Whoops! Your doctor messed up. What do you do?

Dr Gary
By Dr GaryCA Latest Reply 2016-02-16 19:01:29 -0600
Started 2016-02-11 15:00:21 -0600

Does your doctor make an error from time to time? Maybe overlook something that should not have been overlooked? Wait and see when action should have been taken immediately?

About three years ago, I stopped in at a medical clinic – not my regular doctor – to take a look at a little bump on my hand that seemed to be causing swelling. I was told to take an antibiotic but not worry about it.

Well, the next day, my hand was so swollen I could not move my fingers. I ended up in the emergency room followed by four days in the hospital for a serious staph infection.

A little error that allowed a dangerous infection to get worse.

Doctors are human. They get busy and don’t pay close attention. They jump to conclusions without getting enough information. They make mistakes in judgment. Like all humans do.

Here’s a link to an article I posted on this topic awhile back:

http://www.diabeticconnect.com/diabetes-infor...

Has that happened to you?

If so, what do you do? Keep quiet about it? Give your doctor a good scolding? Fire him/her?

I’m really interested in how you handle errors that your doctor might make. How do you respond?

At what point does an error on your doctor’s part become a reason to part ways? Or do you decide that your doctor has done such a good job for you over time that you are willing to excuse a lapse in judgment?

And then there is always the question: Is my current doctor the best I am going to find?

I’m talking about errors that don’t place your life in danger or otherwise cause you harm, not medical malpractice. But then, how you decide what constituted malpractice?

Looking forward to hearing from you. Any stories? Advice?


47 replies

Lakeland
Lakeland 2016-02-16 19:01:29 -0600 Report

Here's my horror story. in my late 30's I had pelvic pain & wierd period, I have no children & my biological clock was playing a mind game. will there be anyone to take care of me when I get older, but the pain was bad & I had to start looking. I found an obgyn that I liked, we could talk about anything & so I wanted his help. Since the emotional with the no children thing. to stop the bleeding I did novasure which meant very low pregnancy chance. That stopped the bleeding but nothing with the pain. No endometriosis showed up

I found an obgyn 1 hour away, who is an multi book author on women's pain. at first I was impressed his website said he worked with several doctors to look at the entire body & put a plan together but by the time I got there he was alone, but he gave me a 2 hour appt & a very long physical & came up with a game plan, I was driving 1 1/2 hours to get a nerve shot in the crease of my leg to numb the nerve. He explained that if you hold your hand in a fist for hours, the hand feels normal in the fist postition, however, when you open your hand, which is a normal position it will hurt & this treatment will be a long process & I bought into it. after months I wanted to stop. & He wasn't pleasant when I told him I don't think this is working. He also did lupron shots, he said if they worked then, a hysterectomy is the answer

It is so discusting each doctor only looked at me through their specialty & even though I thought this guy was good, He wanted to see me through his specailty, I noticed on one set of notes he said it was a muscual problem, so I thought I'd try a chiropractor & he gave me a local physical therapist to help with my pelvic floor.

The chiro practor hurt me, my back wasn't adjusting the way he wanted it to so he put his elbow in the middle of my back till it snapped & I started bawling. the other one had a table that levels dropped out to make the adjustments & I started bawling with him too. They really hurt me.

so I went to a female obgyn who said difficult cases were her specialty & she said it was endo, I figured she can do a d& C & look for endo, She told me after surgery she got it & I was "inundated with endo" So I did call my doctor & said you missed it. He said I want the pathology report & to come in. I got it, he read over it with me & it says nothing about endo. She lied. So I told her & she said some doctors interpret things as endo. She wasn't wrong.

there was a Philadelphia doctor in there too & he couldn't help exect to say he thought it was something & said I need hysterectomy, So he's a specialist so I wanted it done locally & asked my doctor if he'd do my hysterectomy & he said sure. He did & pain remained, when I went back he said "you had a cyst on your overy, I should have taken it. == so I did another surgery & removed the ovary.

I went out of state to find the author of Headache in the pelvis & give him a chance. ( This pain would put me in bed after 3 hours at work) He did a urine test & told me to take fish oil tablets.

