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?