Don't know what to do with my primary Doc.!!

[archkre]

My primary Doc. is the one that manages the dosage of my Coumadin.
I had my last blood draw at the lab last Friday, and today Wednesday I can't have any news about my PT-INR!!
I am leaving messages in the Doc.'s voicemail with no luck!
On the other hand I made a call to the lab to know about the value, but they say they are not authorized to give me that data!
I was already advised to change my primary doc., because this one is an irresponsible mofo....
But when I try to make an appointment with some recommended new
ones, they say the first visit could be in about 2 month!
And I am worried because the last 2 Pt's were 4.7 & 4.6!!
What can I do?
If you live in Hollywood, Florida get away from Michael Hirsch, MD!

 

[Ross]

Well you need the answer the same day or it's no good to you at all. Find someone that will get the answer to you and then learn to manage your own dosing. It's unreal how many professionals have no clue what they are doing.

 

[Marguerite53]

Hi Daniel. How frustrating. I spent a couple of months in Hollywood, Florida...probably long before you were born . I'm sure it's grown and is close to all the things large and metropolitan. Can you just look up ProTime Clinics in the Yellow Pages (or does ProTime have a link to help??) and make some calls and find out which one you can go to to get the service you need? There has to be more than one!! And I would alert your insurance, tell them you cannot work with this "shop" and they have to cover you elsewhere. Yes, I said TELL them, don't ask them!!

I haven't even had my surgery yet, so I may be off base, but I'd certainly skip past the doctor part and just find the right clinic.....they can forward the tests to your dreadful doctor until you get the right doctor. You can get your results on time and be calm and steady while you find a new doctor.

Good luck.

Marguerite

 

[Georgia]

Another thing you might consider is telling your insurer that you're not getting inr results. They'll be paying big time if you have an inr-related problem.

Can you contact your cardiologist and ask him to put in a word for you to get a new pcp? Like call an office and get you in before 2 mos. Alternately, see if your cardio will monitor your inr for the couple of months it takes to get into a new pcp.

But I agree that the ideal situation would be to get into a coumadin clinic and then change docs.

This is so unacceptable - this guy would have trouble with malpractice insurance if his insurers knew what he was up to.

 

[Karlynn]

I would recommend home testing - but with the ineptness of your PCP, I doubt he'd sign off on it.

I would get a hold of him personally and tell him he needs to give written approval for the lab to release your numbers to you on the day you are tested. If he says he can't - tell him you'll be contacting a lawyer so that he can facilitate it because his management of Coumadin is dangerously below standard warfarin management protocol. Tell him that it is not him that will have the stroke or the bleed.

 

[archkre]

My cardiologist does't want to do my PT-INR, despite she has the machine on her desk, because my insurance doesn't pay that to her!

 

[Georgia]

No cardio wants to do inr's - it's a pita for them and a high percentage of their patients are on coumadin. It's possible that if your cardio thought you were at risk due to your pcp's incompetence, she might help you over the bump to get into a new pcp.

 

[archkre]

I would recommend home testing - but with the ineptness of your PCP, I doubt he'd sign off on it.

I would get a hold of him personally and tell him he needs to give written approval for the lab to release your numbers to you on the day you are tested. If he says he can't - tell him you'll be contacting a lawyer so that he can facilitate it because his management of Coumadin is dangerously below standard warfarin management protocol. Tell him that it is not him that will have the stroke or the bleed.

Please, Karlynn I don't need to be more terrified!

 

[Georgia]

You know, this is a life-threatening problem. You absolutely need to have your inr test reviewed on the same day as it's done. You're not going to bleed to death with values of mid-4's - maybe a little nosebleed or gum bleed. But if it goes below 2.0 action needs to be taken immediately - not days later. Karlynn isn't exaggerating at all in her advice. This situation simply can't go on!

 

[Karlynn]

Sorry to terrify you, but your PCP needs to be terrified.

Ask your cardio to write a scrip for a home testing unit. Contact QAS - they do all the leg work.

 

[catwoman]

I would recommend home testing - but with the ineptness of your PCP, I doubt he'd sign off on it.

I would get a hold of him personally and tell him he needs to give written approval for the lab to release your numbers to you on the day you are tested. If he says he can't - tell him you'll be contacting a lawyer so that he can facilitate it because his management of Coumadin is dangerously below standard warfarin management protocol. Tell him that it is not him that will have the stroke or the bleed.