Pain continued my family doctor had me go to an gastro doctor & it wasn't that. & then pain management. The Lady doctor who was giving me guided nerve blocks. said "we were talking about your case over thanksgiving dinner , my brother is a orthopedic specialist for the washington redskins & He thinks it's your hip. So another doctor, It was a labral tear in my hip, but when they did the surgery he hit a nerve & now I live on vicodin.

One day I went blurry, Mom said your dad got that way when he was diabetic
so my mom's meter showed I was at 550 & that's when my diabetes started. I had all those surgeries & my blood work was fine. I called NY Doctor & said send me the urine report & it showed 1000. I said, why didn't you tell me I was that high. He said that's normal in diabetics. I said I"M NOT DIABETIC. Come to find out Lupron is a culprit of diabetes in testes.

So I don't think doctors are worth their pay, They don't look at a person as a whole & they miss things. Granted I wasn't much help because do to the location of the pain I was so sure it was an oBGYN issue. I never thought about referred pain.

So now I live on vicodin, metforming & a blood pressure pill & my blood work yesterday is showing the acedomephine in vicodin is hurting my liver.

It's been a horrible process & it's almost like you need to hire a retired doctor to be an advocate when you go through something like this. Way too many speicalists that just drop you when you don't fit their mold. So sorry for the long post but do your best.
Diane
P.S I did start collecting all test results, blood work results, MRI cd imaging ect. & the one doctor told me I had more records than he did. So I don't know what they see

suecsdy
suecsdy 2016-02-12 17:38:39 -0600 Report

So far my Dr. hasn't screwed up that I know off…Just scared the daylights out of me once or twice with what I consider insufficient information. First with the kidney dx and then with the cyst in my back that they intimated might be cancer… they were right about the Kidneys, wrong on the back problem, but in both cases I was referred to specialists, so mostly just major anxiety.

Dr Gary
Dr GaryCA 2016-02-13 20:15:59 -0600 Report

HI suecsdy! Glad to hear your doctor is on the case so far. That's good. i think doctors aren't always as tactful as they need to be when raising an alarm with a patient. As a result, the patient can end up alarmed, unnecessarily. There is a difference between a precaution and a threat.

Grandmama16
Grandmama16 2016-02-12 13:41:04 -0600 Report

I've had this dr. for over 20 yrs. but one mistake she made was to diagnose shingles from a reddish bumpy patch on my lower back and give me a pres for it. It wasn't anything but a little irritation on a kind of birthmark. No biggie but she did assume. Her office will forget to call in an appt for another thing, like a pain clinic recently so I decided to just forget it. My pain meds for Fibro are working ok, just not very ok. I take a variety of meds. but some of the instructions on the bottle are wrong…like 2 a day instead of 1 but that gives me 2 months supply so I haven't said anything because my blood pressure is good. I've got 2 pres for gabapentin, 100, and 300 mgs but only take 100 in the afternoon or night when I'm most likely to get the invisable itching on hands and ankles. We have to think for ourselves. One error that affected me badly was for Metformin. She pres 500, twice a day and my body couldn't handle that so I asked for 100mgs and have worked up to 500 mgs 4 times a day with her approval, which is working fine. I think Drs should start people on the lesser amts first.

Dr Gary
Dr GaryCA 2016-02-13 20:11:31 -0600 Report

Hi Grandmama, nice to see you! Sounds like you are flexible, willing to go with the flow as little issues come up. As long as your health is not negatively affected, that is probably a good attitude, given that the system is far from perfect. Glad you advocated for yourself on the Metformin. That's really important! And I agree that, when possible, it's a good idea to start at lower dosages to see how your body handles it.

Gabby
GabbyPA 2016-02-12 10:42:09 -0600 Report

Wow, do I have some stories to tell, not with me, but my husband. I have learned to be very observant of him, his body and the doctors and what they are saying. His primary is not my favorite guy, but hubby likes him and that is what is important. So I keep an eye on questions to ask. I do feel that he is too quick to pill someone up so I sometimes push the boundaries. We all do make mistakes, and ignorance is one of them most committed. That is why you have to really tell your doctor as much as you can.

