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General Rant about the US medical system

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FauxLiz

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Okay, I am struggling today as I scheduled and completed 4 medical appointments and find myself in two very different and very perplexing situations thanks to the way health care is "managed" for lack of a better word in this country.

One of my appointments was for a cervical interlaminar steroid injection, another with my PCP for my annual physical, and another "routine" med check with my P-doc. The injection is a painful procedure that could be much less painful and thus traumatic with sedation but the specialist that can provide the procedure is a three-hour drive from where I live and sedation would require a driver and I don't have the support system that can provide someone I feel comfortable asking to take a full day off from work to accompany me. I get it but it is frustrating and I just feel so hopeless.

At my physical my PCP has referred me for a colonoscopy and even though I can get the procedure closer to home (it still would be at minimum a half-day off from work for someone to be my driver/caretaker at it would still be an hour each way and three hour procedure time) I have looked into non-emergency medical transportation but I don't qualify for any of the services in the region where I live as I am not old enough or physically disabled enough so in spite of a significant family history of colon cancer I won't be scheduling the procedure. Which seriously, I don't see any other options which again makes me feel worthless and hopeless but then maybe it's for the best, no screening increases my chances of having undetected cancer or other issues which would permit me to just say screw treatment. Insurance would benefit from early detection to reduce potential costs of untreated issues but they don't offer transportation assistance unless I am in a wheelchair or over 65.

Then my med check with the P-doc. Not an ideal situation he is located in the area where my specialist is and though I had transferred to a P-doc closer to where I live when I moved he left the practice and I couldn't get into anyone closer to do med management for 9 months and couldn't wait that long for med refills. The practice where my P-doc is still using paper records and refuses to electronically transmit to pharmacies prescriptions for controlled meds so I can't see him virtually (even with COVID). Today, he was my fourth appointment, I was "hangry" because of the need to refrain from food and liquids for the procedure and I really don't like him so I pushed back and asked why it is that they can transmit the non-controlled meds electronically to the pharmacy but not the controlled which he finally admitted was just how his practice prefers to operate. Then he told me that the practice has instituted a drug screen requirement for all med management patients. This was after we had just finished reviewing my current meds (I have a chronic pain condition, ADD, major anxiety, and a host of other conditions including PTSD and MDD) which include an opiate, benzo, amphetamine, and all including the P-doc approving of my use of legal marihuana products to reduce my need for multiple other meds to manage the conditions. I asked what the purpose was of doing a drug screen (which yes has a cost to me) when he knows from my current meds all of those items will show up in the screen to which he said that under current regulations it is required. Being in the mood I was in I pushed back again and said no, it is not required as it if was all of my other prescribers (PCP and Pain Specialist) would require the screening, that the FDA recommends screening but it is not required. I know for a lot of people a drug screen would not be an issue, however as my employer receives federal funding and therefore must be a zero-tolerance policy in regards to drug screening. As my health insurance is provided by my employer I am concerned that a positive drug screen could possibly affect my insurability which would raise a red flag with my employer and cost me my job. I am not subject to random testing but would be required to do a screen if I was involved in a work-related accident or injury. I know I am taking a risk with the marihuana products but as I am not under the influence at work it is a risk I am willing to take as I consume less than a 5 mg edible when needed when I am at home and not going out for at least 12 hours. Again I feel as though it is a hopeless situation, I can try to find a different P-doc but I am not hopeful that would be a fruitful search. The P-doc agreed he would hold off on the order until our next appointment in 3 months but I am not any more likely to be agreeable then unless I somehow won the lottery.

I just feel like giving up. I am struggling in therapy, and having issues with my therapist I feel as though what is the point? I want to just walk away from the entire medical and behavioral health establishments but the meds are the only thing that has kept me even partially stable not having them well I guess that could be described as a not regulated method of physician-assisted suicide as I feel like they are controlling my survivability with these discriminatory/exclusionary policies.

Well if you have made it this far I hope that I haven't depressed or upset you with my venting I just want to curl up in a corner somewhere and disappear.
 
