Doctor won't accept "liability'

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nefarious_muse

Hello All,
My husband found info about home testing in his Cardio's office and after reviewing, and deciding to give it a try, he was told by his Cardio that she WOULD NOT sign for the kit as she didn't want to accept the legal liability for any errors in his judgement in watching his levels.

What ever happened to the Hippocratic oath and doing things in the best interest of the patient?????

My husband had his last blood test on Thursday the 8th - and today is the 14th - still NO WORD from the cardio office on his results. It could be that all is fine - or it could be that they just haven't called.....errrrrh!

It's bad enough that my insurance company will not allow him to be tested in her office - he has to go to a lab and wait and wait and wait for the cardio to get the results (or at least report them back to him).

Has anyone else experienced this? Is this a reason to switch cardiologists? This is number 3 since 2000....maybe it's time.

Would appreciate your insight and wisdom!

Nef :)
 
My bro has his INR taken each month; by the end of the day, his cardio, his local dr, his assisted living place, all know what it is. We live in a small area with a small hospital that hasn't much traffic, however his cardio is in a large area but they manage to call the nurse AND my brother with their orders - THE SAME DAY! Don't know what to tell you, but unless you have other issues or unless this has caused you some danger already, I don't think it is a real reason to switch. Others may have other info, tho.
 
Nef,

Waiting a week for INR result is unnacceptable. If the INR is out of range, you can't wait a week for a dose adjustment. Could be dangerous. Perhaps all is kay, and that is why you get no call back. But that is a huge assumption, huh? You need to be on the phone twice a day, or go sit in the office for the result.

My cardio only recommends home tests for patients that he thinks can handle the responsibility. I guess I passed his test. The home tester is soooooo convenient. And in your case, if the doc's office is slow to respond, at least you know the result and can deal with it in the meantime.

PS, if insurance is balking at testing in the doctor's office, I can imagine how they will react to a home tester. But, frankly, something different must be done.

I suggest a "heart to heart" talk with the doctor to come up with a testing method that works. Stick to you guns. The secondary issue is convenience, but that can be very important for consistency and confidence.

Let us know how it goes.
 
All INRs should be reported back on the same day as the test. There is NO excuse for this kind of sloppy medical care. Most doctors know very well how to MAKE the lab get the results back asap.

It is useless to work on yesterday's news when it comes to INR. That can get the patient into BIG trouble.

Air your concerns out with the doctor, and if you don't get a satisfactory response, then consider an alternative.
 
You need to know the INR results the same day, anything else is unacceptable. As Tom pointed out, if a adjustment is needed, waiting longer then one day is doing you no good whatsoever.

I think I'd be cocky and ask that Doctor why be against home testing with instant results vs lab testing and no results. Is she willing to accept responsibility for the lab never calling?????
 
When I do have to have a veinous draw at the hospital lab, I wait there for about an hour after the test, and then I get the results. Whether they forward those results on to a doctor or not is not something I'm very concerned about. I want to know my results, and make any appropriate changes.
 
Thanks so much for your replies :)

My insurance company only allows the lab to perform the test (if my husband pays on his own for the Dr's office testing, then he MUST pay for all cardio care on his own!). Apparently the United Healthcare has a deal with the lab (Quest) that we must honor in order to receive benefits for his care.

My husband will discuss this (again) with the cardio doctor. He left three messages with her office today (still waiting for those test results) and has received no response (it's now 8:24pm here in South Florida). I had him write a letter indicating that he is SCARED of how the lab and doctor's office has been handling his testing - and that he still believes it will be in his best interest to move forward with the home testing. We're going to fax it to them tomorrow morning.

Thanks again, everyone
Nef
 
Nef:

I have United HealthCare through my newspaper's corporate owner, Knight-Ridder. Last year it was called a POS policy (?), may be the same this year but that's not on this year's card.
There are all sorts of policies with each insurer. That's what I was told by one of the companies that sells the ProTime 3. The employer negotiates with the insurance company for coverage levels.