The hospital, however has been a teaching ground for me and getting my answers and asking again and again until I am satisfied. I actually learn a lot from them there if I do it right.

Once, my husband was taken to the emergency room pretty unresponsive and we didn't know why. When I got there with him, I noticed his foot was red and HOT. They had him in there for over an hour already and no one saw that. I pointed it out and it ended up being celucites that we had just missed getting into his blood stream. It took only 24 hours to go from fine to almost dying. I often have to wait to call 911 because he will not agree to go and if you call and he won't go, it's a waste of everybody's time because they don't have to take him. My take away...call them anyway.

Another time we were at his doctors office where he has his pain pump filled. We showed up for his appointment only to have them tell us it was canceled. They kept pushing his appointment back until past his alarm date. We argued with them , but they kept telling us there would not be a doctor available to do his refill. (thanks to insurance limitations, he was the only doctor in town we could use, or so we were told. Found out later there was a doctor on staff who could have done it. REALLY!!?) We were livid, but hoped that the alarm would go off with enough days left to get it refilled. It did not. Two days before his alarm date, his pump was empty and he ended up in ICU for 13 days. I met with the administrators of his pain clinic and we had a very calm, but emotion filled conversation and I brought photos. There were protocol changes made that day in that clinic and in all of the local pain management community here because of that. Medtronics (the maker of his pump) even did a webinar a month later on the dangers of low pump levels and the risk of harm.

We did try to file a lawsuit, but we found that unless he died or was permanently damaged because of what happened, no one would touch it. That was incredibly aggravating. That hospital stay was totally avoidable and caused by their lack of paying attention to what the patient required. The clinic did end up paying for the hospital bills after some back and forth. For that were were grateful. But to be honest, it was not the doctor, but the people who ran the office that caused that issue.

What I have learned is that you can never offer them too much information. If they choose to ignore it or say it isn't relevant, that is on them. But share all kinds of little details. You never know if one of those things will switch the light bulb on to a different course of action. You also must always stand your ground. I am not one to make a scene, but I have learned the hard way that sometimes a scene is the only way to get them to listen.

Dr Gary
Dr GaryCA 2016-02-13 20:01:00 -0600 Report

Gabby, I really appreciate your post. Great examples of why it is really important to communicate what you see to health care professionals, because they might overlook something on their own. As well as why it's really important to advocate for yourself. The story about your husband's pain pump is just incredible! It's amazing how bureaucratic bumbling and obstinance can get in the way of responsible health care, and place patients at great risk and inconvenience. I am sure you were a trailblazer on this one. I totally agree. Never too much information, even if health care professionals don't think they need to hear it. Another reason why we have to be advocates in the health care system! Thanks for checking in!

Dan360
Dan360 2016-02-12 09:36:52 -0600 Report

We all make mistakes. That is true, but before you forgive a mistake you need to review what led up to the mistake. How serious does the doctor take his patients? They see a lot of patients and the information they need to keep track can be rather daunting. Are they up to the task?

What I cannot accept from a doctor is him/her not remembering important information about my health from one appointment to the next. Once, I got a call from the doctor's office telling me I needed to come in for a yearly physical. When came in for my appointment the first words out of the doctors mouth was, "What brings you in today". On other occasions I have had doctors forget important information from one appointment to the next. It is as though they are running an assembly line practice (next patient, please!).

Another thing I have experienced is doctors prescribing medication without explaining why this medication. What does this medication do? What do I need to be aware of while taking this medication? It seems to me that not many doctors want to share their knowledge. They just prescribe without believing that the patient has enough medical knowledge to understand what is going on with their bodies. They are the doctor, you are the patient. They tell you what to do and you do it. They are too busy to try to explain things when the patient will probably not understand anyway. My business is understanding what is going on with my body! It is necessary for me to do the best job possible of taking care of myself.

