Wednesday, February 8, 2012

Pros/Cons Docs

Just had an interesting conversation with my shrink.  The whole thing got started because I went on a rant about my doc instigating the possible revocation of my driver's license.  After I got the rant over with and we got through the discussion of what to do next, we moved on to whether I should keep my doctor or not.  Of course my husband wants me to dump him.  Hubs reasoning is simple: 1) hubs has no tolerance for indecision and the "wait and see" mentality and 2) the concierge service is expensive.

First let me explain concierge medicine since this is integral to the rest of the post.  I pay an annual fee of $1500 so that I get access to my doctor 24/7.  I get half hour appointments often same day.  I always see him and not a nurse.  I can call him directly after hours without having to go through an answering service.  I have his email.  Blue Cross pays for the medical services, appointments and tests.  What I pay for is access and continuance of care.  And yes, it is elitist and classist and I had to really think hard about it before I signed up years ago.

So here is my pros and cons list with regard to my doctor.  This exercise is to help me decide whether I should stay with him or not.

Pros:

  • He believes in CFS/ME.  He knows it is real.  He doesn't doubt me or any of my symptoms.  This is HUGE!!!  
  • He treats me well and listens to what I have to say (most times).
  • He tolerates my use of alternative medicines.
  • I always see him even for little problems, which leads to a continuance of care that I haven't had with other practitioners where I get foisted off on the nurse practitioner.
  • I have half hour appointments.  Longer if need be.
  • I can talk with him on the telephone or via email for off hour care or problems.
  • He is good about giving me referrals I ask for.
  • He is good about adjusting meds for my weird reactions.
  • I've been with him for years so he knows me prior to CFS.  He knows I'm not faking or seeking attention or a slacker.
  • He is good about giving me med samples if he has them so I don't have to pay for new meds that may not work for me.
  • He is good about filling out forms for work, insurance, legal and anything else.
  • He is good about dealing with my lawyer and writing affidavits.
  • I can get same day or next day appointments.
  • I don't have to wait. He runs on time.
  • He is a pretty good physician.
  • He is genuinely concerned about my physical and mental health.
  • He is part of the Winchester Hospital network which is one of the most highly rated hospitals in my area.  My hospital care has been top notch.
  • I have access to Tufts Medical in Boston with some of the best specialist  in the area.
Cons:
  • He has a wait and see attitude.  If I want something done I have to push.  It took my husband going in with me for me to get to see a virologist when I first became sick.  This lead to me not seeing the specialist in Boston until I was sick for six months.  This is a BAD problem for me since I tend to not push for things but I know how to deal with this problem and it isn't insurmountable.  I just have to grow a pair.
  • He sometimes skips tests that later would have helped diagnose/document problems.
  • He always says my gait is fine even if I am using a walker to get around with and can't walk unsupported.  Not sure why this keeps happening.  
  • He forgets to set up referrals, particularly if he doesn't think they are important but they are ones I've requested.  I have to call to remind them.
  • He doesn't like prescribing pain meds.  I will have to find a pain clinic if things take a turn for the worse.
  • He didn't discuss the potential revocation of my driver's license with me first.  I wouldn't be so angry if he had explained his reasoning first, instead of my finding out from the copy of the placard application.
  • It costs $1500 to see him.
So I guess I'm staying with him.  At least for now.  The cons aren't that bad and I have work arounds for most of them.  I get to much good stuff by staying with him even if I do have to pay extra.  Hubs is just going to have to accept it.

1 comment:

  1. First I have never hear of a concierge program. All the benefits are amazing. But the cons are really disconcerting as well.

    However, not having this service means you would have the cons and more all the time and every time!

    Maybe you can talk to him and get move some of those cons from the cons list to the pro list?

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