UHC paid for my ProTime 3 unit last November. I test weekly, because I want to stay on top of any changes. Testing weekly is a good argument for having your own testing machine. My PCP has 2 or 3 other patients with their own testing machines. I don't know if my PCP has declined to approve others because he believes they would not be good candidates for self-testing.

In 2003, UHC paid 100% for my INR tests. There's a co-pay this year, but I've only had to have one INR test at my PCP's office in 2004. He has a CoaguChek, so all patients on Coumadin are tested in office. My co-pay for PCP is $15, $30 for specialists.

Your husband apparently is hitting a bottleneck somewhere. Have him contact UHC and talk to a LIVE KNOWLEDGEABLE person there. (Is finding a knowledgeable person at a health insurance company possible??) Talk to a supervisor @ UHC.
Are all your husband's doctors in network? It's hard to believe that an insurance company will pay for lab draws but not for tests at a PCP's or cardio's office that would give more immediate results and thus allow for more timely corrections if needed.
 
Am I Crazy????

Am I Crazy????

Well the saga continues about home testing vs lab testing.
So far to date I have been treated like gold when it comes to my INR testing and results. I am registered with the Aticoagulation clinic in the city, when the lab in the small town next to me gets the results they fax them to the city to the Antigoagulation clinic. Then usually by 3:00 p.m. THAT DAY, they phone me with the results as well with the dosages that they wish me to take for the next few days. As far as waiting for any results, it just hasn't happened. BUT..and I say BUT.. I live in a small village, the hospital is 20 minutes away in the next town. This blood testing at the lab isn't all that big of an issue right now when I am still off of work, but when I get back to work, then it will be harder to get in for the test. Lab is open from 8:30 a.m. to 4:30 p.m.. I start work at 7:00 a.m. and finish any where from 5:00 p.m. to 10:00 p.m.. I really want to get my own home testing unit, but that is where I come in with my comment about being crazy. I will have to pay for it on my own and am really rolling it around in my head to justify spending that kind of coin especially when I am currently being treated like a king when it comes to my testing. I know it is a personal choice and I know any one who has a unit would never go back...

Next question Protime and CoaguChek S....are they both made or sold by QAS? I was thinking that the two different units were competiton for each..but maybe not... A rep from Roche emailed me and told me that the CoaguChek S units would require me purchasing CoaguChek Controls and the cost of them is $29.00 and then I need the strips @ $325.00 for 48 or $86.00 for 12. This seems to be a lot cheaper than the cuvettes for the Protime units...
Which units are the best and which are the cheapest to operate and use? And for that matter it seems that the CoaguChek S unit is cheaper to purchase to begin with. This is just a confusing issue for me and I go round and a round with it in my head. if any one can enlighten me I would really appreciate it.

Thanks in advance,
Brian
 
nefarious_muse said:
Thanks so much for your replies :)

My insurance company only allows the lab to perform the test (if my husband pays on his own for the Dr's office testing, then he MUST pay for all cardio care on his own!). Apparently the United Healthcare has a deal with the lab (Quest) that we must honor in order to receive benefits for his care.

My husband will discuss this (again) with the cardio doctor. He left three messages with her office today (still waiting for those test results) and has received no response (it's now 8:24pm here in South Florida). I had him write a letter indicating that he is SCARED of how the lab and doctor's office has been handling his testing - and that he still believes it will be in his best interest to move forward with the home testing. We're going to fax it to them tomorrow morning.

Thanks again, everyone
Nef
Click to expand...