Dr Gary
Dr GaryCA 2016-02-13 19:49:10 -0600 Report

Hey Dan, that's a very good point. Is this an ongoing issue, and a sign of not taking patients seriously, or an isolated incident? The example of not knowing why you came in for the physical you were requested to come in for is quite an example of doctors not paying attention, or a lack of organization in his/her office, both of which can place patients at risk. Assembly line is a good term. That's also a good point about doctors making patients aware of what they need to know about a medication. I think it is a time issue, unfortunately. Doctors so often want to do their job and move on without a lot of interaction. Time is money.

Kalisiin
Kalisiin 2016-02-14 16:08:44 -0600 Report

Actually doctors do NOT want to "do their job and move on without a lot of interaction" but the way it is the insurance companies have forced this.

Dr Gary
Dr GaryCA 2016-02-14 17:46:58 -0600 Report

Yes, I meant to say that but didnt make it clear. I think most doctors would like to have more interaction with their patients but the managed care system has changed things.

Kalisiin
Kalisiin 2016-02-15 10:01:41 -0600 Report

Precisely! As a biller/coder I know this, first hand. The office nurse and the pharmacist often give out more info now than the doctor does.

Of course, this shoves more of the administrative stuff the nurse USED to do…onto biller/coder people like me…but I do not mind.

OrchidNox
OrchidNox 2016-02-12 09:07:29 -0600 Report

When I first moved to Ohio, I visited a gyno that told me (to my face) that I was going to hell for living with my then-boyfriend (now husband) out of wedlock and then she stuck a finger up my butt w/out warning (no gyno previously had ever done that particular maneuver). I not only fired her, but I reported her to the Ohio Medical board.

When I moved to KS, I found a doctor and while he was a very nice man, he was more interested in selling me a diet than listening to my needs and hearing what I had to say (to the point that I was effectively poisoning myself for 4 months before I finally put my foot down and went to a different doctor in the practice).

If your doctor makes a mistake, that's cool - human, as you said. But when they are willfully ignorant or pissy or obnoxious, fire their butts. You deserve to be treated like a human being.

Dr Gary
Dr GaryCA 2016-02-13 19:32:25 -0600 Report

OrchidNox, nice to see you. Wow! That is pretty incredible. It's amazing how some professionals think they are entitled to treat patients. Mind boggling. Not to mention use them as piggy banks like your second doctor. And I totally agree. We all deserve to be treated with professionalism, respect, compassion. Thanks for sharing this.

Kalisiin
Kalisiin 2016-02-13 16:53:38 -0600 Report

I had a similar experience of being totally disrespected in an medical office by an overzealous religious nut.

He was reported to the Jefferson County Medical Board. I testified at a hearing.

In the end, the guy was reprimanded, but nothing further came of it.

OrchidNox
OrchidNox 2016-02-15 09:35:57 -0600 Report

Yeah - basically nothing came of my complaint, either.

Now, tho, I kind of have a nervous reaction to seeing a Bible in my doc's office. I moved to KS this last year and EVERY medical professional has a Bible in their office. Thankfully I haven't come up against that weirdness again, but man it makes me nervous.

Kalisiin
Kalisiin 2016-02-15 10:04:36 -0600 Report

This does not bother me. I try not to throw the baby out with the bathwater…religion can inspire some to greatness, and others to pettiness.

The doctor I currently use…has Bible stuff all over the place, and has NEVER treated me with anything but respect. In fact, my doctor's clinic is named "ACTS Medical Clinic" and yes, that is intended to be after The Book Of Acts.

I can certainly understand your reaction, though.

