Getting fired by your doctor

[geoDoug]

First, I admit that this is a mea culpa.

Several months ago, I had an experience like none other in my life. A little background about me first: I have always been one of those people who is an active participant about follow doctors' recommendations for things like procedure followups, blood tests, medication levels, etc. for anything related to my healthcare. (not related to my cpap) Until now.

Here's the kicker: for one reason or another for the first time in my life I haven't followed the doctor's orders very well when it has come to sleep therapy. Yes, I realize how insanely stupid this is. There have been several different reasons--sometimes related to cpap adjustment issues, some personal, and some a psychological "block" on things--but that's not the point of this thread. I won't pretend to make excuses.

The point is this. In another thread, somebody recently said this, which resonated with how I've felt for months--ever since I was completely caught off-guard by my cardiologist:

There is an employee health clinic at my work that I usually go to. Whenever I come in and say that I am feeling fatigued, run down, and just not very healthy in general, it's like they don't even listen. They just blame it on sleep apnea.

For a year, I've dutifully taken my blood pressure at the same time every morning and have a seven-day average graph. When my cardiologist, who originally referred me to the sleep clinic, saw the graph he said, "You aren't following my directions. This is a GP issue. I don't want to see you again." I was flustered. That quote above from another thread really resonated with me because he absolutely refused to work with me to the point of refusing to make the usual suggestions to improve your BP (exercise, eating right, etc.) and literally said, "cpap, cpap, cpap. That'll take care of your problem."

All that said: We've talked many times about firing doctors for one reason or another. Has anybody else here experienced the flipside of being fired by their doctor?

And like I said, i know that I've been stupid and he was right. One of my new Year's resolutions is to get really serious about the one area of my healthcare I've got a block on. The only reason for this thread is that I'm curious to know if anybody else has experienced the same thing.

Doug.

[Slinky]

No, I haven't. But there has been a time or time my poor gastro probably would have been justified if she had wanted to!

I'm sorry to read you've had such a rough wake up call - but, hey, whatever it takes. On the other hand, you could have been given some additional advice besides the shove it in your face justified wake up call about CPAP, CPAP, CPAP.

All in all, probably not all that great a loss to your healthcare team. Buck up, there's a New Year ahead of us. Lets straighten up and fly right and get serious about CPAPping, whatever it takes.

[Snoredog]

doctors get paid for their "opinions" it is not a employee/employer relationship.

you pay for advice, as we all know a lot of that advice isn't any good.

The advice you get from a doctor should be coming from their

-how well they listen
-professional training
-research
-experience

A doctor that blows the first one on the list usually isn't any good with the others either.

if you don't have a good repore with your doctor like you one you would have with somone you play golf with or drink a beer with you have the wrong doctor.

I've been with my GP for more than 20 years, when I first started seeing him he didn't know squat (as he just finished up his internship}.

He's been with me thru a stroke, back problems, OSA you name it. Now he's pretty smart that he has 20+ years experience under his belt.

He's now my neuro, cardiologist, sleep doc you name it.

[geoDoug]

On the other hand, you could have been given some additional advice besides the shove it in your face justified wake up call about CPAP, CPAP, CPAP.

Yeah, I think that's why I was so rattled at the time. I fully expected going in to get a speech that included all those other things. Such an absolutist approach really got to me personally. Playing pop-psychologist on myself, which I realize is absurdly meaningless, I could make the argument that the real reason it hit me so hard was simply that he was hitting a nerve and that I already felt inadequate/guilty about my being "less-compliant-than-I-could-be." (Wow. Let's count the number of things wrong with THAT sentence. Time to turn off my internal editor now...)

Doug.

[jcranmer]

I've never been fired by a doc, but I am seriously thinking about firing my sleep doc..

In all the times I have seen him (4 or 5 times in total), he hasn't spent more then 30 seconds with me. I spend much more time with both his nurse and his nurse practitioner.

I'd be happy just to cut him out altogether and see the NP. She writes the orders for new masks, and any meds I need (I take Ambien CR). So really the only thing he has been doing for me is take my money.

