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Old 10-12-2009, 06:41 PM   #1
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NEED NEW DR--Dr. Z (Maryland) drained my insurance & left me high and dry. NEED HELP!

Im new here. I am a 41 year old male. I have suffered from degenerative disc disease with a mildly herniated disk that has gotten worse over the years and is begining to resemble stenosis.

I also have suffered from anxiety and been on xanax for about 20 years. It has been suggested to me that my pain is amplified due to my anxiety.

I will try to be brief and factual to spare details.

Things were going well for many years as I had convinced my general practitioner to provide qty 120 of 10/325 percoset along with my xanax.

After the Virginia medical review board clamped down on my general practitioner one year, he said he could no longer do so.

A friend of mine suggested an internal medicine doctor, 'Dr.Z' that practices in Maryland who is liberal with the pain meds.

'Dr. Z' had me change my insurance to display him as primary doctor immediately and began placing me on Duralgesic patches starting with 100 mcg and then attempting to find a dosage that would let me lead a normal life took me to 200 mcg every 3 days which has worked for the last 2 years I have been seeing him.

He kept me on the percoset for break thru and later added opana. My insurance eventually had a problem with me being on 2 timed release narcotics (opana/duralgesic) so we switched that a few times and eventually found that 100 mg demerol would have a dual effect to help and at the same time keep my colic laden gall bladder at bay.

His administration consists of a couple nurses and an extremely incompetent receptionist who is supposed to file all the paperwork, but never does. Other patients have complained about her in the waiting room as you spend hours there. She takes the phone off of the hook in the afternoon when the office is full, but I digress.

My insurance requested more information before it would approve an MRI (my third last being in 04). He complained that he wanted me to provide the information, so I did to the best of my ability but I recently received a letter stating declination due to the insurance not receiving any of the additional requested information. I argued with him but to no avail.

Dr. Z now told me that I would have to pay out of pocket for the MRI, or change my insurance otherwise he would no longer see me. I told him that he knew the likely hood of either happening was none.

It hit me only then, that this establishment just puts out pain pills so long as it can effortlessly collect from insurance and could care less about me. I've read where this is more common that one would think as I've searched online for a new doctor.

I realize I am on a lot of pain meds but I think the doses are reasonable and I am productive rather than crippled.

Due to the pain it is impossible for me to 'get a buzz' from anything and Id rather not be on oxycontin but will take what I can get at this point.

If I do not find another doctor that I can convince to prescribe what I have been receiving for a couple years and as recent as last week, I imagine Im going to be a mess at the end of the month.

I can fly anywhere United flies so I just need access to a doctor who is going to understand what has just happened to me although I would prefer to stay in Maryland or Virginia (but I believe Virginia to be a lost cause).

I apologize if this was lengthy. I welcome comments about resources, and what people did when this happened to them. Also if I may have any legal recourse based upon your experiences.

I know this sounds awful from a newbie but I am in a jam and have got to ask outright as there is no way to sugar coat it and I will soon be out of time.

Please give me the names of doctors that are liberal with the pain meds that are nearby airports serviced by United or in the Washington DC metro area.

I havent been in trouble with the law in my lifetime, and I promise to protect the doctor's interests.

As much as I loathe what was done to me, it is more important that I help someone in need than punish the doctor.

If you can do nothing else please pray for me.

Last edited by Mod-S4; 07-26-2011 at 12:06 PM.

 
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Old 10-12-2009, 07:13 PM   #2
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Re: NEED NEW DR--Dr. Z (Maryland) drained my insurance & left me high and dry. NEED H

Welcome to Healthboards. Many here have a wide variety of experiences, thus, can offer lots of support and guidance.

How much is the MRI the Doc wants you to get? Is it possible to change insurance, or are you locked into an employer plan & etc.?

Regards,

Ex

 
Old 10-12-2009, 08:28 PM   #3
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Re: NEED NEW DR--Dr. Z (Maryland) drained my insurance & left me high and dry. NEED H

It is United Airline employee plan. For the whole spine $2500. Doctors in the previous two only opted to scan the lumbar area. I suspect there is trouble in the upper area. My wife recently has undergone treatment for breast cancer. I imagine we have been a huge weight on the insurance company's bottom line and thus the scrutiny where there was non in the past. I imagine this is happening to many as there was a recent video of protesters getting arrested for blocking the entrance to United Healthcare who provides the insurance through a subsidiary.

Even if I did have an extra $2500 lying around I dont think I could justify this. It is not my fault it got declined. The doctor submitted nothing. I will attempt to appeal due to the circumstance but I am doing my best right now just to be brave.

You see I knew this day would come, but not like this.

There is a Dr. in London who is using ones own adult stem cells to regrow degenerative disks. It is in clinical trials. This is my goal.

I am only looking to be on the pain meds until I can afford the cure, then I will be delighted to pay out of pocket.