WASHED OUT
WASHED OUT 2016-02-12 09:31:01 -0600 Report

I agree OrchidNox I went through a similar bad experience years ago back in 1997. I had an on the work accident in which I got my lower back injured. I had a disk in my back bulged, this doctor told me what was wrong with my back and because I had degenerative disk as well wasn't interested in helping me because it was a workers comp. case. I filed a Complaint to the State Medical Board on this doctor and had a copy placed in my medical records. I ended up going to a spine specialist in another state which was willing to help fix the problem and he gave me a disability rating as the damage was permanent. The company then sent me to a doctor of their choice which also gave me a disability rating. They didn't like what he said so they sent me to another doctor, by this time I had employed a lawyer to represent me. The second doctor they sent me to just did an evaluation without even really doing the evaluation. His report stated that he ran all these physical test that he most certainly didn't do, as well as that he reviewed my xrays and MRI on my low back which was impossible. Well,as it turned out I had checked out those films to take to the first doctor they sent me to, and didn't even take them with me to that second doctor. My lawyer loved that, he proved the second doctors report was false and that he didn't really examine me. The company had to use the report of the first doctor that the company sent me to that game me a permanent partial disability rating. Doctors can be bought by Companies and Corporations to say whatever they are being paid to say. That is a black mark on behalf of the treatment of real people with real injuries or problems. I guess there are good doctors and there are also Bad Doctors who don't have the patient's best interest at heart. The world isn't fair and it most certainly isn't a Just world. Although they get paid highly for their work, good or Bad.

Dr Gary
Dr GaryCA 2016-02-13 19:35:29 -0600 Report

Washed Out, I hear similar stories about doctors hired to evaluate for disability claims. They may be gatekeepers being paid by interests that want to keep the gate closed.

OrchidNox
OrchidNox 2016-02-12 10:07:26 -0600 Report

Man, that sounds like one big pile of $@%! I'm glad that you got some satisfaction from it, but wow!

WASHED OUT
WASHED OUT 2016-02-12 10:42:55 -0600 Report

That was against General Electric , They have the money and influence to buy whatever doctors and opinions they desire. Sometimes, you can catch them in the act of it. I was lucky enough to have a good lawyer and set that second doctor up to get caught in his lies. Otherwise the outcome would have been what the company paid to have. I also was put on weight and lifting restrictions which the company said they had no job fitting my restrictions. I was fired or dismissed from the company after being off work for one year. I filed a case with the American Disability, EEOC and also won that case.

cmr55
cmr55 2016-02-12 01:59:48 -0600 Report

Five years ago I was a newly diabetic on insulin. I was constantly having stomach pains. I would see my doctor and tell him what was going on. He ignored me. I thought maybe I was having gastroparesis. But all's he wanted was for me to have gastric bypass surgery. He never checked my stomach. he really did not listen to what was going on with me. I suffered for months. I changed to my husbands doctor. She checked my stomach and I had a hernia. Amazing I felt great after having surgery. I try to take control of my health etc. Research etc. I know doctors are busy and have a lot of patients. But they have at times do better listening to their patients. No one is perfect and doctors make mistakes. They need to let us know when they over looked something. If I feel a doctor is not doing what I feel needs to be done I will change doctors. I did it three times in the last 5 years. Glad I did because those doctors would still have me on insulin and diabetes meds. I am now off all.

Dr Gary
Dr GaryCA 2016-02-12 22:58:01 -0600 Report

Hi cmr55, good to see you again. Taht is quite a story! A good example of a doctor who doesn't want to have to think and, instead, makes the patient feel like they are imagining things. Glad you got to a doctor who was willing to listen! I think you bring up a good point here. If doctors really listened to their patients, we might very well see fewer errors being made. Glad to hear you are doing so well.

Caroltoo
Caroltoo 2016-02-11 23:20:19 -0600 Report

Generally, I think I am very patient and try to talk things through. Sometimes, I find it is lack of knowledge on my part, so I listen and learn. Other times, it is them not fully understanding the shortened version of the problem which is the result of their protocol of questions.

When I slow the process down and clarify, we usually agree. I had some really good care earlier this week from a new practitioner who started to stop me from giving background information (a time issue). My response was: I know this doesn't sound important, but I think its very germane, so please let me give you this information. She looked a little surprised, but did listen. It was an effective intervention and I'm feeling much better because I got the targeted care I needed.

I think the only time a doc and I have had a real problem was over what I consider the beginning of my diabetes process. I had many infected nails/toes (not the same ones) about every 6 months over a over about a 2 year period. It was when the medical profession was rightly moving toward using fewer antibiotics. Every time I went in with blood and pus dripping off my toes, the Doc would say with evident concern: you don't have a fever, so the protocol won't allow me to give you antibiotics. Try this instead. "This" never worked and I started going to ER. They would say why not to to my GP. I would explain and come away with the needed RX but at a much HIGHER cost.

