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Old 09-06-2008, 12:13 AM   #1
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When [under what conditions] do you contact your PM and how easy is it?

I hope to find out what other people's experiences are with calling their PMs -under what conditions do you contact your dr. between appts., do you feel like your doctor encourages or discourages you from calling? Does the office staff make it easy or hard to contact the doctor?

Supposedly, it's a red flag to contact your PM "too often." The receptionist at my PM's practice appears to have had an unhappy childhood ;-). Actually, no idea what her deal is - she is simply a sourpuss . One of her main objectives in life seems to be to prevent you from getting through to the doctor (I understand that the receptionist has this function in some places/practices.). She doesn't leave messages for the doctor that she says she is going to leave, which resulted in missing a call from the doctor. Today she simply refused to give my doctor the message that I was trying to reach her. At least she was honest this time. She sounds irritated that she has to talk with you at all.

My mom thinks that the office staff is a reflection of the doctor and the practice, something I'll have to consider a bit more.

I know there is a wide range of availability w/ PMs. My first PM would not take any calls between monthly appointments.His PA and nurse returned calls if they felt like it, which was rare.

My current PM seems to lie somewhere in the middle and the receptionist for the practice seems to be in the same place as my previous PM.

I really don't think pain patients should feel badly or feel like they have to hold back on calling their PMs in the middle of a med change if there's a problem. If there's any question about medication, I would like to feel ok about calling my doctor. I can understand doctors getting upset if you call when you're stable and nothing is going on, but I don't like feeling that I can't call her if there is a problem with my meds, especially during a change.

I know it's sometimes considered a red flag if a patient calls too much, so I'm curious when people call their PMs - under what circumstances will you call your PM? I imagine it varies somewhat according to whether or not you have a sourpuss as a receptionist, and if the dr. encourages or discourages you from calling, and what your relationship w/ the doctor is like, among other things. Thanks for sharing your experience here with calling your PM here (and if you have a sourpuss receptionist, feel like your dr .encourages you to call if there is a problem).

Last edited by Confused089; 09-09-2008 at 01:51 PM.

 
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Old 09-06-2008, 04:37 AM   #2
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Re: When [under what conditions] do you contact your PM and how easy is it?

Confused, Since I am kind of new to PM I cant say to much, but I know mine does get his patients in if he can. How they decide I dont know. I have heard a patient thanking the staff for getting him in & of course they requested I come in when my pain was flared up. Mine also took me aside when I had a question & I was only there to pick up a script. On the other hand I felt rushed through an appointment & did not feel I had his attention. I will say I know I still have a good PM & that your mother is right, the staff reflects on the PM & vice versa. I know you have responed to my posts about my PMs staff & I am grateful that thus far this staff is really attentive. I ruled out PMs because of the attitudes of the staff during the calls I made when choosing a PM.

Of all practices PMs should have a compassionate staff. I feel so bad for you because you are left to suffer & so unsure on how to proceed. I honestly think you should address these concerns at your next appointment. I guess it would be in the way you approach & word it. IMO I think you have every right to ask questions & be given an answer. I would let her know you dont want to be left wondering & in pain but at the same time you dont want to be "red flagged". Let her know if at all possable you would just ride it through till your next appointment but in cases like this you are just suffering way to much & the expense of it all is to much of a burden, my gosh you dont have a money tree. Think hard on the best way to approach it but try your darndest to get some answers. Its not right at all, I understand PMs can be overwhelmed with calls, look at us here, we all have some bad days, but if its ongoing it needs to be addressed & that is a PMs job. When is your next appointment?
I am realizing I chose well with my PM, & that is thanks to what I learned here. I really investigated & used my CP family here to help me choose.

Steve, who I have deemed "communication coordinater" is great with helping out when it comes to communication between us & our PMs/doctors. I am hoping he will have some suggestions for you. Hang in there & if it gets to the point you cant take it then try put in a call. If its that bad what do you have to loose? good luck, you are in my thoughts, Sammy

 
Old 09-06-2008, 07:01 AM   #3
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Re: When [under what conditions] do you contact your PM and how easy is it?

I understand exactly where you are coming from, and deal with pain every single day too. I do not have a pain management doctor, but I have asked many times for a referral to a pain management, but my pcp felt he could manage my pain on his own. I had a couple of other problems with my pcp so he is no longer my pcp, and I have new one, who has agreed to take on my care. Do you get more help when you call the answering staff, and then they can page your doctor? I am sorry you have to feel this way, and battle the sourpuss repceptionist, all you want to do is get quality pain control, and the right help.

