Please Help me get though my Chemo with my MD...

bar62

I feel a distinct difference in my treatment though I have chosen a really fine ONC. I lost my secondary...part of divorce  agreement no longer being paid by EX.. I chose a Medicare Advantage PPO plan with care...I paid my co-pay today, with comments by my MD that he is giving me a break. That I can take. But he does  go off sometimes about how Medicare is going to be broke soon, how some docs in NYC don't take ANY Insurance...I know that...and how the payments are so awful to all the docs. I know that too.

MY problem; do I sit quietly, take my chemo treatment--I had my first  chemo today-- and get out fast. I do like him believe it or not, I am a RN and recognize his desire to make a decent living, or  should I tell him how upset I get  with all his comments about Medicare Payments  since I am in this awful Cancer crap  and hope he'll understand how I feel.

Any thoughts  and suggestions will be appreciated.

OneBadBoob

bar62--

I think the reimbursements to physicians these days, both by medicare and regular insurance, are indeed ridiculously low, and he is correct, MANY doctors in NYC no longer take any insurance, you have to pay up front and they will file with your insurance company for reimbursement to you directly of whatever portion insurance covers.

I may be wrong, but because you, as an RN, are "in the business" so to speak, I think your onc possibly feels more free to speak to you about these things than he would to another patient who was not involved in the medical world. 

I think possibly a nice, quiet conversation with him, agreeing that the while the whole medical reimbursement system in this country is broken and has to change, but that at this point in your treatment you would prefer to not to discuss or focus on it, but instead to focus on your treatment plan and getting through your chemo with the least amount of stress possible, and that at this point, dicussing the problems of our health care system is indeed stressful to you, since you need it at this point, and are indeed stuck right in the middle of it.

I cannot imagine that he would not understand this or be in the least bit offended by your request.

dash

Either he accepts the insurance or he doesn't. That's unprofessional to accept it but whine about it! 

The nurses saw me more frequently than my onc once chemo started. I would see him once every few weeks until towards the end of treatments, when my numbers were screwy when I saw him practically once a week. He was always rushed and dealing with my SEs/blood test results and so we never had a moment for more personal talk.

 I don't think you should sit through a lecture about medicare but I bet that's the last you'll hear about it. He should now start to concentrate on YOUR needs when he sees you. I would imagine he wouldn't even remember who has what insurance the next time you see him. If he does say anything else, I certainly would just say, I'd rather not talk about that as it's upsetting to me/adds to my stress.

Best wishes

bar62

Hi onebadbadboob,

 . I know  you're right. Morning clears the head sometimes. My doctor is semi-retired, administers chemo personally in his office to  a few patients and  is a full professor and researcher.

 I met one patient when I went to him for my introductory meeting, who told me her family member had been given a "death sentence" when my doctor took him on 10 years ago.  I realize after reading your post that he is comfortable talking to  me about medical/research matters, and that he is a genuinely kind, caring compassionate person who didn't turn me down;  I am extremely grateful he has taken me on.

 I believe my first chemo treatment yesterday made me nuts in the brain. I was SO totally  afraid of  bad side effects. I had an awful time  a few years ago when  I took Methotrexate for my Rheumatoid Arthritis even though it put me in remission. So far so good. YEAH!!! 

He gave me a succession of  IV drugs, including the two bad guys,  for a total of  four 250cc bags.Yes, my urine was red yesterday. He also gave me an oral medication and an IV push of Decadron, all through my peripheral vein on my  "goodboob" arm NO problems. I am dancing as I type.

xoxo to you and thanks for all your help

bar62

Hi Bayyy,

Thank you so much. If he continues his lament  about poor Medicare reimbursements, I will  gently let him know how much it upsets me while I am getting treatment; I know he will listen.

 I am much better this morning. I have Diabetes and sometimes I'm not my clear thinking self at the end of a long day. He is a wonderful doctor and I know he will do all that he can for me. Yesterday was my first Chemo day. I was terrified because of the horrendous side effects I had when I  took Methotrexate for my Rheumatoid Arthritis, even though it put me in remission. So far so good. Thank goodness my sister-in-law went with me.

 Again, I appreciate  you talking with me this morning.

spar2

It is very unprofessional for him to discuss this with you.  Maybe the nurses he works with but not a patient and I would tell him it make you uncomfortable.

bar62

Believe it or not this doctor got worse...arrgh. He told me he would refer me to the the hospital  clinic if I got  too expensive to care for pharmacologically and medically. He is not happy with Medicare though I did tell him after I finished my first session of Chemo how upset it made me to hear him complain about their payment schedule.

I called Medicare and after talking with a wonderful  person, who suggested I report him to the state medical association, I've decided to  call my insurance plan and locate another Oncologist. I will report him later, maybe.

Medicare says any and all doctors who use the system should bill them.   I am not sure why he is acting this way but I have to receive my treatment in a stress free environment.  Thanks for all your support. This is my first experience with a doctor acting this way with me and I can only move on from him and get well. I appreciate that I had the chance to talk about my concerns here, to family, friends and a very informative Medicare representative these past few days since my first treatment. Thank you again

dash

Bar62--I can't believe it! I do hope you find another doctor and please report him. He deserves it! Best wishes,

Holly

Shirlann

Honey, obviously, he feels like you are a member of the same group as he is.  He was just venting, poor choice in timing, I must say.

Definitely, find someplace where there is quiet and peace.

No need to add his personal frustrations to your already fragile state.  He is an idiot.

Gentle hugs, Shirlann

bar62

Shirlann,

 I just got back here...Thanks for your hugs. I'm  looking now and have another appt October 7 2008. fingers xed. My PMD sat with me this week and was very supportive and helpful.

bar62

Hi Bayyy,

 I just got back ...I am scheduled for an appointment October 7 with another Oncologist..fingers xed...Thank  you for  all your good wishes.

Staying sane one minute at a time. My breast surgeon is the most wonderful woman in the world. She's petitioning Medicare to place  my port even though I've signed on with  a Medicare Advantage PPO plan since my surgery. I will try to transition out of this plan  and buy a secondary Insurance in January. I miss having my secondary and it's best  to purchase one if I can...

xoxo