I look back on this now and wonder: if those infections had been dealt with in a better and more timely manner, would I even be Diabetic? I don't know, but I wonder.

When I was eventually diagnosed, with blood and pus still dripping off my toes, but also with a BG of 400, he told me I needed to start 4 insulin injections a day. I declined, saying I wanted to try diet and exercise. He told me there was "no way" I could do enough. I pacified him by agreeing to a Diabetic Educator's visit and then put it off for 2 months while I worked my program successfully. When I returned with the D.Ed's support and a BG of 120, he was conciliatory. I am sorry to say this, but I really think this was the result of his ignorance about Diabetes. The skin infections are a "tell" for Diabetes. I don't know how he could have missed it unless he just didn't know.

Soon after, he left the practice and I now have a wonderfully supportive doctor. We always talk things through. Sometimes she gets annoyed, sometimes I do, but we can communicate and do resolve our issues.

robertoj
robertoj 2016-02-11 22:43:58 -0600 Report

I can discuss things with my doctor. I took about 40 years to find one. I'm not about to drop him for making a mistake. I would tell him and work to get back on track.

Dr Gary
Dr GaryCA 2016-02-12 22:54:58 -0600 Report

Hi Roberto, that is a good attitude. Errors can happen. It takes time to build a relationship and so the alternative of finding a new doctor needs to be factored into how you decide to respond to an error.

Kalisiin
Kalisiin 2016-02-11 19:40:07 -0600 Report

As you may know, Dr. Gary, I am a business owner. Specifically, my business is in medical billing/coding and EHR management. So I am very much within the medical industry, if in a support role.

Nevertheless, I would treat a mistake by a doctor in the same way I would treat a mistake someone made in my business.

As a business owner…I know that mistakes DO HAPPEN. Usually, they are not made with any intent of malice. So, for me, it depends on what the person who made the mistake does to correct the situation. It depends on the level of concern they display for the inconvenience/harm that their mistake caused.

If they are truly apologetic, sympathetic, and do what they can to rectify the mistake…and the harm caused by said mistake…then I actually judge them highly. It is all too easy and tempting…to point the finger of blame elsewhere, sweep it under the rug, and hope the harmed person will give up, go away, and end of story.

Those who own up to their mistakes, learn something from them…and do what they can to mitigate the harm their mistake caused…earn far more esteem from me…than those who try to blame the mistake on someone/something else.

Assuming, of course, as you stated, the mistake does not place my life in jeopardy, or cause serious health problems.

And this is how I would hope people deal with me…and judge me…when I make a mistake…as I have, and will do again - because nobody is perfect. When I make a mistake, I own up to it, I apologize for it, and I rectify the mistake.

Dr Gary
Dr GaryCA 2016-02-12 22:52:40 -0600 Report

Hi Kalisiin, nice to see you. I do remember that you run a business. You certainly play a very important role! I agree that mistakes do happen. Doctors need to be on point at all times but sometimes they are not. We just hope the mistakes are small and result in inconvenience and not something more serious. By the way, the doctor I origninally saw had left a message on my phone every morning while I was in the hospital. I listened to them when I returned. She expressed concern about how I was doing and asked me to call her and give her an update. i thought this was really out of the ordinary for a drop in clinic. When I told her what had happened, she apologized for not sending me to the ER right away. I respected her for owning up to a misjudgment.

Kalisiin
Kalisiin 2016-02-13 16:51:40 -0600 Report

Exactly. You and I are of a mind, I also respect people who own up to a mistake/misjudgement. As long as they also do everything they can to make it right.

trsquare
trsquare 2016-02-11 18:03:17 -0600 Report

Oh gosh, what a horrible experience! I realize that my doctors are trying to look out for me when I'm there, but I also need to do my part and if something seems to be out of normal for my body, to get bugging someone until it's taken care of. I have a HMO, so I tend to try and take care of things myself, and write everything down so that I have a short list when I see my doctor.

