The Non-Compliant Patient


Since getting a new rheumatologist in July, I feel as though I’ve been engaging in a polite battle of wits–or will–with him and his office staff. His staff said he required my medical records from my previous rheumy in order to accept me as a new patient. So I did as I was told.

Later, when I finally had my first appointment, he asked me when I’d last seen an eye doctor (I have my eyes checked annually for possible damage caused by taking Plaquenil). Heck if I know… Isn’t that why I had my records sent to your office? Alas, you didn’t review them. I was mildly annoyed, but I was ready to forgive my doctor’s laziness and move forward.

Oh ho! But wait, rather than checking my records, he refused to write a 90-day prescription for Plaquenil until I saw an eye doc. Fine, so I took a 30-day prescription in the meantime and waited to receive a referral in the mail for the eye doc. The referral never came. My medication was running low and I was getting very pregnant and less mobile. I got another 30-day supply. Then I forgot all about the referral and got completely absorbed in preparing for the baby. I refilled my prescription again for 30 days’ worth, using up the last of my refills. Then I had my baby.

One day my phone reminded me that I had an appointment with the doc. Since we weren’t sure if delivering a baby would bring on a lupus flare, the appointment had been made tentatively before I gave birth. But as I had been in the months before and during my pregnancy, I was symptom free! With three weeks of meds left, I called his office to cancel my appointment. The woman I spoke with wasn’t pleased. She grilled me, treating me as though I was being a non-compliant patient. I dropped the niceties (she started it) and told her that if the doc couldn’t give me a compelling reason to see him now, I wouldn’t reschedule until my annual visit was due. Then I asked about getting a referral to an eye doc and a new 90-day prescription (it saves money and can be mailed directly to my home). The woman said I didn’t need a referral (really?) and would send a message to the doc. Two weeks later, I still hadn’t heard back.

Out of frustration, I called my general practitioner and got another 30-day prescription, no refills. Meanwhile, I found a reminder in my calendar to make my annual eye doc appointment–in February.

If my rheumy had only looked at my records in the first place, we could’ve avoided wasting my money on short-term prescriptions. If he and his office staff hadn’t treated me like a non-compliant patient when I refused to waste more money by going to an appointment that wasn’t medically necessary, perhaps I wouldn’t be angrily typing these words.

My mother, an RN for nearly 30 years, once told me:

“You are your own greatest (patient) advocate.” 

Her words are true, but that doesn’t mean the medical establishment will play nicely with those who choose to follow this adage. So in this case, am I being a patient advocate or a non-compliant patient?

5 Responses to “The Non-Compliant Patient”
  1. Helen says:

    ah yes, what a wise mother. I don’t think any of this is uncommon, unfortunately. When we know better we do better, eh? Now you know their game. More office visits = more revenue= more vacations/new cars/ face lift for doctors wife, etc. The main thing is you delivered the cutest baby, and I’ve seen lots of them. You are both doing well. You’ll remain tired for a while and someday you’ll realize you slept until morning and woke up rested without an alarm. Well maybe that’s a stretch.

  2. I agree with our mom, and LOVE the picture, it is so ME today! LA

  3. tattooedpoet says:

    I think you’re handling your shit the best you can in a difficult times. If the office staff can’t understand why a brand-new first-time mother doesn’t want to keep an appointment, then they aren’t very good at their job, which entails working with people’s schedules to get them the care they need. The doctor sounds like he is more interested in covering his own ass than he is in monitoring a patient who has very well controlled lupus, in part because she DOES follow medical advice and takes DAMN good care of herself. I have put up with sub-par doctors and medical staff for far too long because I was too forgiving. My advice: find a new doctor, stat. Oh, and get copies of your medical records in person otherwise you’ll never see them again.

    • lupinelife says:

      Ugh, I know you’re speaking truthiness, but I’m too lazy to change docs right now. But I now have an appointment with an eye doc this Monday, and I’m hoping to get a stinkin’ refill before I run out on Wednesday! Pain in my ass…

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