In my view your cardiologist is not only an idiot but insensitive to boot. My advice would be to fire her and get another doctor. He or she does not need to be a cardiologist. A good general internist would be my recommendation. I am disgusted by the treatment you have received. If anything bad happens to you during this critical period, get a lawyer and I will be happy to testify against this cardiologist who is so afraid of a lawsuit
 
Nef - If you want to convince your doc, go thru all the past threads here that deal with pro - home testing and print them for the doc. My own cardio was extremely supportive and I not only do home testing but home dosage - I do email my results in and any changes I have made and encourage the lab to correct me if they see a problem - so far they have not seen the need to alter my dosage levels. hope you get it straigtened out. Chris
 
LOL..Ross...LOL..
I've been reading and reading....but I must have missed the fine print..LOL.. :confused:
or it is my short term memory loss from the surgery...LOL..I am going to mik that excuse to the end...LOL... ;)
 
Thanks again for the advice. I think we are going to start shopping for other doctors.

Well we finally got the results this morning. After two more calls, we learned that the Nursing Assistant was on vacation, and her replacement was supposed to be covering all messages, etc.

What a joke.

Turns out he was at 3.6.

Here's a copy of the letter we faxed to the doctor (and as of this writing, she has yet to respond):

April 16, 2004

Dear Dr XXXXX

I am sitting here on April 14, 2004 waiting for my INR and PT blood test results. I went to Quest on April 8, 2004 to have the test performed. I still don?t have the results. This is typical of the delay between my taking the test and getting results. I have never gotten the results the day after taking the test, three days to a week or more between taking the test and getting the results is normal.

I wanted to formally make you aware of my uneasiness with this situation.

There is a home test kit that I could have. I have made you aware of the lag between taking the test and my getting the results at each of our appointments going back over a year. Someone in your office gave me the information on that home test kit over a year ago also. I have repeatedly asked you for the prescription I need to obtain one of these kits, you have refused.

Your reason being the legal risk of being sued.

I guess you see the risk to my health due to waiting several days to a week or more for results to these tests as subordinate to the risk of you being sued. What?s strange is that my health is obviously more at risk the way we are presently doing this, but I guess that since the home test kit is new, you feel the legal risk to you is more substantial than the health risk to me.
Is there a legal waiver I could sign?

I am scared. I really feel that waiting a week for these results is dangerous.

Sincerely,
Rich XXXX
 
catwoman said:
Nef:

I have United HealthCare through my newspaper's corporate owner, Knight-Ridder. Last year it was called a POS policy (?), may be the same this year but that's not on this year's card.
There are all sorts of policies with each insurer. That's what I was told by one of the companies that sells the ProTime 3. The employer negotiates with the insurance company for coverage levels.

UHC paid for my ProTime 3 unit last November. I test weekly, because I want to stay on top of any changes. Testing weekly is a good argument for having your own testing machine. My PCP has 2 or 3 other patients with their own testing machines. I don't know if my PCP has declined to approve others because he believes they would not be good candidates for self-testing.

In 2003, UHC paid 100% for my INR tests. There's a co-pay this year, but I've only had to have one INR test at my PCP's office in 2004. He has a CoaguChek, so all patients on Coumadin are tested in office. My co-pay for PCP is $15, $30 for specialists.

Your husband apparently is hitting a bottleneck somewhere. Have him contact UHC and talk to a LIVE KNOWLEDGEABLE person there. (Is finding a knowledgeable person at a health insurance company possible??) Talk to a supervisor @ UHC.
Are all your husband's doctors in network? It's hard to believe that an insurance company will pay for lab draws but not for tests at a PCP's or cardio's office that would give more immediate results and thus allow for more timely corrections if needed.
Click to expand...

