I was diagnosed as a Diabetic several years ago. I presented with acute Pancreatitis and a blood sugar of 565. Normal for a non-diabetic is 80, and for a Diabetic normal is 100.
I spent 5 days in the hospital and the doctor in question was undoubtedly one of the team who saved my life, while also being a part of the hospital and team that just about bankrupted me.
Turns out that having grandparents on both sides with Diabetes, a mother with who is hypoglycemic, and a father with Diabetes put a giant target on my front.
The years have passed with, thankfully, no more hospital visits, as I have been a "good" diabetic. I've kept very good track of my blood sugar, and I've presented myself to my Endocrinologist regularly for AC-1 tests, among others. AC-1 is a test which measures how much glucose is sticking to your red blood cells. It is a measure of how well you've done over the past 2 or 3 months, as blood glucose sticks to the red blood cells and stays there until the cell dies, which can take a few weeks.
I've adjusted my diet, my way of cooking. I never snack, except on things guaranteed not to raise my blood-sugar much.
After paying off the hospital and doctor bills, which totaled somewhere around $10,000.00 (yes, I do have insurance), we had no savings whatsoever.
Enter the failing economy.
The routine doctor's visits have been an additional expense to the $700.00 monthly crap insurance policy in addition to the several hundred dollars worth of diabetic drugs and supplies I must purchase each month. I've had to take my time paying them, though the insurance brings an average visit with just one or two tests to about $140.00.
Creeping up slowly...the failing economy.
I closed my business, which was providing some cash flow, but was costing more all the time. People just stopped spending discretionary income.
I had to slow down the frequency of my doctor visits.
Next, we were metaphorically smacked in the face by failing economy.
My husband's job was redacted...edited out of existence.
So now the two of us, scrambling for alternative income streams, find ourselves pinching every penny. It will hopefully be temporary, as we have plans in place for a new venture, and he does have some interest in a re-hire from a different company.
Our austerity measures include, but are not limited to heating our home with wood. We've cut down the food budget, we've got no entertainment budget, no nothing, nothing but food and bills, and we've got a couple of months to turn this ship around. I also began ordering my fast acting Insulin (Novolog) from Canada at a 60% savings.
I had cleverly procured from my Endo-doc a set of prescriptions to last a year. Unfortunately I lost the envelope, or husband lost it while filling one of them for me. Can't be sure.
I phoned my Dr.'s office asking for replacement prescriptions to be sent to my local pharmacy.
This was done, after I protested their policy of making me come in, for the reasons posted here. The scripts were phoned in all right but but only "part" prescriptions. A few days of the pill prescription. One vial of one of the types of insulin I take.
Apparently I am not alone in being "held hostage" to a doctor's visit in order to have my prescriptions renewed.
Yes, I do understand that it is in my interest to keep up with the tests.
This must be balanced with my ability to pay for a doctor's visit and pay for my meds, and pay for my insurance as long as I am able to.
It is unfair practice, IMO, to withhold prescriptions for meds that keep people alive until they show up and pay for a doctor's visit when doing so is a hardship to them.
The doctor's assistant told me that this was about his "liability". I don't think it is about his liability as much as it is a common practice to keep the revolving door of his bread and butter business in a constant revolution.
So, what is a "good" diabetic to do?
Remembering a conversation I had with my doctor, that if I wanted anything I should just phone, because email and faxes have to go through a lawyer, I thought....hmmm.
The following letter, with most personal data omitted, was faxed to my doctor. I had my life-saving prescriptions the next day.
____________________
To: Dr. X
Diabetes Associates
Fax: 555.555.5555
Phone: 555.555.5555
From: {Ms. Concerned Patient}
Phone: 555.555.5555
Fax: 555.555.5555
Today’s Date
Dear Dr. X:
It seems that you are refusing to issue me prescriptions for my Diabetes on some of my medications because I have not visited your office in a while.
This cannot be helped on my end as both my husband and I are unemployed at this point and we are watching every penny. I certainly can not afford to pay quadruple the cost on Metformin simply because I have not had an AC-1 test recently.
I spoke to an associate from your office on the telephone a couple of weeks ago, and had expected a phone call from you or from someone who has the power to make a decision. I did not receive such a call.
We discussed how I had not been in for a while and she told me I needed to come at least once per year. I agreed that I would come in March, which would be one year.
I have prescriptions for some of the meds I use every day but I need prescriptions for Lantus and for Metformin.
My Metformin runs out in two days.
My Lantus will last a couple of weeks. My {Pharmacy Name} prescription reads “part” until a date in Nov 2012. I’m not sure “part” is going to work.
I use X units in of Lantus per day.
There are four boxes of syringes left. I use X-U-100 31 gauge fine needles per day.
Dr. X. I am an X year old woman who has managed her Diabetes well since you became my doctor. I am not in a position to visit your office. It truly comes down to simply not having the funds. I really do resent being made to beg for prescriptions which keep me alive.
My average reading this week is 107. It will certainly go up if I have to do without my Metformin and that will happen this weekend.
I take X-Xmg ER timed release tablets daily.
Please have your nurse phone my prescriptions in to {Name your Pharmacy} on X road at 555.555.5555.
Thank you.
Most sincerely:
{Your Name}
{ Your DOB }
______________________
Bolding added for emphasis here was not bolded in the faxed letter.
I made it easy for my doctor to understand my situation. I was clear about my need to have my meds at insurance reduced prices, and I was clear that I did intend to come in when a year was up.
(The person I spoke to on the phone also mentioned that at least once a year was the minimum a patient could come in.)
I think that is fair, so I agreed to it in the letter.
I also made it easy for the doctor to write prescriptions just from the letter without having to look old prescriptions up.
I have since looked into it and this practice of "no meds without paying for another appointment" seems to be a common practice for Diabetes Doctors, otherwise known as Endocrinologists.
I would never recommend this option to people who are not in control of their diabetes.
But, having said that, I am an adult. I can make my own choices, and I do not need to be blocked from getting meds I need to take proper care of myself by the doctor who is supposed to be helping me to do that.