Story of my primary care doctor's office

As promised yesterday, here is the story of trying to get a scan ordered by my PCP.

On Monday, May 16, Mark and I had our follow up appointments with our new primary care doctor. We had each been asked to have blood work done, and this appointment was to go over the results. As it turned out, I had already received my results from my radiation oncologist much earlier because he had gotten a copy. My results were all fine; however, during that visit, I mentioned to him that I had been feeling light-headed, dizzy, sort of like I would pass out when I walked a lot in the heat. It had been happening since mid-March because I know I was walking around Epcot with Evey when it happened one time. He checked my ears and pronounced them fine. Then he said I should have a CT scan of the head, but I needed pre-authorization from CIGNA for that. He said his office would get the pre-authorization and then call me to set up an appointment for the scan; meanwhile, I should make an appointment for one month to follow up on those results. I left with an appointment for July 7.

On Wednesday, May 18, I called CIGNA to see if I had the pre-authorization. They had not heard from the PCP's office.

On Tuesday, May 24, I still had not heard from the PCP office, so I called CIGNA again. No, they had not heard from the office either. There is nothing in my file about pre-authorizing a CT head scan. I then called the PCP office main number, which links you to a customer representative. I explained the situation to the girl who answered. She set us up on a three-way call with the PCP's local office. I explained to her that I was still waiting for the pre-authorization. She said she would look into it and get back to me.

On Friday, May 27, the customer care girl called me back to see if I had heard from my PCP office. I said no. She said, "Do you want me to call them right now and set up another three-way call?" At that point it was 4:30 on the Friday before Memorial Day weekend. I opted not to set up the three way at that time. I said that since they closed at 5, there was nothing going to be done before next Tuesday anyway.

On Tuesday, May 31, I called CIGNA again to see if by some chance the pre-authorization had come through yet. She said, no, but by the way, you don't NEED pre-authorization. HUH??? The PCP office said I did need it and the two previous phone calls to CIGNA had not mentioned this. Well, she repeated that I did not need it and apologized for the other CIGNA reps lack of explanation. Hm...So immediately I called the PCP office directly (skipping the customer service number route) and explained everything to two different people. Now is when it goes beyond frustrating and into the weird. I explained everything and asked for a prescription to take to the imaging center when I set up the scan. She said OK. She would get the doctor to write the prescription for my ABDOMINAL scan. WAIT! I said HEAD; there is nothing wrong with my abdomen. She said, NO, I can't get you authorization for the head because in the doctor's notes he wrote abdomen. I said that in my patient instructions form that I got as I left the office (and which I was looking at right then) it said HEAD. Well, that may be true, she said, but his notes say abdomen, so that's all I can get you. I said forget it. I'm not having an abdominal scan, so just cancel my July 7 appointment. There will be no need for that now. She said don't cancel the appointment yet. She wanted to contact the doctor and get it straightened out. She will get back to me. That was the last conversation I had with the doctor's office.

On Friday, June 3, I had my four month follow up with my medical oncologist. During that visit, she asked a long list of questions about any symptoms that I might have been having in the last four months. When she got to light-headedness or dizziness, I explained this whole story. She said, no problem, I'll write the prescription for the CT head scan as well as an ultrasound of the carotid artery and mammograms. The front desk will set up all the appointments for you before you leave the office. And they did. I'm having the CT head scan this afternoon at 3:30 at the cancer center. (Of course, I have to call CIGNA and remind them that the radiologist who is going to read this is not a CIGNA plan doctor but that he has contracted with the cancer center and is entitled to be paid by CIGNA. That took months of calls after my February PET scan!)

The icing on this cake is that when I got home from the oncologist visit, there was a voice mail on my home phone from some other imaging center that I had never heard of before asking me to call to set up my appointment for my scan. She did not say what type of scan, so I don't know if the PCP office called in an abdominal scan or a head scan. It's still too early this morning as I'm typing this blog to call them back and ask. I will be doing that at about 9 a.m. this morning. I will also be telling them that I won't be using their services. Apparently the PCP office must have sent the prescription directly to this imaging center, but they did not bother to call me and tell me that they had done that.

My medical oncologist did, of course, say she cannot do primary care work. I need to have the PCP's office call her office to get these scan results and keep my appointment with him on July 7. She also said that if the results are normal she will not call me. If there is something irregular, I will hear from her office right away. That's good.

I'm thinking this really ought to be the last nail in this doctor's coffin. Everyone told us to drop this doctor after our first unsatisfactory visit back in March. This is just pure incompetence on everyone's part. We have been given the name of a PCP about 25 minutes up the road by people in my cancer support group. Everyone loves this guy and he takes CIGNA. Mark and I plan to switch to him soon.

Meanwhile the X-Men movie and rodeo were both excellent yesterday. I also had a nice half hour swim in the pool while my arm was unwrapped. It will be rewrapped today at 2 p.m. I also have my six week follow up with the radiation oncologist this afternoon right after the PT appointment and before the head scan. Three doctor's appointments in a row! I know I'm old.

PS I just got off the phone with the other imaging center. YUP, sure enough. They got a prescription for an abdominal scan. Needless to say I declined that offer. I am calling the customer rep for the PCP and explaining all of this.