Re: Am I Wrong?
From: Lorianne (anonymous@obgyn.net)
Thu Nov 5 20:49:39 1998
HMO = Health Maintenance Organization
It is a type of health plan that has a certain group of participating health
care providers and does not have a reimbursement plan for any health care
provider no ton the plan. However, you have a set fee or co-pay, which
ranges from $5.00 to $20.00 depending upon the level of the plan as set by
your monthly insurance premium. Hospital emergency visits cost only $25.00
or $50.00. Inpatient care is $50.00 or $100.00 total no matter how high the
actual bill gets. These figures are just examples.
This works ok if you are generally healthy, but you get limited when you
need specialists, etc. For instance, I'm afraid of obstetricians... so I do
not use them for anything other than the pre-natal care. I hire an
out-of-plan certified nurse-midwife group to be with me at home for labor
and delivery. I pay for their services out of pocket. The fee is the same
that an ob/gyn would charge for a normal, uncomplicated delivery; it is
about $4,000.00. I believe with all my mind and heart that I get better
service and experience from the BirthCare group than any ob/gyn I've ever
come into contact. They are far more thorough in examining me than any
doctor ever did. They do participate with several insurance companies, but
not yet with the one my husband has through work.
If I had a regular insurance plan, I would instead pay just a percentage of
the fee. It is usually expressed as an 80/20 plan, meaning the insurance
will pay 80% of whatever the fees are.
Sunshine,
Lor
-----Original Message-----
From: anonymous@obgyn.net [mailto:anonymous@obgyn.net On Behalf Of Carmen Ouellette
Sent: Thursday, November 05, 1998 8:13 PM
To: Multiple recipients of list
Subject: Re: Am I Wrong?
Hi Lorainne,
Could you please tell me what HMO stands for?
I really like your idea of faxing the doctor.
I suppose this only makes sense, but the more I stand up for myself and ask
more questions, the better care I get. I used to think what the doctor said
was it, but now I know it's okay to ask questions!
thanks again,
Carmen
-----Original Message-----
From: Lorianne <anonymous@obgyn.net>
To: Multiple recipients of list <anonymous@obgyn.net>
Date: Thursday, November 05, 1998 7:53 PM
Subject: Re: Am I Wrong?
>Dear Shalena,
>
>These techniques have always worked for me in the past when the doctor's
>schedule was too busy:
>
>I'd ask the office assistant/nurse for the doctor to refer me to another
>doctor who could accommodate my request for an earlier appointment. At the
>same time I'd mention that I am trying to avoid an ER visit and wanted to
>know if they were interested in helping me avoid an ER visit. In a single
>instance, I was referred... and found the other doctor even more to my
>liking... so I moved my business there.*
>
>I also send my doctor fax transmissions so that he or, in some cases, she
>reads and sees my wording, not the translation from the nurse/office
>assistant. You know the telephone translation experiment results on how
>original messages are invariably altered.... Well a faxed letter solves
this
>problem for me. Some doctors now also have e-mail, but you never know how
>often they check it. Either way, calling the office to ask them to confirm
>receipt of any transmission is what I do. That way I have confirmation
that
>they are aware of my correspondence. And, quite frankly, doctors are
>unaware that their assistants are sometimes being less than friendly to
>their patients. Most of the nurses and assistants are women, who often
>have PMS or other problems from time to time or other issues... it is just
>that being a human, especially a woman, isn't easy. So I try to give
>everyone the benefit of the doubt, but I never leave my message open to
>anyone else's interpretation other than the person it is intended for. So
>I depend heavily on written communication. Plus, each written
communication
>is added to the medical record of the patient. This allows the doctor to
>review my history. All my doctors have come to expect a transmission
before
>every appointment. That way I won't forget to mention anything that has
>been on my mind and it gives them a day (sometimes two) to come up with a
>response during my appointment. Two of my doctors actually like this
method
>because it enhances the appointment time schedule for them.
>
>Hope this encourages you, because I don't think you were wrong to voice
your
>need. Sometimes we must push to get what we need. Follow your instincts
>woman, that is one of the best allies we have... our instincts.
>
>Hugs to you,
>Lor
>
>*Anyway, that was in the good old days when I could see any doc for
anything
>I wanted. I'm now in an HMO and need actual written referrals... It slows
>me down, but doesn't stop me. Even HMO gyns have someone on call for their
>patients when they are unavailable for any reason, including over booked
>appointments. But, the referral/ on call program is mostly used for out of
>town business and vacations, etc.
>
>-----Original Message-----
>From: anonymous@obgyn.net [mailto:anonymous@obgyn.net On Behalf Of Lesley Ironside
>Sent: Thursday, November 05, 1998 2:13 PM
>To: Multiple recipients of list
>Subject: RE: Am I Wrong?
>
>Hi Shalena
>
>Like others, I don't think it is wrong to push for an appointment when you
>are in pain and obviously suffering. It is the doctors who are wrong
>because they think the disease is slow acting and that we can wait for
>treatment. Pain is pain and to allow people to suffer with severe pain is
>unforgivable. Your docs schedule is not your problem, your pain is. I
>hope it goes ok.
>
>Best Wishes
>Lesley
>
>> -----Original Message-----
>> From: endo@obgyn.net [mailto:endo@obgyn.net]On Behalf Of Shalena Conder
>> Sent: 04 November 1998 21:40
>> To: Multiple recipients of list
>> Subject: Am I Wrong?
>>
>> I just called my doctors office, I have an appointment a week from
>> Friday and was wondering if I could get in earlier. I have been in
>> constant pain and the pain medication isn't working. Last night I
>> completely broke down emotionally,and stayed up crying until 2:00am. I
>> can't handle the pain anymore I am so exhausted, but when I talked to
>> the nurse she was very short with me and told me that there was no way
>> that I could see the doc early and to just keep my appointment that I
>> already had. I told her I had endo and was in constant pain and needed
>> to see the doc. She was very rude and said that he didn't want to see
>> any more patients this week, he was already double booked one day and
>> was leaving town on Tuesday of next week. I still pressed her and she
>> finally said that she would page him and see if he wanted to see me and
>> then she would call me back. Was I wrong to push and try to get an
>> earlier appointment? I have never pushed in the 2 years that I have been
>> a patient of his but i am trying to take a more active role in my health
>> care. Was I wrong to push? Shalena
>>
>
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