Ripped off a triangular piece of skin about an inch and a half on a side. Not a big deal. If I were twenty, normal first aid procedures might well have been fine. But I'm sixty-four. I've got circulation problems in my legs. Injuries heal slowly, and I have to watch out for infections. I'm not diabetic, but I have to be careful about leg and foot injuries for some of the same reasons.

    So after first aid at home, I drove to my doctor's busy office, walked in without an appointment, and was being looked after -- less than an hour after I swung the car door.

    Give me those Canadian waiting lines, any old time.

    by Canadian Reader on Wed Jan 23, 2008 at 08:31:54 PM PDT

•  The Medical world is screwed up.....

  I agree 100%...Been thru this numerous times, myself and along w/ my mother.
  The politicians are so busy flappin their yaps, and not doing something to back it up. Hope it changes before its too late to matter.

  Keep calm barb and let me know how gramma is......im here.

  by EShadowgirl on Wed Jan 23, 2008 at 07:33:36 PM PDT

  •  You know I will honey....

    by Barbara on Wed Jan 23, 2008 at 07:37:58 PM PDT

•  As one...

  ...with a 79-year-old mother who just had heart surgery, I look upon you and your mother's situation with horror--and wonder what the future holds here.

  by AaronBa on Wed Jan 23, 2008 at 07:35:11 PM PDT

•  I hope your mom gets better soon

  but I'm a little confused.  California Pacific instituted an urgent care for kids and it's saved me from the emergency room many, many times (one of my twins has a chronic illness that can make cold and flu season miserable).  I'm not happy, particularly, when I call at 3:30 and get told I have to wait until 5:30 for urgent care or go to the emergency room, but I think this system is better than the old one of waiting for hours to see a doc in the ER.  I know the docs there are freelancers for whatever reason and perhaps because they deal with kids, it's simpler.

  Is it that Sharp's urgent is so bad?  Is it a system now or is it confined to Sharp Hospital (heh, where I and my brother were born)?

  by ksh01 on Wed Jan 23, 2008 at 07:38:22 PM PDT

  •  Sharp...

    Hospitals, urgent cares, clinics, it is apparently under a huge umbrella.

    I went to that urgent care about 9 months ago for a seriously injured leg that was putting me on the floor with pain...it took FOUR HOURS TO BE TRIAGED by a NURSE...

    Then an hour and a half LATER after arguing to be seen because I was screaming in pain and was getting flat throw up sick from it...I had a doctor see me that did NOT understand English and told me there WAS NOTHING WRONG AND TO LEAVE...

    That night I went to Scripps ER and found out just how much WAS wrong.

    My brother said that Urgent Cares are used because doctors don't want to spend time with patients and many are over booked (it comes back to the whole insurance billing thing)...often the UC doctors are marginal at best and few know what they are doing to the extent of what they should know.

    by Barbara on Wed Jan 23, 2008 at 07:47:12 PM PDT

    •  You need to find someone you can trust

      Each town has its own set of problems. Urgent care outfits vary from place to place as do hospitals and doctors. You need to find someone who will be there when you need care.

      Right now your mother does not have a doctor.

      by FishOutofWater on Wed Jan 23, 2008 at 07:55:00 PM PDT

    •  wow, I'm lucky up north

      and no matter where I go, little kids and babies are seen first (sometimes that means the kid is stabilized and you wait for hours, but it's better than for adults)....

      There's only once in my life that I injured myself badly enough to barf from shock and I wouldn't want to be there again. I'm amazed a nurse wouldn't find this alarming.

      I guess what I've learned is that Urgent Care as a system and as a tool varies vastly from city to city and probably gets abused pretty frequently.  Thanks.

      by ksh01 on Wed Jan 23, 2008 at 08:21:59 PM PDT

•  Ask John McCain for help!

  No, wait --don't. I don't think he will sympathize. I think this is one reason our candidate will have a shot in November,

  by Bensdad on Wed Jan 23, 2008 at 07:45:39 PM PDT

  •  John McCain can EAT SHIT as far as I'm concerned.

    I cannot stand him...he is flat evil and a nasty, heartless person.

    Now should I tell ya how I really feel?

    by Barbara on Wed Jan 23, 2008 at 07:48:20 PM PDT

    •  I think he has already done that....

