Has anyone here ever been kicked out of a Doctor's practice for non compliance by refusing a statin drug?
I got a phone call today from the nurse at my doctor's office telling me that my lab appointment for tomorrow has been changed to a fasting appointment. The GP has ordered a diabetic labs including A1C and fasting cholesterol.
I asked why the cholesterol test when I am intolerant of statin drugs because of some side effects? The nurse reminded me of the fact that my LDL level was out of control and my A1C at 6.1 wasn't very good either.
She then insuinuated that when a patient's levels are out of control that it makes the doctor and the practice look bad. I was told that 'they' (whomever they are) are putting the pressure on the doctor for all patients, especially diabetic patients, to be under control, and perhaps if I wasn't under control that I would be kicked out of the practice.
So.......now in addition to worrying about managing my diabetes, blood pressure and cholesterol - I have to worry whether I will be kicked out of the doctor's practice too? I thought this was America, where we have freedom to choose what medicine we want to take? :(
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Permalink Reply by Spock on December 18, 2012 at 5:08pm I so agree! That and concierge medicine. Start a new thread.
Permalink Reply by acidrock23 on December 17, 2012 at 11:37am All of the discussion in the thread illuminates an aspect of the original topic, the poor communication paradigms we have to deal with, while taking dangerous drugs and balancing the amount of the drugs with food in what amounts to a challenging environment, all day every day. Then, somebody at the doctor's office, like Mayumi's wicked nurse of the west, adopts an absurd and ill-informed "You'd better behave, or else..." without bothering to outline what the goals for continuing to treat with this provider might be, if the goals are clinic-driven or insurance driven or simply something the doctor pulled out of his wazoo because the doctor is a wing-nut. If insurance is involved, was it the insurer themself, or someone at the insurance company making the same sort of ill-informed guess that the nurse did? I get a letter every January or so telling me "Medicare says you only need 4x test strips/ day..." but then, as if by magic, the usual number, or maybe the usual number-50 arrive.
There are so many different layers of information behind any doctor saying anything that it seems as if sometimes we are almost guaranteed to get a convoluted story that will change if we give "them" the least bit of blowback like "are you nuts, where did you get that?"
I'm not sure the Obamacare is quite the "slam dunk" death-knell to quality care that some people think that it is. I think that it's a step towards improved management of the dialogue between government, insurance, providers and patients which I think is a very important thing to have. Right now we have patients, including me, who feel entitled to 12-15 test strips/ day (at least...) and insurers who will cough up 10-13, the AMA/ ADA who I think recommend 7ish and then Medicare recommending a paltry 4. There should be a scientific answer about how many strips are needed for "the pursuit of happiness" and insurance, whether private or public, should cover it.
I believe that Medicare 'rules' for diabetes care may have been formulated with non-insulin requiring type 2's in mind. I think the entire system medicare as well as insurance never thought of a day when children with type 1 diabetes would live to medicare age (I was diagnosed before US medicare existed) and have and be able to use the tools for intensive treatment of diabetes. I think the system is designed for a minimalist approach to control using diet and oral drugs (metformin). This approach is obviously inadequate for type 1 diabetes, but that view interferes with a better approach to the treatment of the disease.
Paul I agree with you wholeheartly, Medicare re: Diabetes is for Type 2s. I too have lived past that expired date that they thought I would live because I was dxed before Medicare. We all know with Type 1 there are no hard fast rules for managing this disease. Reminds me of the Movie, I think it was called 1984 with Lew Ayers and he played a person with D. In the movie he was given a ration of insulin and if he used that up before he was due to order more, then tough cookies.
Wow, 1984 was one of my favorite books/movies. I had no idea there was a character with D?!
If I'm not mistaken. If Lew Ayers was in that movie then that is the pic I'm talking about. I don't know what year it was made but I know it was before 1984, at the time it was a futurearistic pic. In the movie I remember it clearly because I had been dxed years before in 1959. Lew Ayers was a pastifist who was inducted into the war, can't remember if it was WW 11 or Korean and his movie career after the service plummted because of his views on war.
I'm a lot more familiar with the book which was a classic by George Orwell, and yes it was a future novel what's called a dystopia which is the opposite of a utopia. I just googled it. The book was published in 1949 and the movie was actually made in 1984 but Lew Ayers wasn't in it.There was a previous film of the book made in 1956 but that didn't have Lew Ayers either.
I've been a pacifist since 1963 (apropos of absolutely nothing!)
Permalink Reply by acidrock23 on December 17, 2012 at 7:49pm There should be hard and fast rules for having enough supplies and I think that it's gross medical negligence that the doctors and insurance companies running that part of the show don't figure it out and adopt a more aggressive stance regarding the importance of testing a lot.
The letters I get are from my insurance company whose computer should be well aware of what type of diabetes I have, they are just citing Medicare, which strikes me as absurdly inappropriate.
Permalink Reply by Nell on December 17, 2012 at 7:17pm I can't let comments by Clare and Christy, yesterday, go without comment. I just now read them. They said there were people with diabetes who don't care about taking care of themselves. I strongly disagree with that. There are people who "don't" take care of their diabetes but not because they don't care. First, walk a mile in their shoes before you diagnose their attitude. You don't know what other priorities and pressures are taking precedence. They may not know the importance of self management. They may think they can't do it. They may not know how, within their life situation. They may think they are doing OK. There are hundreds of reasons. You both have the right to your opinion but I just wanted to put mine out there too as some kind of counterbalance. Thanks.
Nell I am in agreement. Perfect example is myself for 40 years I didn't know how to manage but the little info I had gotten as a child I thought I was doing ok. Not until the 1990s when I was referred to a CDE because of problems I was having did I get the truth re: how to truly manage this disease. Life circumstances are different for whatever reasons and passing judgment on others is unfair.
I wasn't comfortable with that phrase either. I personally think Pwd's don't take care of themselves for lots of reasons: denial, fear, money, ignorance, hopelessness.
Permalink Reply by Clare on December 17, 2012 at 7:40pm I'm sorry Nell, there are people with diabetes who don't care about taking care of themselves. While you can strongly disagree with it, it is the truth. I grew up with someone who was diagnosed with D at age 15. He was told that if he kept on the path he was taking he would be dead. It had nothing to do with the priorities or pressures he was undergoing he just didn't give a shit. And he is dead now as a result and he died a horrible death as well. I know this because I was diagnosed within a year of him at age 14 and I have walked more than just a mile in his shoes because I was exactly like him until I watched him die.
Manny Hernandez(Co-Founder, Editor, has LADA)
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