His routine is to come into the room, tell me my reports look great and if I could lose some weight they might even be better. Thanks Doc, how about something I don't already know. (Thanks to this forum)

Since I am keeping my AHI around 2 - 4. (Down from an RDI of 118 during my sleep study) I am really not seeing the value in continuing to visit him.

At this point I think I am just going to continue to monitor things myself and get my GP to write any scripts for Ambien. I only have to see the sleep doc once a year anymore, but it just doesn't seem worth it.

Sorry if this is a bit of a rant, but I just had my last appointment with him on Friday and I swear he wasn't in the room more then 10 seconds this time!

[Slinky]

I totally understand. My experience has been tho that I get charged the same whether I see the NP or the doctor. At least, in your case, turns out the NP's time is worth more than the doctor's time spent w/you. I've done as you are thinking of doing. Wrote off the specialist except for once a year (or less) and off to my family doctor for my needs. My family doc and I are doing as well or better than the specialist and I were doing anyway. All we need the specialist for is a certain procedure.

[j.a.taylor]

I've never been fired by my doc, but I'm sure that I've probably frustrated my present one . . .

The first time I went to him, the family had been going for some time, I got a lecture because it had been 8 or 9 years since I'd had a physical . . .

I told him that doctors are kind of like preachers, most of us don't go looking for one until we really need them . . .

He shot back, "Yeah, and by then it's usually too late" . . .

I liked him right away, and have been regularly seeing him ever since.

[Slinky]

Yes, JA, I think I would have liked him right off the bat too w/that reply!!!

[kteague]

Doug,

No, but I've had a couple who wanted to. One was the sleep doc I asked for an auto machine because I was getting worse and worse on cpap at the pressure he prescribed. He got so angry he left the room and sent the nurse to finish up with me. At that point I knew he didn't have to worry about ever seeing me again, as he had been so condescending and downright rude to me.

Doug, did the cardiologist fire you or was it a matter of "don't come back till you're doing what you already know to do"? Your cardiologist sounds like my sleep doc. When I went in recently with my sleep logs, my very direct doc said, "We can't ignore the elephant in the room." I was taken aback till I realized she was saying we can't ignore the obvious and not making a reference to my weight. I continue to go to bed when I feel like it in spite of her specific sleep hygiene instructions. She was quite frustrated with me not even attempting what I was told yet whining about how bad I feel.

I sure hope your cardiologist didn't overlook something that needed attention. At least now you know how important this specialist feels your cpap treatment is to your heart health. That's sobering. Not just for you, but for all of us.

Best wishes in working things out.

Kathy

[geoDoug]

Doug, did the cardiologist fire you or was it a matter of "don't come back till you're doing what you already know to do"?

I think it was more the latter. I guess if you think about it, that's more of a "temporary reassignment to another department" than a firing.

Doug.

[6PtStar]

I had one I figured would fire me after some very bad things I said about him and at the top of my voice so that everyone on that floor of the hospital could hear me. After my wife chewed on my posterier regon for a while I went back and apologized for what I said and I think he retracted my firing. I still think that we should have parted on a mutual feeling of distrust (I still don't like or trust him) but I have to live with the Doctor who refered him and my family. Oh and he was one of them cardiologist fellows too. Arrigant bunch arn't they.
Jerry

[oceanpearl]

Was almost fired by my sleep doctor. I ended up firing him.
He is the guy who told me that if I didn't start using my CPAP he could no longer be responsible for my health and I would need to find a new doctor.
After taking an old card in on two visits and not having it discovered I decided that I needed a new sleep doctor. My understanding is that he was supposed to be monitoring mt progress, GUESS I WAS WRONG!

[Wulfman]

I couldn't vote in your poll because you didn't have a category for "Did YOU fire your sleep doctor".
My sleep doctor (pulmonologist) and I had a "mutual aggravation" relationship and three visits with him were all I could handle.....one before the sleep study, one when he wrote my prescription and one follow-up a couple of weeks later.

I had the equipment and the software to monitor my therapy......didn't need him anymore.

Den

[Nodzy]

Season’s Greetings. And for those that indulge….. Merry Christmas and Happy New Year.