      ...he stores it in his left cheek in case he wants to munch on it later.

      by Bensdad on Wed Jan 23, 2008 at 07:57:11 PM PDT

•  its so interesting....

  reading this from the perspective of a RN that just got off of my 3rd 12 hour shift in 3 days in the ER.

  by Hind2 on Wed Jan 23, 2008 at 07:50:12 PM PDT

  •  Can you say more?

    I'm interested in your perspective.

    by Red Bean on Wed Jan 23, 2008 at 07:55:32 PM PDT

    •  I see you say

      quite a bit more down thread.

      by Red Bean on Wed Jan 23, 2008 at 07:58:45 PM PDT

  •  For profit health care & insurance is killing us

    Many doctors don't want to take care of 80 year olds any more because it's more trouble than it's worth to them. Insurance and Medicare pay a doctor to do procedures, but routine office visits and inpatient medicine are paid marginally. Old people take too much time for the marginal payment.

    Our reimbursement system is badly broken.

    by FishOutofWater on Wed Jan 23, 2008 at 08:00:18 PM PDT

  •  Hind2, you clearly want a fight...

    don't look for it hear...infact if you are so damned tired from your three straight 12 hour shifts, turn off your damned computer and go to bed.

    You lack of compassion and clear meanness is glaring.  

    by Barbara on Wed Jan 23, 2008 at 08:04:51 PM PDT

    •  It looks like burnout...a real problem

      Our nurses and doctors often get pushed past the point of compassion. It's a big problem.

      by FishOutofWater on Wed Jan 23, 2008 at 08:12:46 PM PDT

      •  I dont lack compasion at all....

        but waiting 4 hours insane.  It sucks her PCP would not see her...

        by Hind2 on Thu Jan 24, 2008 at 03:23:54 AM PDT

    •  I dont want a fight...

      you were the ONLY one that made a personal attack.  Lack of compassion?  FOr not agreeing with incorrect statements like "it took 4 hours and she has insurance!"

      I think it sucks that everyone cannot be seen immediately.  Until that changes patients will have to be traiged.  YOur personal attacks reak of a complete and total lack of ability to converse in a civil manner.

      by Hind2 on Thu Jan 24, 2008 at 03:25:34 AM PDT

  •  good night

    Time for you to go night night dark dark...No arguing please........theres other threads for that~~~~>>>>>>

    by EShadowgirl on Wed Jan 23, 2008 at 08:13:25 PM PDT

•  We have a 75 year old friend...

  ...named Terry, who is getting ready to go in for her 2nd knee replacement surgery next month. She's got health insurance and a nice pension check from Pratt and Witney, and from Social Security, so she doesn't qualify for Medicaid.

  You see for 30 years she was the only woman in an all-male machine shop (back in the days when job equality was in its infancy and wage parity still but only a pipe-dream)that custom-made special replacement OEM aircraft parts, plus she was a professional singer as a sideline. Her old singing tapes would blow you away. She sounded exactly like Patsy Cline or Peggy Lee, and had the star looks to boot!

  Anyway, she's scared to death that her Medicare and supplemental insurance isn't going to cover everything. She's more scared of the residual hospital costs than she is of successfully recovering from her surgery!

  When someone has worked like a dog their whole lives, it should never have to be that way, especially in their twilight or golden years! Someone needs to do something to fix our antequated, and woefully inadequate healthcare system. Immediately, if not sooner.

  by ImpeachKingBushII on Wed Jan 23, 2008 at 08:07:02 PM PDT

  •  scary huh.....

    A close friend of mine..found out her cancer has returned...and its terminal this time....shes more worried bout her medical bills, than getting thru chemo and spending time with her family.

    Its sad when we cant focus on getting better, and/or getting more time to be alive and with our loved ones.....because of the stress of "is my medical going to cover it, or kick in" or "will i get medical aid to help with my expenses".  

    very sad....

    by EShadowgirl on Wed Jan 23, 2008 at 08:12:13 PM PDT

•  Just damn lucky

  Ive got a gramma thats tough..even at 80. She'll not back down when she knows shes sick and needs medication.