Yesterday I went to an eye doctor who specializes in problems of the eye, or behind the eye, and I traveled 3 hours, and then on my way back, still 2 hours away from home, I saw my facial pain doctor. I thank god for him, 2 days ago I had a tmj flare up, and as he examined me he said my tendon is inflammed, and my face is spasmsing, and very painful again. He said we need to get the spasms under control, I am not his typical patient, and we might need to go the surgical route. He made me feel validated, and ok. My pain is, and can be extreme, not only from tmjd, but also from fibromyalgia. He gave me a new prescription for my breakthrough med, vicoden 10/325 and take 2 every 4-6 hours. I currently have been taking vicoprofen, ibuprofen and hydrocodone, and the pain has been so bad, so I have been taking over the daily maximum of ibuprofen for a while now. It scared me some, so I am relieved with a change for awhile. Here's where I was afraid, I had a contract with my old pcp, switched doctors officially this week by signing the release, and my new doctor told me she was not comfortable taking over my pain management until she had my medical chart. So I guess I am in between, and do not have a contract. I like following the rules, and I do not want to do anything wrong, I respect pain management too much, but yesterday I needed help. I called my old doctors office and they said it was okay I get a pain medication from my facial pain doctor (after all he is my facial PAIN doctor, but I have never asked for help from him), but to call my new pcp office and tell them of the rx and why. I was unable to do that due to I got out of my appt after 4pm, and they were closed. I still feel bad, but my facial pain dr, was comfortable, he saw the pain, and even told me to increase my valium to 2 a night instead of 1.

Why are we, who have real pain, that is sometimes unmanageable, and we are nervous, apprehensive, and scared to ask for more help? It is not right, and unfair to us, who need help.

So I came back home and took my new rx to the pharmacy, the same pharmacy I take all my pain medications to, and the pharmacist said, "you are taking an awful lot of these." I felt so bad that he said that I almost wanted to cry. I had my medication bag with me and I showed him how I had close to a full bottle of pain medication, and that my facial pain doctor wanted to give me something that did not have ibuprofen in it, and something that might help control the pain. I seem to not do as well on oxycodone, and better on hydrocodone. I wanted to tell him, to expain why I am in pain, he said, "now why are you on medications again?" I began to tell him my list of diagnosis's, and at first he took out a piece of paper and pen, then after I listed off the 5 or 6, he said,"ok, I understand now, and that was it." In the meantime, I have my children with me they are 2 and 5, and I need to be able to take care of them, and they are ransacking the store. I have always liked this pharmacist, but he made me feel terrible yesterday, like I was doing something bad. I do not need that, I deal with it everyday from family who are not educated, and have called me an addict, my own husband. I also take a long acting med, oxycontin 20 mg, and recently I wanted to get off this med, so I was on 40 and went down to 20mg. I do not feel I respond to oxycodone, I never felt anything but some pain relief when taking it, and I am still in pain.

Have you ever said anything to your doctor about how to better reach her? Or have you ever said anything about the receptionist? Maybe she is in the wrong office, or wrong field. If she said oxycontin she meant long acting, are you taking oxycodone for bt meds? I know it can be confusing. I know we are never pain free, usually we strive to be at a 3 or 4, and we feel better, but usually we are higher, and it is so discouraging, when we cant get relief. I am sorry, again, that you have to deal with this, but maybe you need to be more stearn and really tell the receptionist what you are going through. She might respect you more, and get you right through to your doctor. Or next time, bring her a small gift, kill her with kindness, like a box of chocolates, or small bouquet of flowers, something to feel like she is special and needed, it might make the world of difference. Good luck, and I hope your day is pain-less.

Kass

 
Old 09-06-2008, 08:36 AM   #4
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Re: When [under what conditions] do you contact your PM and how easy is it?

I really shy away from calling the doc, because of the potential problems you mention. Luckily, when I call the office, I can "press 2" to leave a message for the clinical assistant, who will convey the message to the PA I see. I have only had to call once to talk to the PA, and when I left the message, I stated that she told me it was okay to call. If I were you, next time you have a doc appointment, I would mention your difficulties with getting through, and ask if there is something else you should do if you need to get through to leave a message or if you have problems that require the attention of the doc.

 
Old 09-06-2008, 01:27 PM   #5
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Re: When [under what conditions] do you contact your PM and how easy is it?

Confused, I have been thru h*ll and back with getting proper pm and PRAISE GOD I finally have that like you have said. I am so ever appreciative because I have been in your spot.

