Battle of the Urologists 

  
Ever have a claymation-style dream where your doctors are battling it out in a wrestling ring Celebrity Death Match style? Would be funny, right? Which doctor brings the scalpel, which one the forceps? Is lubricating jelly optional or is it playing dirty? 

In our last few posts we talked a little bit about the Medicaid crisis happening in Florida–shortage of doctors, denying medical coverage, refusal to accept insurance, the list goes on. While the schermish between doctors and insurance providers continues, it left Tan’s care in this weird Bermuda Triangle–medical care is on track one minute, totally gone without a trace the next, and then remnants of the wreckage peek back up to the surface months later. Having to admit to your doctor who’s your insurance provider is like admitting you have a communicable disease: Prognosis–scratchy, rashy irritation upon contact and no compensation; Treatment–drop that patient in need like a sack of potatoes. 

One of the first doctors to go was Tan’s long-term urologist. After spinal cord injury, and the subsequent rehabilitation in a facility for a few months, persons with SCI take on managing their care with a battery of specialists who help to treat, monitor, and control the care of the individual’s body. Kidney and bladder function are one of the top priorities for care in SCI, so having a trusted and knowledgable urologist on your roster is a necessity. What you learn living on a system of government insurance is that with any change to coverage there’s a period of time where doctors drop patients while they negotiate new terms with the insurance provider, leaving the patient without care while terms are settled, or in a cycle of rotating between doctors, care clinics, and hospitals. Going without a urologist for a few months while these two too-big-for-their-britches entities duke it out is really just par for the course and so, when Tan’s urologist dropped his care, we didn’t panic too much. Not until those test results came back from the ultrasound…Then it was on to the hunt for a urologist, and quick.

Pensacola was the nearest urologist Tan’s primary doctor was able to find who accepted Tan’s insurance, and so began our travels for Tan’s care. Forms were signed. Documents and medical charts, medical history and waivers all had to be signed, sealed, and shuffled from one doctor to another. It’s a process. Just a day before our first trip to see the new urologist, Tan’s primary called with hopeful news–there was new doctor in town and rumor had it he was accepting Medicaid. Could it be true!?  We continued on with our plans to see the doctor in Pensacola, not willing to gamble away the only urologist we know for sure will provide medical care for Tan, but in the background we worked with the nurses and office staff of the new local urologist to get Tan an appointment. We went from having no doctors two doctors! 

Still in the practice’s infancy, the nurses of the new local urologist practice encouraged us to continue Tan’s care with the doctor in Pensacola. This way Tan’s care wouldn’t be put on hold and any tests we had done with the other doctor could only be helpful for the new doctor. It was a win win situation!

And then we get the call…

Tan’s long-term urologist of yore wanted to know why Tan was moving his care, but only after he learned that the care was being moved to another local doctor. The doctor’s very nice nurse wanted to assure us that the doctor wanted to continue with Tan’s care…just so long as we got a prior authorization approval done before each appointment. Funny thing was, we had tried this route–twice! Tan was refused treatment at the door both times. 

The Bermuda Triangle effect–now we had our choice of three doctors! 

In the end, their was a clear choice of winner in our book. Despite the long-term doctor’s affirmations that he wanted to remain Tan’s attending physician, when we needed him most for a medical emergency we were met once again with refused care until we got a third prior authorization approved, despite the  still current one on record. That Tan need urgent care made no difference, even knowing getting another prior authorization could take 72-hours to three weeks to get approved. The new attending physician in Pensacola canceled Tan’s scheduled appointment. Though it was for a surgery, the cancellation happened just an hour before the appointment where we were supposed to learn about Tan’s tests results; after we had already traveled 331 miles and three hours for that visit. That was one costly missed connection. 

It was the care, thoroughness, and expertise of the new urologist and his staff that sealed the deal, making this match a total knockout. Though the doctor himself was out of town on an emergency, he flew in another doctor from his fellowship to continue the care of his patients while he was gone. In his waiting room he provided patients with a pamphlet detailing his education, study, mission work, fellowship, and publications. His nursing staff were courteous, conversational, and very thorough with the medical and personal information they gathered. Perhaps most encouraging was that the doctor was so experienced and versed with symptoms and care of spinal cord injury. He was encouraging and proactive, provided us with information about future care options to consider, has set Tan up on a new program and has started the wheels in motion for Tan to receive more physical therapy for increased independence with his own care. 

As for the results of the tests done in Pensacola–they’re sort of useless…

Yep, the tests ordered were incomplete. Funny thing was, the reports accompanying thes tests even said they were incomplete tests and had no way of determining the results of the anomalies the doctor authorized the tests for. Tan’s new urologist 3.0 has ordered a complete battery of tests, acknowledging the anomalies worrying us all, and ordered some additional tests to check the function of Tan’s whole urinary system. As a side note, this is the first physician who has ever given Tan an actual physical! That alone made him a keeper.

On to more tests in our future. It’s been a nonstop parade of phone calls from medical suppliers and representatives as we kickoff getting Tan on a new program. We’ve also entered into a new path to more rehab therapy for Tan that is still in its infancy, but it’s all about the baby steps. 

Keep sharing our mission to get Tan mobility independence. If you can, please consider contributing to our goFundme at http://www.gofundme.com/HelpAQuadOut. Follow our advocacy for the mobility independence of wheelchair users and up-to-the-minute updates on our Facebook page at http://www.facebook.com/HelpAQuadOut. Love pictures? Check us out on Instagram @quadout. 

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