Hi There, Thanks for the advice :) Yes we checked with UHC and they will cover the cost for an exam and blood test - but not weekly blood tests. Also the issue with home testing is not with UHC - it's with the dopey cardiologist. None of her patients are allowed home testing (according to her) - in fact, the nursing assistant told my husband that the staff got in trouble for distributing the home-testing paperwork in their office :rolleyes:

Nef
 
Hi Nef,
I'm waiting with baited breath to see what the outcome of this will be! My boyfriend Jim is having a similar problem, although the chains of command are different here as we're in England.
Jim's cardiologist's main role has been to forget to refer Jim to the surgeon for 2 months, prescribe drugs which seem unnecessary, and send him away until November. The surgeon was the one who "referred" Jim to the anti-coagulation clinic, so the cardiologist is really out of the loop in this case. Jim has his blood taken (venously) at his GP's clinic, from where it is taken to the anti-coag clinic at the hospital 5 miles away, and they phone him that day if he needs to change his dosage, or if not just return his anti-coag record book in the post.
However, Jim recently asked his GP about getting a coaguchek monitor to test himself at home. At first his GP said it was a great idea, but then he told Jim that the anti-coag clinic would not accept his readings and should any problems arise he would not be able to sue them for malpractice (sound familiar?).
Anyway, after some gentle nudges from Billy ;) , we have decided to go ahead and buy one anyway - you don't need the cardio to write a prescription here as it's paid for by the patient. His mother has very kindly offered to pay for it, and we have written to the haematologist at the hospital asking for an appointment in a few weeks to check that the coaguchek results tally with their lab results, and to discuss the intervals at which they need blood tests in the future. Hopefully we'll be able to talk sense into her at this appointment and demonstrate that Jim can home-test and ring his results through.
I'll keep you posted, and hope we both get what we and our SO's want in the end!
Gemma.
 
GemmaJ said:
Hi Nef,
I'm waiting with baited breath to see what the outcome of this will be! My boyfriend Jim is having a similar problem, although the chains of command are different here as we're in England.
Jim's cardiologist's main role has been to forget to refer Jim to the surgeon for 2 months, prescribe drugs which seem unnecessary, and send him away until November. The surgeon was the one who "referred" Jim to the anti-coagulation clinic, so the cardiologist is really out of the loop in this case. Jim has his blood taken (venously) at his GP's clinic, from where it is taken to the anti-coag clinic at the hospital 5 miles away, and they phone him that day if he needs to change his dosage, or if not just return his anti-coag record book in the post.
However, Jim recently asked his GP about getting a coaguchek monitor to test himself at home. At first his GP said it was a great idea, but then he told Jim that the anti-coag clinic would not accept his readings and should any problems arise he would not be able to sue them for malpractice (sound familiar?).
Anyway, after some gentle nudges from Billy ;) , we have decided to go ahead and buy one anyway - you don't need the cardio to write a prescription here as it's paid for by the patient. His mother has very kindly offered to pay for it, and we have written to the haematologist at the hospital asking for an appointment in a few weeks to check that the coaguchek results tally with their lab results, and to discuss the intervals at which they need blood tests in the future. Hopefully we'll be able to talk sense into her at this appointment and demonstrate that Jim can home-test and ring his results through.
I'll keep you posted, and hope we both get what we and our SO's want in the end!
Gemma.
Click to expand...

Hi Gemma, So sorry to hear that you are also dealing with this! It is really an eye-opener, isn't it? Please keep me posted on your progress, OK?

I'm thinking that if we can go ahead and purchase the home testing unit ourselves - at least we'll have the peace of mind until we can find a decent cardio doc. We seem to have some real "winners" for cardio docs in S. Florida! The first guy was great, but he is about an hours drive away - was too difficult for my SO, who was trying to get back to "normal" with his job, etc. Now that his visits are only every 4-6 wks, we are thinking of going back there - as he was the only cardio that seemed to have a clue :) The others close to our home (including Cleveland Clinic in Weston, FL) were worse than our current doc! It is so very frustrating...and scary.

Thanks again to you - and the others - for your thoughts and concern...very much appreciated :)

I'll keep you all posted on how we make out
Nef
 
kinda off topic but....

kinda off topic but....

Ross said:
You seriously need to get away from that Cardiologist as fast as possible.
Click to expand...

I gotta tell ya Ross, I love that avatar! Too cute!!!

Nef :)
 
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