Menu
Jump to content

What's with the ads?

hjffkj

Medical Field Rant

Recommended Posts

Excuse me while I rant a bit!

I am 15 weeks pregnant and can't find a darn provider who will take me as a patient.  My previous provider was amazing and I wish I could just call him up and have him for this pregnancy but I moved to a different state recently and he is not covered under my new insurance so that is out.    So, I make an appointment with a dr who came highly recommended by multiple people.  I give them basically my entire complicated medical history prior to the first appointment in order to ensure that things will run smoothly the first appointment. Did that happen.. NOPE!  Dr comes in to tell me that I am too high risk for her to take on as a patient,  6th csection scares most drs.  I knew that going into this and that is why I made it clear that I was looking for a dr who would take me as a patient before I wasted my time with an appointment.  

Anyway, she gives me scripts for my initial blood work and ultrasound to get things rolling while I get in touch with the dr she referred me too who would likely take me.  Problem number one, that doctor isn't covered under my insurance.  Problem number two, when the place that is going to do my ultrasound tries to get preapproval from this dr she says I'm not her patient so she can't approve it. WTF! Why give me the script to get it done if you aren't going to authorize it when they need you too.  (insert stream of curse words here.)

So, I then spend hours calling various drs in the area and no one is taking new patients even though they are listed as taking new patients.  One place couldn't tell me if they could take me until they saw my medical records, which is reasonable, but I can't get my the previous dr to fax them the darn records because they are incompetent. Now all the offices are closed so I have to have this burden on my shoulder all night and likely through the weekend since many places are closed on Friday.

I can't even explain how much crying I've done today because of damn pregnancy hormones and having to deal with this.  I'm not generally someone who cries easily but I've been a waterfall all day.

End rant. 

  • Sad 12

Share this post


Link to post
Share on other sites

I’m sorry, that’s super frustrating when you need care and they’re all afraid to do it because of liability.  Add to that insurance issues.  Sigh.

  • Thanks 1

Share this post


Link to post
Share on other sites

I'm so sorry. I might try calling the local labor and delivery ward where you would deliver and ask to speak to the charge nurse. Ask her which doctors/practices care for patients with your history. At least that will narrow it down a lot. Feel free to cry while calling. Explain that you know you are high risk and are looking for a doctor to handle that.

Other option -  have you tried maternal-fetal medicine specialists? Given your risk factors that might actually be a reasonable option, and you can't risk out of that kind of practice! At the least maybe they can get you started - often they coordinate care with another regular OB, so they'd know who to refer you to for coordinated care and them arranging it might get you in even cold calling doesn't. But again, with your risk factors, being seen at least some by the maternal fetal specialist might be a great idea anyway. 

Also, consider checking the list of pro-life ob/gyns on the internet - they are more likely to see large families and have experience with multiple c-sections. 

And hugs. It is ridiculous that they more important it is that you recieve care the harder it is to find that care. I've done the cold calling, dealing with insurance, trying to figure crap out dance while pregnant and it is awful. Most stressful thing ever. 

  • Like 6

Share this post


Link to post
Share on other sites

I've been there done that too with pregnancy. It's super frustrating and that is compounded by pregnancy hormones. Ktgrok's idea of a maternal-fetal medicine specialist is a good one. Even if they are out of network, it is worth a shot. They can probably help you navigate everything to get you with someone who can help you that is covered if nothing else. Or maybe they can work with the insurance on your behalf since this is a high risk pregnancy and get them to cover things they ordinarily wouldn't cover.

I had a MFMS on my high risk pregnancy (placental abruption detected at 14 weeks, wasn't expected to make it to 20 weeks, scheduled to deliver at 30 weeks, bought her 6 extra weeks in the womb before she was born at 36 weeks. She's 13 now with no issues at all related to her birth). The MFMS was wonderful and was wonderfully kind and caring about a pregnancy that by all indications could have ended tragically. She didn't downplay that the pregnancy was a risk to both of us, me and the baby, but she wasn't all doom and gloom either. She was definitely good at her job. I've never met another person in the obstetrics field like her.

  • Like 3

Share this post


Link to post
Share on other sites

I'm sorry you're dealing with this issue. How stressful! When we were having trouble finding a specialist for DS because nobody was taking patients, I was very surprised to find that the insurance company was willing to call around and try to get us an appointment. Depending on how your insurance works, maybe that's an option given your high-risk status? We're sometimes been assigned to family advocates or something similar who have been very helpful. If your insurance is the kind where you call and get a different rep each time, it might not work. But possibly if you push, they might have someone who can advocate for tough cases. Good luck. (And congrats on your new addition.)

  • Like 4

Share this post


Link to post
Share on other sites

I would call your insurance company and beg them to make an exception and grant your old provider in network status or otherwise find a high risk provider that will be in network and accept new patients.

In most of the states I've lived in cases like this were handled by public university hospitals.  Like when we lived in Iowa there were outreach clinics for the University of Iowa all over the state.  I'm high risk, but just OB (rather than midwife) high risk, so I never had to plan a birth at the hospital in that situation, but I'd guess that there is something similar in most states. 

  • Like 3

Share this post


Link to post
Share on other sites

If you can't find anyone to take you the insurance company can issue a gap exception where they cover out of network. 

  • Like 5

Share this post


Link to post
Share on other sites

I am glad some people have some advice that will hopefully help. 

I am so sorry, this isn't how it should be.  So stressful.  

  • Like 1

Share this post


Link to post
Share on other sites
1 hour ago, Ktgrok said:

If you can't find anyone to take you the insurance company can issue a gap exception where they cover out of network. 

This. My son just had surgery and since there are only two surgeons in the state who do this particular surgery, he was able to get it approved for in-network coverage, even though neither surgeon was in-network. The doctor’s office handled all of the paperwork for him.

  • Like 3

Share this post


Link to post
Share on other sites

I'm sorry.  is there someone at the insurance company who could help find a provider?  generally, if they can't find one in your area on their plan who will take you, they will (or should - you may need to contact your state insurance commissioners office) cover an out of network provider.  

Share this post


Link to post
Share on other sites

That's just crazy!! I agree with the others about getting your insurance company involved.  I've been surprised that they actually have patient advocates who can step in and help with this type of thing.  (At least sometimes!)

After that, I might call one of your legislators. 

I'm really sorry you're going through this stress!!

  • Like 1

Share this post


Link to post
Share on other sites

Thank you all for the support and advice.  I will certainly be looking into all that great advice given first thing Monday morning.  I've decided today I need to take a mental health day so I don't let this ruin my weekend.

The most annoying part is I went through all this crap when I was pregnant with my 3rd but I was desperately trying to find a supportive dr to let me try to have a vba2c.  Since I had already had 2 c/s no one would sign off on anything but a scheduled c/s.  So,  I decided to try a HBA2C, which I didn't want but I knew it was best chance at avoiding a bunch of c-sections since I knew I wanted a bunch of kids. After 72 hours of terrible labor I had another csection and have been stuck with them ever since.  So, if they would have been supportive then I might not even be in this mess now. It is ridiculous.

  • Sad 4

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×
×
  • Create New...