  Im lucky i live in an area that has decent medical care..and i work for a company that provides me top notch benefits.  I wish i could do more to help the rest of my family.

  by EShadowgirl on Wed Jan 23, 2008 at 08:09:04 PM PDT

•  Please go ahead and make an appt with her doctor

  And when you finally get into seem him, tell him what happened. I share your suspicions about the schedulers. Sometimes the docs know, and sometimes they don't.

  by Free Spirit on Wed Jan 23, 2008 at 08:09:23 PM PDT

  •  I'll call tomorrow...I have

    power of attorney for my Mom and while I seldom use it, I do when it comes to her health...

    by Barbara on Wed Jan 23, 2008 at 08:16:10 PM PDT

    •  Free Spirit is giving good advice

      I care for my mom at home, she's 87. We share the same GP and having for over 10 years. I love our doc, but her gate keepers sometimes take their job way too seriously. We've gone the rounds more than once.

      From my experience the last thing you want is your mom in an UC facility. They don't know her history, what meds she might not get along with, and she'll be exposed to all kinds of other bugs.

      Call and do whatever you can to get her in and make your objections known. Since they screwed with Medicare my mom's ins. has been awful and she had great ins. Federal Blue Cross. She costs them money and they are doing whatever they can to make her want to switch. Our doc has told us that they don't want to pay, they throw lots of extra paperwork at her and make her justify everything.

      Mom is screwed up in oh so many ways, osteo, COPD, both hips replaced twice, she's in pain and has trouble sleeping because of it. Every once in a while they refuse to "authorize" her meds, make her check with her doctor and wait. Of course she can't, we cover them while her paper flies back and forth and that's one month they don't have to pay.

      I know I'm ranting, too. It's something that really pisses me off. Your mom shouldn't have to go through this crap. I hope things turn out OK and that she feels better.

      by high uintas on Wed Jan 23, 2008 at 08:56:45 PM PDT

•  As usual it comes down to money.

  I suspect that your mother's doc works with either a capitation or incentive system.  In both cases the docs are paid per patient, so of course the more patients they see the better.  

  Many clinics schedule patients at 5 minute intervals.  It doesn't take a medical degree to see that 5 minutes does not give enough time to do a physical exam, let alone make a diagnosis, write a prescription or explain a treatment plan, record a proper record, and, oh yes, talk to the patient and/or relatives.

  It used to be that docs were advised to block out one or two appointment per day for emergent or unscheduled patients.  Not any more.  To keep the cash flow up these patients are advised to go to the ER or urgent care which effectively destroys the idea of continuity of care.

  Since docs are often employees of clinics they cannot set the standards of care.  In assembly line clinics like this the doc either practices assembly line medicine or is asked to go elsewhere.  Quality of care standards are minimal or non-existent under these conditions, and excellent medical care cannot be delivered, but since only patients suffer it hardly matters does it?

  by caduceus on Wed Jan 23, 2008 at 08:15:17 PM PDT

  •  You are no doubt right

    I went in with Mom to see her doctor when she got out of the hospital last time...I LIKE her doctor and clearly she LIKES my Mom, so I find it hard to believe she would have said that because she knows Mom's history and told her that if EVER she felt even sort of like she was getting the same thing to get in immediately and she would see her...

    It's just not adding up.

    by Barbara on Wed Jan 23, 2008 at 08:17:56 PM PDT

    •  Sounds like she needs chest x-ray, cultures STAT,

      IV Solu-Medrol, i.e. admission.

      by venatrix on Wed Jan 23, 2008 at 08:31:49 PM PDT

  •  Right. When I call my doctor's office...

    ...for my regular diabetes maintenance appointment, the answering machine prefaces the recorded message with, "If this is an emergency, call 911 or go to the ER"! I don't need a 2X4 up beside the head to figure it out that it's all about the benjamins.

    by ImpeachKingBushII on Wed Jan 23, 2008 at 08:20:40 PM PDT

    •  Some of that is a little CYA

      hear that on my doctor's phone line also

      by VA Breeze on Wed Jan 23, 2008 at 09:04:50 PM PDT

•  My mother's doctor has become very distant

  and far too hardened in contrast to her attitude a few years ago.

  She had a very serious crisis recently and the doctor refused to do anything more than suggest she go to er for treatment.

  My mother has very good insurance but the doctor has closed her practice to new medicare patients.

  It is my opinion that the doctor wants her to go elsewhere for care because the reimbursements are no longer adequate.

