preferring providers disorganization
Jan. 28th, 2025 11:25 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
adrian_turtleI am in search of new medical care. I am not dangerously ill, but I'm not healthy either, which is probably a good time to be going about it. I found a doctor 3 months after moving to Massachusetts, and stayed with her for almost 25 years despite being decreasingly thrilled with her and her practice. (My study group unanimously think she's terrible, which makes me think defensively that she used to be good. Except being so disorganized. And usually referring me to specialists that don't exist, or were actively bad.) Moving to Boston made me think it might be a good time to find a new primary care doctor, but I just didn't get around to it. You know how it goes.
Changing to a new insurance provider is nudging me to actually find a new primary care doctor. And actually find a new neurologist. The latter is more urgent, (even though my migraines and seizures are as controlled as they're likely to get) because good neurologists keep retiring or leaving town and the one I saw most recently was really pretty bad. I have a lot of interacting health problems, and treating one gets in the way of another. My dentist suggested (correctly!) that I might have sleep apnea, but he also left me with a slight ongoing toothache, so I'm not sure it's been a net win for the headaches. Furthermore, I would prefer a primary care doctor who can notice that sort of thing.
I'm looking for a primary care doctor and a neurologist in the same hospital network, all 3 covered by my insurance. If I need an EEG or something else they do in a hospital, I want it all to be covered. I didn't expect it to be so hard. I mean, I expect doctors to be busy, or not taking new patients, or to be assholes who don't take fat women seriously. I expect neurologists to specialize in strokes or brain cancer or Parkinson's disease. And I expect the ones who DO treat epilepsy to believe getting seizures to zero is more important than maintaining quality of life.
I started out with a promising hospital, BI-D. Vicki sees a neurologist there and thinks well of him. They have a comprehensive headache clinic I'd like to try. So I called the insurance company and asked, and they assured me the hospital was in their network. Conveniently, the hospital has a "find a doctor" index you can search by location, specialty, whether they are taking new patients, etc. The primary care provider index even shows if they have any subspecialties. (I don't need Pediatrics. I have no idea if LGBTQ+ is relevant. I thought Integrative Health was important, but it turns out it doesn't have anything to do with coordinating care around interacting problems.) To a first approximation, none of the doctors in that hospital index are covered by my new insurance. The HOSPITAL is, but the doctors affiliated with them are not.
So I tried the index from the insurance company. That gives me less information about each doctor, but I can track down whether the doctor once I have their name. Most of the nearby ones are only affiliated with a hospital that went out of business last year. A few are affiliated with B&W or MGH, and on my first pass I skipped right by in search of somebody connected to Beth Israel. I couldn't find any. (You can't set hospital affiliation as a search criterion. You have to click on the clinic, then the provider, then scroll down.) So I finally called the insurance company and asked if the other hospitals were in their network. Some locations. Some locations of the hospital are in their network, what is the address I'm interested in? No, it's not that the downtown hospital is in-network and the outlying branches are not. It looks like a large hospital building is in network, and another one in sight of it is out-of-network.
I have 2 searchable indices. I have a map. I have an insurance company that actually answers questions over the phone. Why the hell is this so hard? It can't be good for my blood pressure.
Changing to a new insurance provider is nudging me to actually find a new primary care doctor. And actually find a new neurologist. The latter is more urgent, (even though my migraines and seizures are as controlled as they're likely to get) because good neurologists keep retiring or leaving town and the one I saw most recently was really pretty bad. I have a lot of interacting health problems, and treating one gets in the way of another. My dentist suggested (correctly!) that I might have sleep apnea, but he also left me with a slight ongoing toothache, so I'm not sure it's been a net win for the headaches. Furthermore, I would prefer a primary care doctor who can notice that sort of thing.
I'm looking for a primary care doctor and a neurologist in the same hospital network, all 3 covered by my insurance. If I need an EEG or something else they do in a hospital, I want it all to be covered. I didn't expect it to be so hard. I mean, I expect doctors to be busy, or not taking new patients, or to be assholes who don't take fat women seriously. I expect neurologists to specialize in strokes or brain cancer or Parkinson's disease. And I expect the ones who DO treat epilepsy to believe getting seizures to zero is more important than maintaining quality of life.
