Cardiologist in Central Florida

[Bugsy]

Does anyone know a cardiologist in Central Florida that allows home testing? I switched a couple of years ago because the office that set me up with home testing startedcharging me $25 each time I called in my results (I might understand it if they provided the machine and/or the test strips). I called around and most offices wouldn't allow home testing. I finally found one that does but they have such terrible customer service they don't return my calls when I try to schedule and echo, I need my coumadin prescription refilled and they haven't done that or returned my phone calls regarding a refill. I test every month, call in my results and am rarely out of range. I guess there is no such thing as an independent cardiologist anymore, they're all part of a group and I'm sure it's more about profit than the patient's well being. I'm not sure what I will do if they don't refill my coumadin in the next few days. BTW, my GP will not have anything to do with my coumadin.

 

[Bugsy]

I've been making a few phone calls and it sounds like there are a few now that will allow patients to home test but they all go through another service like Philips which I guess used to be QAS. I just have to wonder why they use these services, I know the monitoring service is probably making a killing on insurance but what advantage does the doctors office have from using them?

 

[tom in MO]

Home testing is not familiar with all health care providers. You may be able to get some names from your local hospital that does OHS.

I believe that they use the services to protect themselves from human mistakes and the litigation, but also, from their point of view, to provide better care. The call-in services have a phone number or website that is active all the time, whereas the doctor's office does not. The staff of the services know the subject possibly better than your GP or individual cardiologist does.

 

[AgilityDog]

No, Philips does not do any adjustments at all of your Rx. They take your phone call with your INR, then they fax it to your MD, who is responsible for making the adjustments. Philips just sends you new testing supplies. Philps requires you to test weekly. For this they bill in excess of $250 per month to your insurance carrier. Woe be to those on high deductible plans as they will then may you pay the full $258/month until your deductible is used each year. Whic means you are paying $2500 for your testing supplies and a fax, each year. The strips cost about $5 per if you buy them in bulk. The machine can be purchased retail for about $1500, or $800 if you can get it via a friendly doctor or a medical supply house that sells them direct to the patient.

Get a friendly doctor with a good coumadin manager/nurse. I second calling the local heart hospitals. Good cardios are worth the work to find. Not all will let you self-manage, but there are many who will let you self-test, and call in your results.

 

[Protimenow]

Personally, I can't understand why a person with a meter should NOT test weekly. (In the past, I've gone longer between tests, but only because I was out of strips, and couldn't afford new ones).

In the past, when you had to drive to a lab, park, go into the lab and wait for a phlebotomist who may or may not have done a very good job of drawing the blood without leaving a big bruise, it may have made sense to stretch the time between tests - but there's no way to know what happens between monthly tests (if your tests are roughly the same once each month, this doesn't necessarily mean that your INR is stable -- it just means that the INRs were close on the date that you had your blood tested). My personal preference is for weekly testing -- if only to prove to myself that my INR is stable and not fluctuating week to week.

I keep a spreadsheet that records all my test results - my dose, time of day, meter or lab used, and any other factors that may be of interest. My spreadsheet goes back to 2009, when I was finally able to start testing. If you do the same, you'll have a document that you can show to a doctor when you request a warfarin refill. If the doctor is comfortable that you're able to self-test (and the doctor may be comfortable adjusting your dosage or, perhaps, may trust you to manage your dosage), you should be able to get refill prescriptions. (I'm not suggesting it - but at one time, I was buying my warfarin from a supplier in India - I tested after I started taking it to confirm that it had the same effect as the domestic stuff (it did), but with the $10 for 90 day generics, there is little reason NOT to get it from a local pharmacy as long as you find a doctor who will prescribe it for you).

Good luck finding a doctor who is comfortable with writing a prescription. And also, please consider testing more often than once a month.

 

[Bugsy]

Thanks for the condescending tone Protimenow. That really helped me out. I'm happy you can afford test strips to test every week.

 

[Protimenow]

I didn't mean for this to sound condescending. And I didn't need your negative response either. I"m just pointing out that I believe you should test weekly. (Hey, dood, I went for 10 days and had a stroke -- even though my INR LOOKED okay the last time I tested - I don't want this to happen to anyone else)

I hope you find a doctor who is okay with your self-testing, and that will help you get that warfarin refilled.

 

[lance]

Hi Laurie,
Except for making an inordinate amount of money it doesn't make sense to double the amount of work required for one little finger stick.
I'm accustomed to things costing more here so I'm surprised at the prices quoted (not questioning the accuracy of quoted prices).
Philips have themselves a nice little money-making niche.

No, Philips does not do any adjustments at all of your Rx. They take your phone call with your INR, then they fax it to your MD, who is responsible for making the adjustments. Philips just sends you new testing supplies. Philps requires you to test weekly. For this they bill in excess of $250 per month to your insurance carrier. Woe be to those on high deductible plans as they will then may you pay the full $258/month until your deductible is used each year. Whic means you are paying $2500 for your testing supplies and a fax, each year. The strips cost about $5 per if you buy them in bulk. The machine can be purchased retail for about $1500, or $800 if you can get it via a friendly doctor or a medical supply house that sells them direct to the patient.

Get a friendly doctor with a good coumadin manager/nurse. I second calling the local heart hospitals. Good cardios are worth the work to find. Not all will let you self-manage, but there are many who will let you self-test, and call in your results.