  I had a similar experience when I was under a capitation type of insurance with my primary and had an illness that required a year long course of frequent care.  My doctor became very unresponsive about problems as time went on and I had no choice but to find a doctor who was more involved.

  I am convinced that patients are being puposely driven away because the doctors can't really dump unprofitable patients easily.

  I think mom gets that her doctor put her life at risk and needs to get fired.

  If I am right and this is a trend it's another obscene wrinkle in broken healthcare system.

  by dewey of the desert on Wed Jan 23, 2008 at 08:18:28 PM PDT

  •  What is WRONG with all of this...

    I keep hearing these stories, about healthcare...I saw what fellow Americans were treated like after Katrina and Rita, what happens when we as Americans need something and we can just not rely on that which we work so damned hard for.

    What a clusterfuck.

    by Barbara on Wed Jan 23, 2008 at 08:21:48 PM PDT

  •  Medicare

    Medicare has continued to reduce its payments to primary care physicians. In return a growing number of physicians are reducing services or dropping Medicare patients. If we want "Medicare for all" we need to put our voices behind better payments for primary care physicians.  My physician friends tell me that the Medicare payments, in many cases, do not cover the cost of processing the paperwork.  The limited number of Medicare patients they treat are done pro bono. The problem is not with the physicians, but with the Medicare program.

    by VClib on Wed Jan 23, 2008 at 09:07:03 PM PDT

    •  Medicare's payments

      have been reduced across the board, to primary doctors, specialists, and hospitals.  Democrats said, "Medicare works pretty well, why can't we have Medicare for everyone?" and Republicans took that as a mandate to screw Medicare up by making it unpopular with medical people.  Having other insurance doesn't help much, because current Medicare law forbids the doctor from collecting more than Medicare's "allowed amount".

      by Calamity Jean on Thu Jan 24, 2008 at 05:43:09 AM PDT

    •  Doctors and Hospital

      Subsidize the doctors and the hospitals, not insurance companies.

      by chigh on Thu Jan 24, 2008 at 11:41:25 AM PDT

•  I hate going to urgent care

  If it was an emergency I wouldn't call (I would just go) once they see your not dying they usually wait forever. So when I decide to call, I've already decided I would like them to fit me in when they can. Unfortunately anytime you say 'trouble/difficulty/issues with breathing you set off bells in the doctor's mind. I don't know if someone who wasn't 80 would do any better, but I always tell them what I would prefer. One time we took our son (who suffers from Asthma) to the doctors office they gave him a treatment there and wanted to admit him into the hospital. After discussing it, the reason turned out to be he would need a treatment every 4hrs (and they thought we would prefer to have the nurses do it in the hospital. We ended up taking my son and the 'machine' home and taking turns giving the treatments. Many times they will say you can come in later or see another doctor if they know you don't want the Urgent Care. If they won't accomodate you there are usually other choices.

  by Sacramento Dem on Wed Jan 23, 2008 at 08:28:37 PM PDT

•  I've come across some attitudes like Hind2's

  in recent years. If an MD comes across like trhat - they are fired on the spot , as far as receiving my copayment , insurance coverage , etc. Also can write some very effective letters.

  by Abra Crabcakeya on Wed Jan 23, 2008 at 08:42:24 PM PDT

•  The federal government

  can eminent domain doctors' offices and have doctors from Mexico and India here in less than 24 hours.

  by SingleVoter on Wed Jan 23, 2008 at 09:44:10 PM PDT

•  Upsetting day

  I can understand your upset about what happened today with your mother. When our parents get older and ill it can be unnerving.
  I have been a geriatric nurse for 20+ years and to me this seems like a not very nice misunderstanding.

  1. An 80 y/o who calls her MD and states cough, congestion and BREATHING DIFFICULTY should have been directed to the ER. Not the UC and not the MD office. It is impossible for anyone on the end of the phone to know what is wrong. Pneu is only one of several possiblilities even though your mother had it previously. She should have been instructed to call 911. And yes that covers the MD from liability but it also might be needed.

