Justaseeker's Journal page 10

[Pamsc]

I think you said your new doc doesn't take insurance. Your insurance company and your MD's group may have some agreement or reward system about reducing overuse of specialists. But if your insurance company doesn't pay it isn't likely to count, and your MD might not fully count a DO doing integrative medicine as a doctor. I may be putting the pieces together wrong--those are just my guesses, that it is about money, not control.

[justaseeker]

I think you said your new doc doesn't take insurance. Your insurance company and your MD's group may have some agreement or reward system about reducing overuse of specialists. But if your insurance company doesn't pay it isn't likely to count, and your MD might not fully count a DO doing integrative medicine as a doctor. I may be putting the pieces together wrong--those are just my guesses, that it is about money, not control.

The staff told me that the DO doesn't have any relationship with any insurance companies and doesn't file on services. They provide coded paper work and I'll file with the insurance myself. However, in the new patient packet the paperwork has a place for my insurance information and a statement that they do courtesy filing. So, I'll have to sort that part out.

I changed my plan two years ago to one that allows me to be in control of who I see and when - and there are no limits. I don't have any need for a PCP on file or to refer me to specialists. I can see any specialist who will see me, whenever. I confirmed that fact once more with the insurance company's patient advocate when I decided to see the DO.

So, the only control that the MD can have in this situation is to refuse to provide me service if I don't adhere to their terms. She never actually said that was a possibility, just that they keep all services within their system. IF the justification is that way they can keep the communication organized/computerized - well, HA HA! They can't even keep the simplest info organized. I'm going to once again be doing that part myself. Oh, well.

The DO is a board certified internist doing BOTH traditional and alternative medicine. Real enough. But, if I tell the MD that I am seeing her for alternative treatment, which I am, my MD can't really do more than cluck her tongue and roll her eyes - like she does about some of my supplements and evidently now my primal diet. I can also refuse the mammogram in favor of a thermascan - which my insurance covers equally with a mammogram - one of the few companies to do so.

I guess I am not going to be in the running for a gold star from the MD, but being a "good patient" is not my priority.

[Gwynn]

Justaseeker,

We have that same plan, we can see a specialist any time without a referral from our family doctor. We do have a monster deductible. We are self employed so we didn't have much choice.

Did I understand correctly that your doc would "fire" you if you went outside her care? Maybe they are the ones who need to be fired. Correct me if I am wrong, it's been a long day.

Gwynn

[justaseeker]

Justaseeker,

We have that same plan, we can see a specialist any time without a referral from our family doctor. We do have a monster deductible. We are self employed so we didn't have much choice.

Did I understand correctly that your doc would "fire" you if you went outside her care? Maybe they are the ones who need to be fired. Correct me if I am wrong, it's been a long day.

Gwynn

Yep, its more expensive, but well worth it - larger deductibles, no co-pays but a percentage - I pay 30% of covered services - larger out of pocket limit. But, once I get past all of that the coverage is 100%.

She MIGHT decide to refuse me services if I go outside their system. That's a chance I'll have to take. I think that if I only see the DO for alternative care that won't be regarded the same as traditional services - and the type of thyroid care that I want would be considered alternative.

[Gwynn]

Ours is a $25.00 co-pay per visit. $10,000 deductible. Our monthly premium is $388.00. We don't have prescription coverage. (gasp.) SO FAR we feel we are ahead of the game, even with DH's colonoscopies. Now, I have been to Target and have seen people picking up prescriptions that cost hundreds of dollars, and that was WITH insurance. I know it can get scary. We may revisit the prescription drug coverage or try to wait for DH to turn 65 so he will have Medicare. He is 61 now. Next year he will be eligible for Medicaid if Obamacare isn't overturned.

I had my allergies tested last week and the doctor took a dim view of my iodine therapy. He was skeptical about bromine toxicity and fluoride and chlorine and all of the stuff we have been discussing for months. He did do a metabolic panel and my TSH was 2.1. Is that bad?

Sorry, not trying to hijack your journal by talking about me!LOL
Gwynn

[justaseeker]

Ours is a $25.00 co-pay per visit. $10,000 deductible. Our monthly premium is $388.00. We don't have prescription coverage. (gasp.) SO FAR we feel we are ahead of the game, even with DH's colonoscopies. Now, I have been to Target and have seen people picking up prescriptions that cost hundreds of dollars, and that was WITH insurance. I know it can get scary. We may revisit the prescription drug coverage or try to wait for DH to turn 65 so he will have Medicare. He is 61 now. Next year he will be eligible for Medicaid if Obamacare isn't overturned.

I had my allergies tested last week and the doctor took a dim view of my iodine therapy. He was skeptical about bromine toxicity and fluoride and chlorine and all of the stuff we have been discussing for months. He did do a metabolic panel and my TSH was 2.1. Is that bad?

Sorry, not trying to hijack your journal by talking about me!LOL
Gwynn

No need to apologize.