I’ve never been fired by a doctor, though I have fired a few over the years. However I recently had one formulate a malicious and punitive diagnosis on a routine follow-up after I found my own best CPAP therapy in June of this year.

For about 4 years I was on straight CPAP with a nasal interface mask. It was like some medieval torture for me, and I could barely maintain 30% compliance. Keeping the mask on all night was near impossible on any night.

In June I bought my own Auto-M and following that a Hybrid mask. After years of CPAP misery I got to know what great therapy really is. All thanks to the many knowledgeable and friendly people on this board.

I posted many of my experiences, and findings here too. Somehow, and probably because I was numb enough to post my actual face picture at that time, someone involved in my medical care discovered my honest rants on the board. They informed the upper echelon at the medical facility of my knowledge and rants.

Subsequently, on a September exam, they issued me a BIPAP-Auto without hesitation, after years of telling me about plain vanilla CPAP…. “get used to it.”

About a week later my medical packet, that I had ordered from the facility, arrived. It clearly stated in a 2002 entry that a BIPAP was to be issued to me.

They had me on straight CPAP from 2002 until I bought my own Respironics Auto-M A-Flex in June 2007, despite my complaining to them dozens of times that their therapy wasn’t working for me and was extremely torturous to attempt to “get used to.”

Essentially, they let me become further damaged for years by not providing the machine that was supposed to be issued to me in 2002, among multiple other lackings in my care.

As obvious punishment for finding my own therapy and presenting my knowledge to them, as well as for speaking of it on this board, I was labeled in my med record in September 2007 as a “hypochondriac” with “questionable pain.”

Laughable yet extremely tragic, since my med packet contained from previous years of tests and exams at that faciity….“severe sleep apnea,” “multiple neuropathies” (more than five specific types listed), “fibromyalgia,” “thoracic disc bulge and damage,” “cervical disc radiculopathy” and “denervation-reinervation,” among other ailments. All of those are painful. And as a note, my pain has never been notably or effectively treated by them.

Because I found my own best SDB therapy, and quickly learned more than many doctors know about SDB, and certainly more about my particular maladies than doctors know or admit to knowing, I’ve been maliciously punished in a manner that is potentially injurious or deadly.

That malicious and punitive statement the doc put in my records will easily delay or negate prompt and effective emergency or routine medical care when needed as long as it exists in my med packet. This came from a doctor with notable, above average, credentials and position -- not some young greenie.

“Hippocratic Oath?” For some it’s more like “Hippo-Ego Loaf” and they slap you with a huge slice of theirs when you least need it.

Y’all be safe and have a great Holiday Season.

Nodzy

[alv7722]

I was fired by my sleep doctor. I was diagnosed (I guess) with OSA, and was scheduled for another sleep study for "titration". Somewhere in the meantime, it became so bad I was in danger of losing my job, having an auto accident, or dying. I begged his office to have him write an Rx for an auto tirtratinh machine. He/they refused. My PCP would not write an Rx because it was outside his area of experience, and I was being treated by the sleep doc. I called the hospital emergency, they let me speak to the ER doc, he said they could not write me an Rx because I was being treated by the sleep doc. He also said there was no risk to my person by using an "auto" machine if I could obtain one. I finally found a vendor on Craigs List that would sell me a machine without Rx. Had the machine in 3 days, saved my life, saved my job! I have a high deductible, so am a self pay, so I don't miss the other $1400 out of pocket for another sleep study.

There is substantial evidence that "home titration" is as effective, or sometimes more so than a "sleep study". These "doctors" are using what may be an outdated protocol to bilk millions, possibly billions from consumers and the insurance companies. At this point I have requested a refund from the doctor for all monies I have paid them due to not receiving any service or value for what I paid. If I go yo small claims court, I intend to ask for punitive damages for patient abandonment, when I had a serious emergency.

The poll soes not work right. Also the doc that fired me was not necessarily a "dork" just a very astute business person. Getting the $1400 for another sleep study, took precedence over doing the right thing as a doctor.

Al V

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CPAPopedia Keywords Contained In This Post (Click For Definition): Titration, auto