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State of the Human Suit

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Had a follow-up with my rheumatologist. He's not only the best specialist I've ever had, but the best doctor, period. He pulled me out of a miserable, two-month long flare-up (my doctors back in Illinois were well-meaning but inept) going on four years ago and has kept my lupus/MCTD stable ever since. And he's the only doctor (and I routinely see quite a few) who actually remembers anything about me or my condition*.

He always inquires about my writing, sometimes asks after Hobkin, and is generally interested and engaging. He's also got an incredibly appealing bedside manner—stern in a grandfatherly sort of way—and has a charming Italian accent. And I actually believe he cares about my health; when I first saw him, he scolded me for not seeing a rheumatologist before for my lupus (I mentioned the ineptitude of my previous doctors, didn't I?).

He's also the reason I haven't wanted to switch to a different HMO despite the fact that it's the most expensive HMO option offered and some egregiously terrible experiences—bordering on (possibly crossing into) malpractice terrible—not to mention the general bungling, incompetence, and inability to provide basic customer service I've suffered at the hands of my HMO. But it seems that the state is making that decision for me. Due to budget issues, my place of work is dropping my current HMO as a benefit option, so come 2010, I'm going to have to switch.

When I first heard about this, I was appalled. My rheumatologist is specific to the particular HMO I'm currently with, so I won't be able to keep seeing him. But, after our follow-up on Friday, I'm a little less dismayed. Not 'cause I like him any less or anything, but 'cause he said that "I've graduated" (his words, hee!) and don't need to see him as often since I've been stable and flare-up free for so long. He suggested we decrease the frequency of our follow-up appointments down to once a year—with, of course, a stern admonition to call him immediately if I start evidencing any signs of a flare-up. And then he teased me about missing him.

Although y'know, I actually will miss him, 'cause I rather enjoy our visits.

But with me only seeing him once a year—and the fact that, at best, I won't mind replacing my other doctors, at worst, I'll be glad to swap them for another one since I can't imagine their replacements being much worse—it's less distressing.

Still, I remain miffed that I don't get a say in this matter. 'Cause in the end, I find any amount of aggravation and incompetence from the rest of my HMO to be a fair trade for seeing my rheumatologist. So even though I can contemplate this mandatory service provider switchover somewhat philosophically, I remain very unhappy that I have to give him up come 2010.


*My p-doc still thinks I have ADD even though I remind her every single time I see her that I'm taking Adderall to combat lupus/MCTD-related fatigue, not to treat ADD. Not to mention that I have no (and have never had any) symptoms of ADD and have never been tested for or diagnosed with ADD. Not impressive. I'd be raring to switch p-docs and would have way before now, except that pretty much all she is to me is a signature on a 'scrip, so it doesn't really matter to me how incapable she is as a doctor.

   

Writing Stuff


Writing accomplished this weekend: none. Glargh. Move along, folks. Nothing to see here. Sigh.

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On November 24th, 2008 05:30 pm (UTC), alaneer commented:
Ahh, insurance companies. Someone needs to regulate them because they have entirely too much power over us.

Hopefully someone will by 2010. I wish you good health.
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On November 25th, 2008 03:44 pm (UTC), eugie replied:
Thanks, sweetie.

"Ahh, insurance companies. Someone needs to regulate them"

Actually they are regulated. Just not very well.
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On November 24th, 2008 07:16 pm (UTC), threeoutside commented:
Yay, you for graduating! But - if you're only going to see him once a year, maybe you could just pay him out of pocket. I mean, they don't fire you from the HMO for seeing an off-the-program doctor, do they?

Just a thought. I loathe our healthcare system, though I have to say, BCBS were outstanding to deal with when my hubby was sick.
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On November 25th, 2008 03:40 pm (UTC), eugie replied:
"if you're only going to see him once a year, maybe you could just pay him out of pocket. I mean, they don't fire you from the HMO for seeing an off-the-program doctor, do they?"

I'm actually not sure how seeing a non-program doctor works with HMOs. I assume I'd be able to, but he's also the one who prescribes the meds which keep me flare-up free, and I'm pretty sure the HMO I'm going to have to switch to wouldn't honor an out-of-system 'scrip as being covered by their drug plan. Plus, the meds I take (Imuran) to control my lupus/MCTD can cause liver toxicity and lowered white blood counts, so I go in every eight weeks for lab work to monitor those, which is also ordered and scheduled by this doctor—and, again, I'm pretty sure my new HMO wouldn't want to cover out-of-program lab work ordered by an out-of-program doctor. So I'd end up having to pay for the visit, meds, and lab work out of pocket. I simply can't afford it.
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On November 25th, 2008 05:24 pm (UTC), threeoutside replied:
"I simply can't afford it."

I hear ya there. And after I posted, the Rx question occurred to me. I hope you can get the new doctors to keep you on the same regimen. Surely they would. (I know; I'm not naive, but why woudln't they, if it's keeping you from much more expensive emergency-type intervention?_

Good luck, sweetie. Hope it works out to your benefit!
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On November 25th, 2008 12:03 am (UTC), sylphon commented:
Who do you go to? I'm looking for a good rheumatologist for my possible Lupus and my RA. I'm glad he's kept yours in check, sounds like he manages it pretty well! Stinks about the insurance change though :-(
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On November 25th, 2008 03:43 pm (UTC), eugie replied:
My rheumatologist is Dr. Eduardo Baetti with Kaiser-Permanente. He's fabulous. I highly, highly recommend him.
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On November 26th, 2008 07:48 pm (UTC), sylphon replied:
Thanks!
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On November 29th, 2008 03:26 pm (UTC), reddherring1955 commented:
Good luck with whoever the new HMO doc is. Maybe, just maybe, s/he will read the old doc's recommendations?
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