  2. MDs are not always in the office even though the office is open. If your mothers MD takes care of even a moderate amount of elderly pts there is usually at least 1 day a week of visiting nursing homes/rehab facilities/assisted living facilities ect. This might be a whole day, 2 half days, 2 hours each morning ect depending on how it is split up. MDs also must visit their pts that are in acute hospitals daily (that is why MDs seem to have a favorite hospital, easier to see the pts) and they must attend required meetings at said hospital, QA, policy meetings ect. If they use more then 1 acute hospital those meetings automatically double.

  3. An MD office and an UC office are not very well equiped. They may have a breathing machine, a little 02, kits to do stitchs if the wound is small ect. But unless they do in office surgery (and most don't) the MD office is a bad place to be in an emergency.

  4. The MD may or may not have a nurse or PA. The employees you see are generally medical assistants. The are trained to take VS, answer phones and do scheduling. They talk to pts for a min and find out what is generally wrong with them. BUT....they don't have training to know what is an emergency and what is not. They are paid less then half of a liscensed nurse and have almost no medical training.

  5. Now is the time to make a plan about what you and your mother will do the next time she has a breathing problem. It would be a good thing to sit down with her MD and discuss this with all 3 of you.

  I hope your mother gets better soon.

  by J Rae on Thu Jan 24, 2008 at 05:28:02 AM PDT

  •  Agree with all you say.

    Would just add that if I see the 80 year old in the office I have half or more of my admission physical done which shortens evening rounds considerably.  I can also write my admitting orders much more intelligently.  [The burden of hospital care is one reason why hospitalists are gaining ground even in small institutions.]

    Also if a patient who should be in ER shows up at the office the ambulance responds at least as fast to a call from me as to 911, and I can call my ER colleagues to alert them that the patient is on the way.

    The suggestion for a conference about future care for this more than usually vulnerable 80 yo is excellent.  Should, however, this office be an assembly line operation this type of meeting is almost impossible to setup.  No billing code really covers the time adequately, and HMOs screech bloody murder about having to pay for "unnecessary" counseling even if it might be life saving.  

    Insurance companies are not in business to save lives or provide adequate care for patients.  They are there to make money and satisfy shareholders.  They provide only as much care as needed to ensure that they remain in business.

    by caduceus on Thu Jan 24, 2008 at 11:23:11 AM PDT

    •  asdf

      Most MDs I deal with don't actually sit down and talk with the pts. Since I work LTC/Rehab nursing sits down with the family and discusses scope of care/DNR ect and documents the family wishes. The MD comes in and signs off on the completed forms. Some MDs do sit and talk with the familys but usually only if they have known the pt a long time (not the usual thing these days).
      I got the impression that maybe this 80 y/os MD was unavailable so 911 or a ride to the ER would be called for.

      I live with my Dad who is HTN/Diabetic/dialysis ect, ect. Even though I am a nurse I have had to call 911 at times. I can't move him if he is down with a TIA or hypoglycemia.

      Hospitalist are great for keeping track of pts.  We have had very good experiences with them.

      by J Rae on Thu Jan 24, 2008 at 02:10:57 PM PDT

•  HMO's SUCK!!!

  Barbara,
  I had similar issues with my mom. She died at age 80 two years ago. My mom had enough crap happen with her HMO to write a book ... and she did. Sadly, she died shortly before she got it published. It was my job to finish (already paid for and everything), and I have not been able to get it done. I will try to sum up and make it short. My mom had lots of breathing difficulties, but her primary care doctor refused to do ANYTHING to help her. She told my mom to LIVE WITH IT. My mom asked the doctor to do a chest xray ... doctor refused. My mom filed an APPEAL with the HMO to get a referral to an allergist. The appeal took many months. Eventually, she got permission to see the allergist. (Her primary doctor "fired" her as a patient for appealing.) Allergist treated her for pneumonia, but it wouldn't get better. Referred her to a lung specialist. Biopsy found lung cancer. It took OVER A YEAR for her to get diagnosed with lung cancer!

  Oh yeah, and when her doctor "fired" her, my mom tried to get her prescriptions renewed, and the doctor REFUSED to renew them. The HMO said, well you can't get a new doctor until the first of the month, so the old doctor has to finish out the month. My mom had to call and call and call before the HMO finally relented and let her get a new doctor ... SO SHE COULD GET HER PRESCRIPTIONS FILLED!!!  I hate HMO's with every cell in my body.

  by jdld on Thu Jan 24, 2008 at 10:40:25 AM PDT