 
Old 10-12-2009, 09:08 PM   #4
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Re: NEED NEW DR--Dr. Z (Maryland) drained my insurance & left me high and dry. NEED H

Any Doctor who dismisses you, or cuts you off because you won't pay for an MRI is a very unethical Dr. Additionally, I'm sure I don't need to remind you that given the meds you are on, doing so could cause serious consequences, especially the high level of fentanyl you are taking. All Docs take the oath of "do no harm" and I'd be very interested in the Doc's rationale for taking this kind of action.

Despite your family issues and cost structure to the carrier, many carriers don't want to pay for MRIs period....As they feel that they are a test of last resort. The rationale is that many other tests or regimens could be used as an alternative first. But certainly, your families large cost ratio doesn't help matters. Surely your Doctor knows that people can't just go about switching insurance carriers. You get what your employer provides or you get a private plan, which will always have pre-existing clauses....Which I'm sure you'd fall under.

I don't mean to be negative as I'm trying to help....I would do all I could to try to repair / save things with your Doc. Given the high level of meds you're on, it may not be reasonable to think that you can just switch PM Docs all of sudden and stay on the same regimen, unless of course, you have a very unique situation. My biggest issue would be getting an appointment by the end of the month. Is there anyway you can buy some more time?

I'm very sorry you are going through all of this. Hopefully, someone will come along who can recommend a specific Doc in your area. The good news is that you're located in a very populated region, so there is bound to be a Doc who may help. I would be wary of getting on a plane and flying across the country to get temporary help. I would look at things from a more long term perspective, but that's just me and easy for me to say...I'm not at risk of being cut off.

If I had to, I'd even think of getting a lawyer given the short notice and get some type of stay until you can get transitioned, or at the very least, weaned. Protocol calls for at least a weaning script. Given the circumstances you have explained, you seem to have a pretty good case for patient abandonment. 200mcg per hour, or 4800mcg of fentanyl per day, is an extremely high level of narcotic therapy.

BTW, here is a very recent recent thread on abandonment that you might find useful:

http://www.healthboards.com/boards/showthread.php?t=713459&highlight=abando nment

The thread is titled "My doctor is cutting ties after 7 years of pain management. I need advice ASAP!"

Best of luck with this, and I'm sorry.

Regards,

Ex

Last edited by Executor; 10-12-2009 at 09:16 PM.

 
Old 10-14-2009, 12:13 AM   #5
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Re: NEED NEW DR--Dr. Z (Maryland) drained my insurance & left me high and dry. NEED H

Any help much appreciated, your response and sentiment is much appreciated.

I'll check out the thread on abandonment.

I actually thought this doctor cared but the way it has come to a halt, it is clear that he does not.

If I were to make that last ditch appointment I would think I am going to half to say I attempted to and am still looking for a replacement doctor, and if I get no where with that maybe suggest that damages are imminent as legal action if he doesnt help me but I cant predict how anyone would respond to threats even if stated mildly an or tactfully as a last resort. I would appreciate any suggestions on a good way to handle that hot potato.

Speaking of last resorts, what are mine? A methadone clinic (do I call county department of health)?

Licenced suboxone doctor? How many mg of suboxone how often and how long would anyone estimate before I would be fine? I weigh about 220.

I was planning on picking and making 3 appointments with doctors and maybe a fourth appointment with a suboxone doctor last.

Any assistance to even a strategy of how one would approach this if it were you advice will be helpful as I am in a state of disoriented disbelief from it all and I need to get planning for all possible outcomes.

I dont even know what to say over the phone to gauge the doctors, or any criteria I could use to select from the list as it is just a list of 100 doctors that advertise as pain doctors and I dont have time to see them all.

I do not want to end up in the ER because of poor planning.

No detail is insignificant to me right now, it all matters.

I havent received any PMs yet if anyone was wondering. I really hope someone will find it in their heart to help as I will have all of the proof of my meds and the insurance letter.

I hope to contribute to this community in the future, but if I fall off for a while you will know why.

May God bless you all as I have empathy for all those in pain and disdain for those that make our lives more difficult by their careless actions or judgments.

Last edited by moderator2; 10-14-2009 at 05:25 AM. Reason: please do not post websites except as described in the Posting Policy

 
Old 10-14-2009, 08:28 AM   #6
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Re: NEED NEW DR--Dr. Z (Maryland) drained my insurance & left me high and dry. NEED H

Quote:
Originally Posted by WikiWild View Post

Any help much appreciated, your response and sentiment is much appreciated.

I actually thought this doctor cared but the way it has come to a halt, it is clear that he does not.
Why exactly did your Doc cut you off...This may help me formulate a strategy. Now is the time to be honest. Was it just the MRI?


Quote:
Speaking of last resorts, what are mine? A methadone clinic (do I call county department of health)?

Licenced suboxone doctor? How many mg of suboxone how often and how long would anyone estimate before I would be fine? I weigh about 220.