Dr Gary
Dr GaryCA 2016-02-12 22:48:21 -0600 Report

Hi trsquare! Nice to see you! It has been awhile. That's a very good point about taking personal responsibility. It is important for us patients to raise an alarm if something doesn't feel right. We need to follow our instincts and ask questions.

WASHED OUT
WASHED OUT 2016-02-11 17:55:06 -0600 Report

Bad mistakes is why they pay for Malpractice insurance , People can't afford for them to be wrong on many things because it can cost Life and Limb. On taking an Oath becoming a Doctor, part of those words were, "First Cause No Harm." Anything outside of Those four small words carry a huge consequence.

Dr Gary
Dr GaryCA 2016-02-12 22:46:47 -0600 Report

Hey Washed Out, good point, we are trusting doctors with our lives. Hopefully they're keeping that in mind when they're making decisions about our health.

Kalisiin
Kalisiin 2016-02-11 19:43:47 -0600 Report

"First cause no harm" also requires a conservative approach.

Thus, aggressive treatment is not often the first approach taken.

And, sometimes, the doctor may not notice something if you do not point it out…so it is incumbent upon you to point it out. Also, if you feel the doctor has overlooked something…or not taken it seriously enough…then engage your doctor to ask him/her why they are taking the approach they are…instead of another approach. Or why they feel something is not a concern…when it IS a concern to you.

Type1Lou
Type1Lou 2016-02-11 17:49:09 -0600 Report

I just visited my endo's office this morning in an ongoing attempt to get the proper ICD coding to a provider for resubmission to Medicare after Medicare denied a claim for a Vitamin D blood test. I have been back and forth with the provider (Quest) and my doctor about this since September when I had the blood drawn. I think we've finally gotten it right. Although I've attempted to stay "cool" and reasonable, the frustration about this has brought me close to tears. I've tried to explain what I need in a reasonable and non-confrontational manner since it doesn't make sense to alienate my endo's office staff. Part of the difficulty and frustration was with different responses from Quest about how to go about resolving this…I think they are so big that one department doesn't always communicate well with the others. (It turns out that Quest had already re-submitted this to Medicare some days ago, after my endo's office had called in the code but, when I called Quest yesterday, I was advised to have the endo's office do it all over again…hence my visit to the endo this morning…is it any wonder I feel like a ping-pong ball?) What I've begun to do is write in letter form the problem I am seeking to solve and include any information that may help with the resolution. It provides a record of the problem and may help with accountability issues. That helps keep me focused and rational. I may wind up writing a letter of complaint to Quest's corporate office in New Jersey recounting what I've been through, in part due to misinformation by Quest employees and the inability of Quest to make any changes prior to receiving a medicare denial and issuing their billing.

Dr Gary
Dr GaryCA 2016-02-12 22:41:32 -0600 Report

Hey Type1Lou, nice to see you. I have been through similar adventures trying to get needed information from a doctor's office, and playing go-between. Ping pong ball is right. It is even worse when you are trying to get a reimbursement you are owed. And I agree, some of these companies are so big that emloyees can't keep track of each other. Great idea to write those letters. They help make it clear what you are looking for and they may come in handy later. And people take letters seriously.

Kalisiin
Kalisiin 2016-02-11 19:45:31 -0600 Report

E55.9 - Low Vitamin D
That is your ICD-10 Coding.
If you need the old ICD-9 nomenclature, the correct code is 268.9

I remember answering this for you in a private message over a month ago…are you telling me they STILL have not gotten this right for you?

They may be correct in being unable to help you until getting the Medicare denial - but that should have happened a long time ago. And there is no excuse for billing you…when they know there is an ongoing situation.

When I have such a claim (and it most definitely has happened to me) I place such a claim into an "ON HOLD" status, preventing the system from spitting out a bill, and making it easy to find for later follow-up. I then make extensive notes within the claim, detailing the nature of the problem, and the steps I have taken to correct it - as well as the planned future steps.

I document these things very well. there are times it DOES take a while to get things set right, so patience is important. but there was no excuse for them to bill you! they should have been more on top of the situation.