So, is this doctor the new doctor who was supposed to be iodine friendly - the one you found through Brownstein's recommended referral site?

TSH of 2.1 is good. There are two reference ranges that you'll run into on lab reports currently - the older one of .05 to 5.0 and the newer one of .03 to 3.0. Supposedly we will eventually be moving to a reference range of .01 to 2.5.

What Is a Normal Thyroid Stimulating Hormone - TSH - Level? Thyroid Testing -- What is the normal reference range.

Are you sure about that deductible? How does that work? With my insurance - both before and the plan now - I pay 100% until the deductible is met and THEN the co-pays or percentages start.

[Pamsc]

Wow justaseeker, that is a good insurance plan!

[justaseeker]

Usually I like to sleep on things and find that I am clearer in the morning. This morning my head still hurts (metaphorically) about the doctor situation.

I had hoped to find a doctor who could be my family doctor who could do both alternative and traditional medicine. That's what - to my mind - an integrative doctor is/does. So, now I have to make decisions. And, it may take more than one night's sleep.

The information in the packet from the new doctor gives me mixed feelings. She is very focused on environmental toxins, which I agree are important. I have been aware of these issues for many years due to my own chemical sensitivities. But, if I am going to be seeing a doctor for these issues I'd prefer to see one who specializes in environmental health. And, I'm pretty sure that if I was seeing such a doctor and s/he ordered lab tests they would be covered by my insurance - whereas this new DO states that many of the labs that she orders are not covered by insurance. Then again, coverage will vary by company and plan - so maybe my plan will cover more than other plans may, regardless of who orders them. My plan covers things like acupuncture, if it is ordered by a doctor.

I also know that environmental toxins can impact thyroid function, so I feel like she may want to push the environmental testing when I say that I want to focus on thyroid. I can refuse and insist on doing the tests that I feel need to be done first and to do a trial of natural thyroid replacement before exploring the whole environmental toxins/detox/chelating issue - which can become WAY expensive really quickly. But, that still leaves me wondering if I want to see her for anything beyond the initial thyroid testing/treatment - with the understanding of how iodine fits into the whole picture. And, maybe that's enough. After all, I wanted the change of insurance plan in order to be in control of who I see and when I see them. So, why worry about keeping things simple?

Well, one of the things in the new patient packet that I like is the statement that the work that they do there is slow and the the patient who can stay the course will get the most benefit. I know that's true. They also say that while they offer many services and products, that the patient is never expected to buy into anything they don't want to. I will look at the supplements that they offer there - but right now I am happy with the plan that I have in place. I don't want to make any more changes for awhile, other than the change to natural thyroid. I prefer to take things slow for awhile and to monitor how primal diet, exercise, natural thyroid, and my current supplement plan (including iodine) work for me - probably over the next year.

[justaseeker]

Wow justaseeker, that is a good insurance plan!

Yes, it is. The doctor who I saw when I first start living in MI told me that its a great plan and would be accepted anywhere and would allow me to go to any hospital in the area. I've also been told that its roughly the equivalent of the plan that US congressmen have under the federal umbrella. I prefer to see doctors who are providers under this plan since that limits my out of pocket expenses - while still giving me freedoms.

[justaseeker]

I am even considering returning to the first doctor that I saw here in MI. She is also a DO. Her practice is both an urgent care and a family practice. I had seen her for both urgent needs (including stitches for a cut on my hand) and regular care. She is part of a different system of hospital care, but one of my initial concerns was that she didn't provide me any guidance about how to choose a hospital system when I was new to the area. Initially, I liked the notion of the new MD being part of a package deal with such a highly rated hospital system. Now, it feels confining.

So, I'm basically doing inventory on what I have learned about the medical community here - which does differ in many ways from the southern state that I live in part time now. Going back through my files to be sure that I am clear about what tests were done and the results.

Another thing that I didn't like about the first DO is that she was disorganized and the office was disorganized - WAY worse than the one that I am seeing now. She wanted to do a lot of testing, including the radioactive iodine uptake test. To be fair, though, she wasn't insisting and I was able to back her off from several tests that I felt were excessive. And, she DID do more thyroid testing than any other doctor, just not all that I want. I didn't know what I wanted then or I would have discussed it with her.

She also gave lip service to lifestyle changes - but the last straw for me was when she stated that I HAD to go on some sort of medication for my lipids, after she had prescribed the wrong medication for my triglycerides - and after she had stated that I had the right to refuse any services/treatments. She clearly didn't know what she was doing with these sorts of medications.

My present MD is not so test happy and she also prefers not to prescribe any medications that she doesn't have to. So far, she has been patient with me while I try to get the lipids under control with lifestyle changes.

Sometimes I feel like Goldilocks and the three bears - I haven't found the one that fits just right. I had hoped that the third time would the charm - that the new DO would be the right fit. But, now she is looking like she will be an alternative specialist not really an integrative medicine doctor. That leaves me wondering if I want to look for another family doctor or just stick with the one that I have now. She is still an improvement over the first DO, overall.