If it were me, I'd go the Sub route (assuming I couldn't find a Doc). I don't know a bunch about Sub, but from what I understand, they put you in WD, and once it starts and happens for a bit, then you start the Sub. You aren't uncomfortable long, I don't think. The Sub kick in quick. Some on the addiction board would know a lot more.


Quote:
I was planning on picking and making 3 appointments with doctors and maybe a fourth appointment with a suboxone doctor last.

Any assistance to even a strategy of how one would approach this if it were you advice will be helpful as I am in a state of disoriented disbelief from it all and I need to get planning for all possible outcomes.
The main issue is "why" you're attempting to make the appointment. You'll have to have some reason as to why you need to be seen right away and why your Doc abandoned you. That's the main issue, I think.


Quote:
I havent received any PMs yet if anyone was wondering. I really hope someone will find it in their heart to help as I will have all of the proof of my meds and the insurance letter.
I don't think new members can receive PMs. You may check the rules. I remember reading something about it. I'm not exactly sure though.


Regards,

Ex

 
Old 10-16-2009, 12:24 PM   #7
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Re: NEED NEW DR--Dr. Z (Maryland) drained my insurance & left me high and dry. NEED H

I believe constant letters from the insurance company eventually took their toll. What was once easy became difficult.

I didnt do anything out of the ordinary or cause any problem but I cant speak for him.

pThank you.

Last edited by moderator2; 10-16-2009 at 12:34 PM. Reason: posted contact info - please read the posting rules

 
Old 10-16-2009, 05:16 PM   #8
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Re: NEED NEW DR--Dr. Z (Maryland) drained my insurance & left me high and dry. NEED H

Even a new doctor will likely require an MRI. I live in Maryland and my PM doctor only dispenses narcotics judiciously and you also have to be involved in other forms of treatment such as physical therapy, biofeedback, and, if appropriate, some procedures. I am not an expert but I would think that it would be difficult to find a new doctor who is willing to prescribe these levels of narcotocs. I would clearly establish a safety-net plan, such as the Subxone route, as you very well may be in withdrawal before you have a new appt established. You could also let your currect doctor know that, since you cannot afford the MRI, you would like him to implement an established protocal for taper off the medications as this is really a reasonable request. I would also consider a reduction in your dosage of narcotics and supplementation of lower doses with other pain medications designed to target the specific type of pain you have such as Lyrica/Neurontin for nerve pain, Celebrex for inflammation, etc. In addition, I could be completely off base here, but I am going to go out on a limb and say that I have a sneaking suspicion that your current doctor is not just wanting but needing that MRI in order to justify to an external source his rationale for prescription of this level of these types of narcotics. In others words, if he is doing this for many patients, without documented need, he could be feeling some heat. Just some things to think about. Hope all works out for you.

 
Old 10-16-2009, 08:54 PM   #9
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Re: NEED NEW DR--Dr. Z (Maryland) drained my insurance & left me high and dry. NEED H

Quote:
Originally Posted by CaliGirl View Post

You could also let your currect doctor know that, since you cannot afford the MRI, you would like him to implement an established protocal for taper off the medications as this is really a reasonable request.
Yes, CaliGirl is correct.....A taper script is most appropriate. PM protocol clearly calls for a taper script when terminating a patient....Even those who have been caught red handed doing something they shouldn't.

Regardless of the "reason" for the Doctor / patient termination, the fact remains that you are on very high levels of narcotics and a sudden stoppage can be very, very dangerous. All Doctors take the oath of "do no harm" and cutting you off cold turkey is a clear violation of this oath, IMHO.

Best of luck to you.

Regards,

Ex

 
Old 10-19-2009, 08:59 PM   #10
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Re: NEED NEW DR--Dr. Z (Maryland) drained my insurance & left me high and dry. NEED H

Thank you all for your caring and informative comments and please keep them coming. I am exploring all avenues.
You are right he does owe me a taper.
His business has tripled since I first saw him and I think this has something to do with it.
When I showed up for my appointment last time at 3pm there was actually someone who was waiting to see him that had a 9AM appointment!
He doesnt need me anymore and is only seeing 'easy' problem free patients.
I imagine I would be made to wait all day on my next visit.
Ill keep you all informed and keep checking back!

 
Old 10-20-2009, 07:21 AM   #11
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Re: NEED NEW DR--Dr. Z (Maryland) drained my insurance & left me high and dry. NEED H

You are welcome to try my PM. He is located right in Reston..and that's not far from Dulles. But as in all things, as good as he is in dispensing meds, I don't think that he will just give them to you willy nilly like you had them before. Those were, as Ex said, extremely high doses, without any other modalities tried.

My PM is the 3rd highest scripting PM in northern VA, so he is aware of meds and what goes on. You will have to really be able to justify what you need and why. If you had copies of your records from the the other place that would help...... His name is Dr. Thomas T. Nguyen - pronounced Win. I adore him and what he has done for me. Good luck.

 
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