Type1Lou
Type1Lou 2016-02-12 09:22:34 -0600 Report

Unfortunately, the answer is Yes…it is still being processed…but I think this time, it will work. Because the test was before Oct 1, the old ICD code of 268.9 applied…(you had also given me that code). Part of the confusion on my part comes from a lack of communication..both from the doctor's office and from Quest. Part of the difficulty was that Quest refused to make any changes to the bloodwork order until after Medicare had denied the claim and I had received a bill. The customer service people at Quest I had spoken with evidently don't communicate with the Quest billing people because the Quest billing rep I spoke with on Wednesday, Feb 10 never mentionned that this had been resubmitted with the proper coding. The test was done on Sept 1 and the bill arrived in late January…very cumbersome and frustrating process. But, I'm not one to let go. Thanks for your help on this.

Kalisiin
Kalisiin 2016-02-13 16:55:56 -0600 Report

No problem…happy to help where I can.

This was one area I was uniquely positioned to help you since I do coding and billing for a living.

sugarfreebarb
sugarfreebarb 2016-02-11 17:36:17 -0600 Report

Part of me wants to say Doctors are only human, they are going to make mistakes, but the other part of me overrides that half. They chose to go to medical school, they chose the profession they are in. People trust them with their health, and in some cases their very life. Mistakes are unacceptable. A doctor can be wrong about something, but a mistake, one that should of been caught is unacceptable. They get called out and read the riot act. If it happens again they get cut, fired, they are out of here. If I cant trust my doctor with the small things how can I trust him with the big things.

Dr Gary
Dr GaryCA 2016-02-12 22:26:15 -0600 Report

Hey sugarfreebarb, I sure can't argue with the point you make here. A mistake can have a pretty big impact. And we certainly rely on them. We even trust them with our lives.

Kalisiin
Kalisiin 2016-02-11 19:53:04 -0600 Report

I understand where you are coming from, barb…but what causes you to judge that a mistake should, or should not…have been caught?

I merely ask for conversation purposes, not to be confrontational.

You and I did not go to medical school…so we may not be the best judge of what should and should not have been caught - that is what I am saying. One needs to really look at the entire situation, including what, if any harm/inconvenience was caused…as well as what steps were taken to mitigate the harm/inconvenience afterwards.

sugarfreebarb
sugarfreebarb 2016-02-12 07:39:52 -0600 Report

I was once given the wrong test results. Changed my diet only to come back and inquire to see if my numbers improved. The same doctor said he didnt know what I was talking about. Went over my test results from my last visit and said nothing was wrong. I wanted to beat him. I fired him instead. They were right there in front of him, he read them wrong. If something is right there, and they give you the wrong information. if they miss something that any other doctor would of seen, like when my mother was told her cholesterol level was fine, only to have her old doctor retire and the first thing her new doctor brought up upon reviewing her charts was a note that said"fine for her age", no joke, and told my mom her cholesterol was too high and to cut back on the fried foods. my mom didnt eat much fried foods, but when she cut them out her cholesterol normalized,soooo, yeah, we all like to assume we have good doctors, but not every doctor is a good doctor, just like every mechanic is not a good mechanic. My mother has gotten into the habit of asking for copies of her labs and asking people to double check everything, because many careless mistakes are made.

Dr Gary
Dr GaryCA 2016-02-12 22:36:09 -0600 Report

Wow, those are both amazing examples of doctors not doing their jobs effectively. i agree that not every doctor is a good one, I have met some that were questionable over the years, if not outright incompetent. Another reason why patients have to be educated and empowered. Your mom has the right idea here.

Kalisiin
Kalisiin 2016-02-13 16:58:46 -0600 Report

I totally agree with Gary here…in this case, barb, I think you are right, it should have been caught…he had lab numbers right in his face.

But not every medical problem is as cut-and-dried as your example was.

This is why it is important for people to be their own advocate with regards their healthcare.

Too many people trust their lives and health to people with a couple letters after their name - without asking any questions.

Next Discussion: Arm pain »