10 years out. I no longer trust my MO. What would you do?

Texas357
Texas357 Member Posts: 1,552

OK, so my first medical oncologist retired shortly after I finished chemo and rads. I was ready to kick him to the curb anyway because he didn't believe any diet or exercise recommendations were worthwhile to keep me healthy. And he kept getting my medical history mixed up with other patients.

I've been seeing the second MO for quite a while. But she doesn't follow current monitoring protocol. For example, she insists on my having a chest x-ray every year even though multiple oncology groups say they are useless. Even more to the point: ILC rarely recurs in the lungs! But she'll fire me as a patient if I refuse to get the x-rays. I hate the idea of extra radiation for no purpose.

So, yesterday I went to MD Anderson Cancer Center. One of the best in the country. Loved their approach and their informative attitudes. The problem? The doctors are in my insurance network but not the facility. I could conceivably run up $30,000/year in medical bills if I had a recurrence.

The only other option, since I don't want to stay with my current MO, is to use some guy whose website is plastered with pictures of him smiling at the side of local politicians. Very little about his care for patients!!!

What would you do?

Comments

  • muska
    muska Member Posts: 1,195
    edited April 2019

    Do you have a PCP and do you trust him/her? I would ask the PCP for a reference to a MO knowledgeable in BC. If you don't have or don't trust your PCP I would do more online research and pick accordingly.

    I am not familiar with how the Texas system works but on the East Coast many docs affiliated with big cancer centers also practice in other locations and might be affiliated with more than one hospitals. I wonder whether MD Anderson oncologists might be available in outside clinics to follow patients like you that are not in active treatment or maybe some are affiliated with other hospitals that are in your network.

    Good luck.

  • kber
    kber Member Posts: 394
    edited April 2019

    I'd move to MD Andersen.  I'm with them as well and I like them.  In the worst case scenario where you had a reoccurrence, maybe they could help with a referral or otherwise work with you.  Plus, check your out of pocket annual maximum.  It may be less than 30K, capping your out of pocket expenses lower.  For my insurance, it's 6K in network and 12K outside, but I have a high deductible plan coupled with a Health Savings Account.  

    There is one medical professional who I like who is outside my network, and she is willing to work with me on her billing.  (I find mental health professionals sometimes don't go "in-network" as often, for whatever reason.)

  • Texas357
    Texas357 Member Posts: 1,552
    edited April 2019

    Muska: I don't have a PCP but my insurance company has an online search by both doctor and facility. That's how I know that my options are so limited.

    Kber: I've got a message into MD Anderson to find out the approximate cost of staying with them. I'm certain about the $30,000 out-of-pocket expense for outside network. For in-network, it is $10,000. Big difference!



  • kber
    kber Member Posts: 394
    edited April 2019

    Muska - very good point.  Both my MO and my BS are associated with their local MD Andersen center and have admitting privledges at two local hospitals.  One is "in network" for me and one is not, but if my in network doc  admits me, it's covered as in network.

    My insurance also offers a patient advocate service.  I've used them extensively to push through approvals for tests, etc.  Texas - find out if your insurance company offers such a thing and see if they can step you through different cost scenarios.  They can also assist with finding a doctor as well.   Based on my recent experiences, I'd advise anyone diagnosed with anything more complicated than strep throat to make their advocate their first call.  My advocate has been a huge champion in getting treatment approved and navigating billing.  I literally credit her with being on the team that can take credit for saving my life - up their with my MO and BS.  

  • Texas357
    Texas357 Member Posts: 1,552
    edited April 2019

    One thing I've considered is moving to an internal medicine specialist, although that's not an ideal option.

  • Texas357
    Texas357 Member Posts: 1,552
    edited April 2019

    Good suggestion! I'll call my insurance company and check out my MD Anderson MO's admitting privileges. Thank you!!!

  • gb2115
    gb2115 Member Posts: 1,894
    edited April 2019

    That's bizarre that they told you they would fire you from the practice if you refuse a chest x-ray. Patients refuse things literally all of the time, and in healthcare we just document the heck out of it and move on. I've only seen patients fired when they become abusive in some way to the provider or staff. Maybe prolonged failure to pay as well. That's just crazy.


  • karen1956
    karen1956 Member Posts: 6,503
    edited April 2019

    Texas, you have to have confidence in your doctor. Listen to your heart and switch. It is your right to turn down any tests that you do not want. I understand the $ issue - but you have to have trust and confidence in your doctor.

    I'm lucky as my oncologist only treats breast cancer. At least for me, his protocol is to draw labs right before my appt with him, he asks questions each visit and does an exam. He only does scans if the patient is symptomatic or if the patient asks.

  • Texas357
    Texas357 Member Posts: 1,552
    edited April 2019

    Karen1956, that's the type of physician I'd love to find!


  • Anonymous
    Anonymous Member Posts: 1,376
    edited April 2019

    Texas, I have lost my MO who just retired. I put out a request in several different threads on the discussion boards asking for recommendations for a good Phoenix oncologist. I also called Mayo to book an appt as a new patient, but they aren't taking patients who just need follow up care. I did ask them to recommend oncologists who were, and who had good reputations, and they referred me to two local cancer centers. I made an appt to interview an oncologist at one of them next month. Others who live in my area have PMd me with some recommendations, too. You might simply cast your net a bit wider on these boards, and perhaps get some recommendations from members.

    Claire in AZ

  • Texas357
    Texas357 Member Posts: 1,552
    edited April 2019

    Thanks for the tip, Claire. I have tried posting on a few more threads but got no good leads. I'll keep after it. But you bring up a good point. My husband is in ill health and sees several different local physicians. I'll also ask him to ask for referrals.

  • gb2115
    gb2115 Member Posts: 1,894
    edited April 2019

    I've always felt that asking doctors you trust for referrals is a good strategy. In a geographic area they seem to know each other or know of each other, and they know who is good and who isn't.

  • Texas357
    Texas357 Member Posts: 1,552
    edited April 2019

    All great ideas! I knew that posting here would be helpful! Thank you!

  • Mavericksmom
    Mavericksmom Member Posts: 635
    edited April 2019

    My sister went to M D Anderson in Houston and received the best care! I agree with others here, go to the M D Anderson doctors and worry about a recurrence if and when it happens.

    I just had surgery for a recurrence but I had been cancer free for 15 1/2 years so everything changed including my insurance! (Which actually changed 3 times and it was employer coverage with same employer!)

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