My view on this has really changed in the last month. I think one of our responsibilities as a cp patient is establish upfront how the doctor wants us to handle this type of situation. I would even go as far as to say:

*since we are titrating medicine is it possible for us to see each other sooner than our monthly appt. Could we see one another in one or two weeks instead of four weeks? Explain that you would rather pay an extra co-pay and see them face to face to discuss any problems/issues you might have rather then sit in pain and wait a month to see them or mess with leaving messages or getting a third party involved in the message process. Maybe they would even consider doing a pre-arranged scheduled telephone call instead of a face to face visit.

*I would also ask once you are stabilized and you have a problem such as a pain level of [U?7?/U] that is not controlled by your current meds how they want you to handle it. Would they prefer an email, an office visit, or a message being left? I would be sure to clarify what pain level they want you to start calling at for assistance.

Lastly, I agree and would sweeten up that receptionist on your next visit. I would thank her for her compassion and kindness the past couple of weeks (even if you have to swallow hard and bite you lip when you say it) during your transition and difficult time. I would even do this for the doctor as well.

Honestly, I would not call and leave a message unless I absolutely could not get a face to face meeting and if you are doing any major medication changes on your next visit ask to be seen the following week so that you don't have to deal with this mess of messaging again. Good luck.

Last edited by ms_west; 09-06-2008 at 01:27 PM.

 
Old 09-06-2008, 02:09 PM   #6
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Re: When [under what conditions] do you contact your PM and how easy is it?

I agree with pepper that you should sweeten up the receptionist. I was just thinking about making candies and cookies for the holidays for people, and I will definitely bring in a box of home-made caramels or christmas cookies for the receptionist at my pain doc's office, with a "from" tag. I have an unusual name, and so people tend to remember me when I am making appointments or calling for something.

When people are friendly to me at work, I'll admit that I usually put a little more effort into working on their requests for my assistance. When I have a good memory of working with someone, I am more likely to try to pull strings for them and I make sure I respond to their messages right away. I just can't help it. I think most office personnel are the same way. It's possible that this woman is just sour all the time, but it is worth it to try to get on her good side.

 
Old 09-06-2008, 03:57 PM   #7
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Re: When [under what conditions] do you contact your PM and how easy is it?

Confused...I say CALL. They are there for you. They are working for YOU. You are paying them big money to be taken care of. In the middle of a med change, especially, you should be able to have access to the very one who changed the meds to begin with! If you have to talk with a supervisor, or an office manager, then you just should. The "gate-keeper" shouldn't have a say in whether or not you get your troubles addressed with the doc. It just infuriates me to think about you sitting there hurting, while wondering if your doc will help!!!!!!!!!

 
Old 09-06-2008, 05:41 PM   #8
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Re: When [under what conditions] do you contact your PM and how easy is it?

I think that doctors [especially those who spend a decent portion of their time doing surgical procedures - ESIs, etc.] don't feel like spending time w/ patients is where the money is. Compared to doing a "procedure," they don't get paid much for patient consultations. I think this is why we're seeing "boutique" medicine more often. The doctor either charges an extra "flat rate" above insurance each year or has patients submit claims to insurance for reimbursement [which means that they avoid the negotiated fee w/ the insurance company.] From their perspective, patient time is not paid very well and phone calls aren't reimbursed at all. I think that doctors who deeply care about their patients or whose self-esteem is based on doing the best job possible will go the extra mile w/o the extra dough though.

I would like a doctor who sees a challenge and is inspired to find a way to address it.

Last edited by Confused089; 09-09-2008 at 01:48 PM.

 
Old 09-06-2008, 05:57 PM   #9
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Re: When [under what conditions] do you contact your PM and how easy is it?

I am one of the lucky or the ONLY one who has a doc like I have. Ive had him for going on three years, and have had his cell phone number from day one.
He is amazing and always picks up even if he is in his car or in with a patient. I try to call him at the end of his lunch, however, he has always told me to call whenever I need anything. He isnt a pm is is a GP, and Ive been with him without being under contract since I met him. He does have other pts under contract. I am extremely lucky, he is a wonderful man, and I try not to bug him more than I need. Usually its just to call him every month to remind him to send my script, and to talk a bit about how things are going.
If I were to have any other doc I would be lost. He is a true friend as well as a doc, and I adore him.
I wish everyone could have my doc. He is an amazing doc, but an amazing wonderful, caring person as well. He wouldnt care if I called him three times in a half hour. Ive not done that, nor would I, but thats just the kind of man he is...
Again, my doc is a RARE breed. Im so very lucky...
xoxoox,
IZZY'SMOM

Last edited by IZZY'SMOM; 09-06-2008 at 06:10 PM.