I asked what the purpose was of doing a drug screen
In what seems like a bizarre twist on this (at least to me), I have a friend who was getting an opioid for a chronic back problem. There might be room to debate whether or not that's actually the best way to handle things, but that's how they were handling things. She doesn't have much money, so she puts stuff off. She ran out of meds a few days before an appointment. They drug tested her, found no drugs in her system, accused her of selling her prescription, and took her off the opioid right then and there. With no "Plan B" I might add, just "go home and deal with the pain". It really seems like there should be a better way to run a health care system.
 
Yeah, I'm a victim of similar issues in the American medical system. The whole thing just sucks balls. Needs an overhaul, and some serious humanity shot back into the system. Right now, everyone's so tied up in knots "following the law" that lots of people who need real help are left flapping in the breeze. I hate them all.
 
he doesn't have much money, so she puts stuff off. She ran out of meds a few days before an appointment. They drug tested her, found no drugs in her system, accused her of selling her prescription, and took her off the opioid right then and there. With no "Plan B" I might add, just "go home and deal with the pain". It really seems like there should be a better way to run a health care system.
@scout86 I get this. I am I suppose fortunate that the opiates that I am prescribed are for use on an "as needed or PRN" basis so there is not a steady level in my system at any given time. They are considered "emergency rescue meds" for my daily migraines that I take when all the other meds have failed and I not only can't function but can't sleep, eat or keep fluids down. The med is delivered as a nasal spray so that it works without needing to be swallowed or injected which if I can't keep things down would have them not work and when I am in that much pain I can't self inject.

I have been to pain specialists before and have other friends that see them regularly and also face the uncertainty of what happens if the levels in their system are not steady if the doctor goes on vacation, their appointment has to be canceled for any reason, meds get lost, stolen, whatever they run the risk of being left out in the cold as your friend was and that is no place to be.
 
An industry in total dysfunction.
Sorry for your distress.
Our medical decisions are dictated by politicians seeking campaign funds and trial lawyers trying to get rich.
You need feel NO guilt for being angry, venting, OR BENDING the system to your will (If that's even possible).
We'll all be seeking MSNT.....Medical System Navigation Therapy....
Thank you for posting.
Me too.
 
They drug tested her, found no drugs in her system, accused her of selling her prescription, and took her off the opioid right then and there. With no "Plan B" I might add, just "go home and deal with the pain". It really seems like there should be a better way to run a health care system.
Cha. I think most of us on opioid meds have had that happen at least once. I keep half a tab -not enough to be in any way effective- on reserve to take the night before just so I’ll pop positive... which is freaking bizarre... as I only have a 2-3 week “supply” per month. The rabbit ears are because those are actual doses, taking one dose a day my Rx stretches for 2-3 weeks. If I took my meds every 3-6 hours? They’d be gone in 3 days. Which I know from acute injury. Because I only use my chronic stuff for certain kinds of exercise, it’s low dose, low count. And yet? I’ve still been taken off of them for 6 months because I didn’t test positive. Um? Hello??? Not my doctor’s purview, it’s a computerised thing, that pisses him off waaaaaay more than it pisses me off. That 6 month time frame? Is because that’s how long it takes to do 2 days worth of tests to make sure there’s real physical need. (Because apparently doctors can’t be trusted to read charts and understand that a degenerative condition isn’t going to magically get better, and go off of the last round of tests). At which point I’m always offered a patch <brick wall bang head> of a MUCH stronger drug, and an Rx for a chair, and referrals for handicaps plates. Um. No. Yes, I’m a BIT banged up. Which is why I use my low dose stuff to exercise. f*ck off with the rest of it, already, and stop interrupting my ability to exercise by taking away my “these can’t be doing anything for you” (YES. THEY DO.) All I want is the edge taken off the pain. And to stay as active as possible. Stupid f*cking computer systems. Leave my doctor alone to manage his patients, and stop trying to get me to take an opiate 24/7/365 becuase it makes your programmer think I’m “less” of an addiction risk? Programmers apparently don’t science so hot. At least not the ones who write medical software. <casts eyes heavenward>
 
"go home and deal with the pain"
This is what I do. I can't get meds (I have no history and the last time I was given a month supply it took me much longer to get through it). I also just quit going to the doctor, even though I have high BP and diabetes. I'm not being treated because I have no insurance and no one wants to treat me at a reduced rate. My pain is so bad much of the time I can't function, so I figure it won't matter if the other two kill me.

The medical system in the US needs a complete take down and overhaul.
 
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