General Question

JLeslie's avatar

Why do doctors who work in a group think it is ok to say a patient cannot switch to another doctor within the group?

Asked by JLeslie (47726 points ) February 25th, 2011

I know this does not happen in every group, but I have heard of it more than once.

Another pet peeve of mine is calling for an appointment, either me or my primary care doctor, stating the medical problem, and being told every doctor in the group handles the problem, when in fact later to find out certain doctors in the group actually specialize. For instance this happened to me with a neurology referral; I wound up with a doctor who generally works with children, and I am 43 year old woman. I now am having a problem for a very specific very rare problem, and want to make sure I see someone who has a reasonable amount of experience before driving over two hours to a specialist and paying out a bunch of money. Why can’t I get a simple answer? My doctors office is calling with the referral, my doctor recommended I see a specialist, this is not me just wanting to direct my care.

So back to main question, I have a fear of being sent to the wrong doctor, and then he not being willing to give me up as a patient to a doctor in that office who might be able to better help me.

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11 Answers

SpatzieLover's avatar

Without knowing the specifics of your condition, I would say this:

Neurology is tough because there are few neurologists and lots of neurology patients. Then to add to it, they do often work in a “group” setting (usually because that’s how the hospitals want it).

We have had this same type of issue with our son. My best suggestion is to research your condition with your state on a Net search and see if there is a charity/group involved that could assist you.

We’ve gotten luckier with good referrals not from our primary care physician, but instead through a therapist and through a psychologist. Both of whom have suggested that when we call for appointments we state specifically that we will set up an appointment only if the physician will have a phone consult with us prior to the set appointment time.

This has indeed saved us both time and money. We’ve been able to state our issues ahead of time, and in some cases we’ve then been given a different referral to move on to. In other cases, the doctors have been able to set up a better time period to see our son (he likes things quiet/less distractions) so that they can get a better sense of who he is and what his needs are.

I would say, if your condition is rare, you definitely need a phone consult before going to any appointment.

JLeslie's avatar

@SpatzieLover My “new” problem is not neurological, just so I am clear, although your answer is helpful. Thank you. I have a very very specific question that should not need a consult but a yes or no answer of whether a doctor in the office has surgical experience on a very specific area of the body. It is a one second question that they seem reluctant to ask before I make my appointment.

SpatzieLover's avatar

Hmmm….Do you have a medical college near you? Do you have any doctor friends? Sometimes to get a straight answer you need to network with medical professionals.

If you do have a medical college, call the director of the area of body you need surgery on. They should be able to direct you to a surgeon that has experience with your need.

JLeslie's avatar

@SpatzieLover I am likely going to Vanderbilt. When I called the appointment girl and also spoke with a nurse said, “all our doctors can do everything.” Too vague for me to feel comfortable. The response was not, “yes, I have seen Dr. So and so treat that several times.” My doctor’s office doing the referral was happy to call me back this morning with an appointment next week at Vanderbilt, their “first available.” I want to wait another flipping week if I need to, and see the right person. It is almost a three hour drive, I will likely have to stay overnight, and of course it won’t be cheap. I don’t see why it is ok for the medical community to function this way. I did call a contact I have who does research in a semi related field, different part of the body, to get his opinion.

SpatzieLover's avatar

@JLeslie Ugh! I despise the inevitable drive, the waiting room wait, then the let down to find you’ve gotten the “wrong” doctor. Considering your drive time and the fact that you will be spending money on an overnight stay, I’d personally call the nurse back. I’d want to speak with the actual doctor prior to spending time and money on a trip to Vanderbilt.

I’d state it exactly that way to the nurse. “Listen, I’m spending a day in a car and a night at a hotel just for this appointment. I do not want to waist my time or the doc’s time just to find out he/she can’t operate on me due to this rare condition. I have been turned down by previous doc’s due to their lack of experience. I need to know that if I am coming, the doc I see has experience”

<<<I don’t see why it is ok for the medical community to function this way.>>> I so agree. Unfortunately, the way the insurance companies and hospitals have the doctors set up, there almost isn’t a chance for change here.

Every so often you’ll find a doc that operates as an individual and will bypass all of this BS. They are fewer and farther between now.

faye's avatar

Can you google the doctor, look him up in the ‘doctor’ book? We have a registry of doctors and what they do and have done lately in Canada, but I bet it’s on google if they are specialists. As I write this, I expect if your condition is rare, it likely wouldn’t be listed.

john65pennington's avatar

Do your homework on your computer. Check these doctors qualifications, before you make the trip and spend a lot of money. You make the choice of the doctor you want to see, not a referral.

Find the doctor you will be comfortable with and then YOU ask you regular doctor to make the referral. You have that right.

JLeslie's avatar

@john65pennington my referring doctor isn’t the problem, it is not being able to get all the answers I want from Vanderbilt. Maybe it is a red flag.

snowberry's avatar

Just a thought. Have you spoken to your insurance company and told them that you want to save yourself AND THEM money by going to the right doctor the first time, and that you need a referral to a doctor who will actually be able to perform this surgery, that you need a doc with experience in this particular field?

SpatzieLover's avatar

@snowberry Great Idea, unfortunately this question addresses what happens when you call your insurance company to ask questions such as this.

If only it were that simple. We pay them for their benefits and ask for assistance—for shame. I cannot tell you how many times my husband & I have gotten the run around from our insurance company.

snowberry's avatar

Insurance companies suck. And doctors who cater to them suck twice. That leaves very few decent doctors to choose from, and many of them are so expensive you can’t afford to go there. Been there, done that too.

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