 
Old 09-06-2008, 05:58 PM   #10
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Re: When [under what conditions] do you contact your PM and how easy is it?

Pepper, everyone - thank you for all the practical suggestions on how to handle this. I think that the advice about asking exactly how the doctor would like me to communicate with her [and offering a lot of thanks for her help during this period] is a very good idea.

Speaking of human, it really is hard not to want to be difficult with sourpuss - I have to remember what is in my best interest. I know sourpuss' attitude has nothing to do with me, and that, unfortunately, she is just not a happy person and does not enjoy her job. If I can keep my focus a bit more on the fact that she is an unhappy person and try to brighten her day a bit instead of trying to push through her sullenness, I will do better. I should have prefaced my last call to her with "thank you . . . "

Last edited by Confused089; 09-09-2008 at 10:37 PM.

 
Old 09-06-2008, 06:13 PM   #11
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Re: When [under what conditions] do you contact your PM and how easy is it?

Izzy- you are truly blessed with such an incredible doctor - I actually forgot to put your dr. on my wishlist - there's a few other PM'ers who have doctors I'm envious of...I've been trying to figure out where I should move ;-) - over to Pepper's neck of the woods, Steve's, yours...;-) A great doctor is really tough to come by. Frankly, after my first PM, I should still be grateful that my dr. will see me more than once a month, and *does* try to return my calls if she is told about them. I have had a doctor give me their cell phone number once or twice and have always been very careful about disturbing them. I know you dr. is just happy to hear from you and really cares about your well-being. You are *really* lucky Izzy - it feels like your doctor is part of your support system.

Last edited by Confused089; 09-09-2008 at 01:47 PM.

 
Old 09-06-2008, 07:00 PM   #12
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Re: When [under what conditions] do you contact your PM and how easy is it?

Kass, I am really sorry you had the experience w/ the pharmacist. It just isn't their d*** business and they have no right making you feel like you are on too high a dose. It must be very frustrating to run into a wall w/ your PCP on pain management. GPs just don't have the training for pain management - I don't like it when a GP, or any other doctor, doesn't acknowledge where their expertise ends and when they aren't acting in the best interest of the patient by not referring them to a specialist. This happened to my dad recently - his GP, who is actually a cardiologist, tried to treat an injury he knew zip about and wound up making it far worse.

I am really sorry your family is not being more supportive either. I hope you will post more on the board and get some support for your pain here. You might want to share some of the posts here with them. No one will judge you for being on pain meds! Thank you for your advice on sweetening up sourpuss.

Last edited by Confused089; 09-09-2008 at 01:47 PM.

 
Old 09-06-2008, 07:05 PM   #13
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Re: When [under what conditions] do you contact your PM and how easy is it?

Before, my doc moved to a big city, and now he is in a huge hospital, he would make house calls. No lie. He was the last of the small town docs who would drive 45 minutes one way just to see someone.
But even now that he has moved on, he still has the same consideration for me and my family. He is 5 hours away now.

Also, I gave my compound pharmacists a gift cert. the last time I was there. They always make my meds up within 2 hours because I travel so far, and I wanted them to know how much I appreciated it. they said they had NEVER ever had a thank you or anything form a customer like that. It is a huge chain pharmacy and they have just started compounding.

The last time I went they all said "thank you" and that they had all closed up after work and went and spent the certificate. They were blown away. I got them all a huge certificate to a movie theatre and they all went to the movie after work a couple of days later, so I do agree with the fact that if you do have ppl that go out of their way or help you more than others, they really do appreciate you adressing that fact.

There are lemons in every walk of life every day, but sometimes if you add a bit of sugar even the sour pusses can be sweetened a bit.
I wish you well....
xoxoxox,
IZZY'SMOM

Last edited by IZZY'SMOM; 09-06-2008 at 08:29 PM.

 
Old 09-06-2008, 11:06 PM   #14
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Re: When [under what conditions] do you contact your PM and how easy is it?

Izzy, that was really sweet [and smart]. Small tokens of appreciation can really make a person's [or in this case, a staff's] day. So, often people forget to express appreciation and gratitude, and it's so important. I'll try to remember that sourpuss isn't happy, may not like her job or feel appreciated for what she does.

Last edited by Confused089; 09-09-2008 at 01:46 PM.

 
Old 09-07-2008, 07:58 PM   #15
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Re: When [under what conditions] do you contact your PM and how easy is it?

Quote:
Originally Posted by Confused089 View Post
I would like a doctor who sees a challenge and is inspired to find a way to address it.
I could not agree more with this statement. How do we encourage this with our docs? Confused, maybe this deserves it's own thread?

 
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