I started out with a promising hospital, BI-D. Vicki sees a neurologist there and thinks well of him. They have a comprehensive headache clinic I'd like to try. So I called the insurance company and asked, and they assured me the hospital was in their network. Conveniently, the hospital has a "find a doctor" index you can search by location, specialty, whether they are taking new patients, etc. The primary care provider index even shows if they have any subspecialties. (I don't need Pediatrics. I have no idea if LGBTQ+ is relevant. I thought Integrative Health was important, but it turns out it doesn't have anything to do with coordinating care around interacting problems.) To a first approximation, none of the doctors in that hospital index are covered by my new insurance. The HOSPITAL is, but the doctors affiliated with them are not.
So I tried the index from the insurance company. That gives me less information about each doctor, but I can track down whether the doctor once I have their name. Most of the nearby ones are only affiliated with a hospital that went out of business last year. A few are affiliated with B&W or MGH, and on my first pass I skipped right by in search of somebody connected to Beth Israel. I couldn't find any. (You can't set hospital affiliation as a search criterion. You have to click on the clinic, then the provider, then scroll down.) So I finally called the insurance company and asked if the other hospitals were in their network. Some locations. Some locations of the hospital are in their network, what is the address I'm interested in? No, it's not that the downtown hospital is in-network and the outlying branches are not. It looks like a large hospital building is in network, and another one in sight of it is out-of-network.
I have 2 searchable indices. I have a map. I have an insurance company that actually answers questions over the phone. Why the hell is this so hard? It can't be good for my blood pressure.
no subject
Date: 2025-01-28 10:33 pm (UTC)I'm not fully thrilled with BMC, which my doc is affiliated with, but nobody has ever tried to make me feel bad about masking, and they've always masked when I asked them to. (Surgicals, of course, but it's better than nothing.)
no subject
Date: 2025-01-28 11:34 pm (UTC)I'm not fully thrilled with BMC, which my doc is affiliated with, but nobody has ever tried to make me feel bad about masking, and they've always masked when I asked them to.
My former eye doctor works out of Tufts Medical Center and also has an office in Cambridge. The people in the Tufts office have a "security" requirement that all patients unmask to be photographed repeatedly. In case a person might be planning to cheat on the glaucoma test by sending a ringer to take it for them.
no subject
Date: 2025-01-29 01:30 am (UTC)no subject
Date: 2025-01-29 01:53 am (UTC)no subject
Date: 2025-01-28 11:04 pm (UTC)no subject
Date: 2025-01-28 11:48 pm (UTC)no subject
Date: 2025-01-29 07:43 am (UTC)I'm not impressed with him as a clinician and he is absolutely not available by MyChart or other email (front desk is by plaintext email). But his attitude is reasonably okay, his availability is as good as it gets, and I've been reasonably impressed by his rolodex. Oh, and his staff are tremendous. I have put them through a lot, and they've been just great.
Let me know if you want the referral in DM.
no subject
Date: 2025-01-29 05:58 pm (UTC)I believe all my readers are old enough to have seen a rolodex.
no subject
Date: 2025-01-29 09:30 pm (UTC)My son sees a pediatric epileptologist. Years ago, when they switched him from a neurologist to an epileptologist, the criterion for making that switch was failing one or two epilepsy meds, and then they switched him automatically. At the time, epileptology was more of a new specialty, and epileptologists were rare. Now, years later, I have the impression that there are more epileptologists than there used to be. So I wonder if it's possible for you to see one of them, rather than a neurologist, so that you are seeing someone who specifically knows about epilepsy. For whatever it's worth, my son's epileptologist seems open to us making decisions of quality of life vs preventing all seizures, so I don't think she would insist that you prevent all seizures at the cost of your quality of life. I don't know if you've failed enough epilepsy meds to see an epileptologist, or if they even still use that guideline anymore. But maybe it's a possibility?
I remember Rolodexes!