Karlynn:
Right on!!!!!!!!!!!!!!!!!!!!!
I agree wholeheartedly.

 

[archkre]

Finally, a nurse from my PCP called at 12:30 PM after my lawyer wife sent them a very tough e-mail threaten them with malpractice and other delicacies....
She said I didn't need the value of my PT-INR, just the way I must take my medication!.
she also told me not to bother them anymore: of course that was already reported to my insurance!

 

[imhayley]

good Luck

good Luck

I'm saying a prayer that this all gets worked out for you Daniel. I'm sure your scared and in desperate need of answers let alone a kind ear. I wish I could just pop down there to Florida with me lil kit and test ya but I cannot, well not today anywho Keep on keeping on as sometimes you need to get a little tough in regards to your care.

 

[Karlynn]

Finally, a nurse from my PCP called at 12:30 PM after my lawyer wife sent them a very tough e-mail threaten them with malpractice and other delicacies....
She said I didn't need the value of my PT-INR, just the way I must take my medication!.
she also told me not to bother them anymore: of course that was already reported to my insurance!

Get a new doctor.

Would they treat their diabetic patients this way? "You don't need to know your blood sugar, just how much insulin we tell you to take." And would they call them days later? They obviously suscribe to the theory that Coumadin is not for the user to handle and they aren't smart enough or equipped enough to do it. This unfortunately is very "old school" thought and just shows how much they don't know about it. The fact that they waited days to reply to you also shows how little they know. For your own safety - get a new doctor or clinic to manage your INR immediately.

No wonder that studies are showing that those Coumadin users that home test and control their dosing stay in range much better than those who go to doctors or labs.

 

[Blanche]

Your doc may be in violation of the HIPAA regulations..

Your doc may be in violation of the HIPAA regulations..

Daniel:
I have found that some employees in doctors' offices take it upon themselves to play doctor. Perhaps the person you spoke of is one of these who have well overstepped their authority. But, that does not solve your problem...and you have a serious one. You really need a new doctor. But, in the meantime, you might want to send the doctor a copy of the HIPAA guidelines and demand that you receive the information you want and need. I know doctors already have HIPAA guidelines, but this action will tell the doctor that you are informed, and that you might just take action against him and the nurse. Just a thought.
http://www.hhs.gov/ocr/hipaa/

 

[Praline]

Daniel

Daniel

Could you maybe check around and see if there is a coumadin clinic in the area. Right now, my surgeon's office is managing the coumadin but after a while I will be referred back to the coumadin clinic. I have dealt with them before and ALWAYS got the results and adjustments if necessary the same day.

 

[geebee]

Yep - you have the legal right to know your test results. I would get my lawyer back to his emailing.

This doctor (and his/her staff) sounds like a real *bleeped*. If your cardio is acting the way you say, I think it is time to replace both.

In the meantime, insist on them giving you your INR so you at least have something to go on.

Please understand that this is potentially dangerous to you.

 

[archkre]

However my wife " the attorney specialized in medical malpractice" says that nothing else besides threaten that Doc., since "no harm was done"!!
That irresponsible physician will get unpunished...

 

[Georgia]

I'm wondering if the pcp knows how p*ssy his nurse is being. You certainly need to know your inr results. Further, if you didn't need to know the values, you have the right under hipaa. The doc doesn't even want to have to start tangling with the state or feds about this.

You might also expect a letter from the doc jettisoning you; this is what happened to me when I questioned a dosage change he recommended. He was wrong; but still told me to find a new doc. Bless him - I'd been planning to do just that and he provided the impetus. btw - couple of months later he was censured by the Dept of Registration for his actions with another patient. Guess I was lucky.

 

[Nancy]

Don't worry about getting even with your doc. Just get rid of the SOB (and I don't mean shortness of breath ) and get someone else who knows what they are doing. If this person is that incompetent, then he/she shouldn't be doing any medical consulting for you or anyone else, for that matter.

This is life-threatening.

Call your insurance company and ask them what you can do. Tell them in no uncertain terms how this doctor has been monitoring you or not monitoring you and that your life is in danger. Tell them to take this doctor off their list for Coumadin management. If they do not find you another person to monitor you, have your lawyer wife threaten them with malpractice.

If they are the sticky wicket, then they have to be "unstuck".

This has to be taken care of asap.

By the way, ALWAYS ASK FOR YOUR PT AND INR NUMBERS!!!