***It’s long, just so you know***
Ok, so Friday’s pulmonology follow-up appointment was….a DOOZY to say the least.
I’ll preface it by saying A. I don’t like him anymore. and B. I won’t be back.
First of all, my appointment was at 1:45. I was put in the room at 2:15. He didn’t come in until 3:30. I know you’re running behind, but almost 2 hours? The last time I was there, I was in and out in 30 minutes so this was just ridiculous.
If you recall, I was just finishing up my bronchitis antibiotics. I just happened to be seeing him during this time, I wasn’t going to him for the bronchitis issues…
The nurse did a spirometer reading – the thing you blow in to see lung function. really? I’m not coming in with anything like that. of course, it came back fine.
When he came in, he asked me all kinds of questions. I explained the bronchitis situation and how it was being treated, and also the rib/chest pain I had for 3 days. Thursday night while I was watching TV, every breath – in and out – I felt a popping sound in the area it was hurting. This went on for about an hour. When the popping stopped, the pain went away. I don’t know if you can pop out a rib or rib cartilage, but that’s what I thought with my non-MD Degree….I told him this and he pressed on my chest and basically told me that was impossible and those ribs (upper chest) can’t do that, there’s something going on with your chest wall? And was talking over me while I was trying to tell him what I felt and had been going on with me. Like answering his questions with his own flavor of answers, not listening to me, THE PATIENT.
He then says, maybe you have some reflux issues and I need to scope you. He says this on the way out of the room. I said NO – you put me on a reflux medicine that I’ve been on for 6 months – I don’t have anymore problems with that. “the nurse’ll be right in.”
So in she comes with a tray of the nasal spray to numb it and then he comes and sticks a scope up my nose/down my throat. “oh I don’t see anything in your nasal cavities or your throat.” NO SHIT. I just told you that!
Next, he starts banging away on his laptop. He said not one word to me. Not what he thinks is going on, how the bronchitis sounds, not what he is diagnosing, not what he’s going to give me. NADA. ZIP. ZILCH.
Leaves the room again and says, “Nurse’ll be right in.” She comes in with an armload of stuff. Samples of inhalers (same ones I had in June), some tube thing and an injection. She starts opening the injection and I’m like WHOA. what is that and what is that for? It’s a Depo shot. Isn’t that steroids? yes. Don’t all those inhalers have steroids? Doesn’t that rx he sent to my pharmacy – prednisone – have steroids? yes. Don’t you think that’s overkill on the steroids? what is all this for? The doctor prescribed it. I just want to know what it’s for. Are you refusing medical treatment? No, I would just like more information as to what is going into MY BODY. Well you can see right here (on the computer) that he selected it for you. That’s fine, but I want to know WHY. Are you refusing medical treatment? No, I would just like to talk to my doctor about what is going on since he didn’t say one word to me before you showed up. He’s with another patient. I DON’T CARE. I’ll wait.
She takes her little injection and leaves. Comes back and says at least you can take your breathing treatment while you wait and snaps a face mask on me, inhaling some type of mist. I don’t know if it was a nebulizer, I’m guessing it was? She didn’t say either. No idea. meanwhile, I am getting more and more pissed at this super secret shit. I get up and get a scratch paper from my purse and try to look at the computer and write down my diagnosis as well as what he is prescribing since no one is telling me.
She comes back while I’m doing this and is all what are you doing? I said never mind, just print that out for me. what? Print that screen out for me. Why? It’s my chart, it’s my information, please print it for me. Insert eye roll. She prints it and gives it to me. I’m reading this when he comes back in. it has 4 diagnosis codes and a paragraph of “procedures” he did/spoke to me about. back to that shortly…
I have no idea what she told him about the injection, but he was all on his high horse about what bronchitis is and how asthma can flare it up more and pointing to this diagram and this poster and again what bronchitis is and how asthma can flare it up. you need to take the shot and everything else I am giving you. we need to bring out the big guns. OK, but WHAT are you giving me and WHAT is it for and HOW will it treat me?
Blah, blah, this inhaler for these airways, this inhaler for these airways, this tablet to knock out the rest of the mucous buildup and to stop the wheezing from the asthma. And the injection? we need it in your system now. Fine.
Nurse comes in and gives injection, says to make a follow-up in 2 weeks.
I make the appointment, leery of whether I will actually return.
I decide I really don’t want Google interpreting the patient info I had printed, so I made a mad dash to my internal medicine doctor. I told the nurse that I would wait between patients or even be the last one of the day, I just needed to talk to her.
Luckily her last patient of the day was running late, so I had some time. I first explained everything that he did to me, and what he didn’t tell me. Then I handed her my sheet.
Diagnosis:Cough (primary) – (I mean, isn’t this a given since I am recovering from bronchitis?)HemoptysisAsthma with acute exacerbationAcute bronchitis with bronchospasm (I wouldn’t consider it acute as it was WAY better than it had been)
Procedures:Chest x-ray full, sprirometer, bronchoscopy, injection, nebulizer, asthma symptoms eval, tobacco use eval (I don’t smoke?), BMI discussion, meds verified
First I asked her what was hemoptysis. She has this look on her face like what? She said that means coughing up blood. my chin hit the table? what? Are you kidding me? She said you didn’t tell me you were coughing up blood. I said I didn’t tell him that either. Well he says you have that. But I don’t. He made this shit up? I said, in his defense even, that maybe when he scoped me he saw blood in my throat that I didn’t know about, yet also didn’t tell me about so he put this down. She said there’s another word for SEEING blood, this words directly means COUGHING up blood. WTF.
She thought the bronchitis and “acute” descriptions were a bit excessive especially since I was at the end of it already.
Now remember I had a chest x-ray on Tuesday for the pain I was having? To avoid further radiation, I brought my CD with me. it was just 3 days old. so he viewed those images. you see the procedures up there? He is telling my insurance that he performed a FULL CHEST XRAY ON ME! He didn’t do this! He looked at existing images! He definitely didn’t discuss smoking or BMI with me. He didn’t do most of what he said he did and he MADE UP A DIAGNOSIS CODE!
Most of his patients are 65+ with lung issues from 50 years of smoking, emphysema, cancer, etc. I know damn well they are not asking for printouts of their information. WHO KNOWS what all he is charging them for! I just can’t even believe it. my blood is boiling just talking about it again.
Doc did say I shouldn’t take one of the inhalers, if I’m trying to not take something (because it seems like so much!) because the tablets will cover the same symptoms so why do it twice? I could tell by her face and what she was NOT saying that she was just as much beside herself as I was.
So my question now is, how do I proceed? I am most definitely not going back in 2 weeks. I need a new pulmo. But what about his wrong information? do I contact some medical malpractice agency? is there such an agency? do I let my insurance know what is going on? maybe they can deny something he is charging me for? if I hadn’t upped my insurance this year, I would possibly be responsible for some of the cost of the x-ray. That he didn’t really do….
How can I let someone know he is potentially scamming insurance companies and giving tests/procedures that are unnecessary?
Martha? Suggestions? Any other medical type people have any advice???