This will be another frustrating, whiny read. You have been warned. Ha.
I’ve still been trying to get an appointment with another endocrinologist after my last horribly disappointing experience with the Lovelace office. The last time I called UNM, I got the “Don’t call us, we’ll call you” treatment. And the concierge endocrinologist wasn’t taking new patients.
I don’t know what made me check her website again, but I did, and now she IS taking new patients. I filled out the contact form on her site immediately. And waited. The message after filling out the form said, “Please be patient. We will contact you as soon as possible.” Hmmm. It had better not be too long. In my mind, that wouldn’t bode well for a concierge provider.
I also called UNM again. I spoke with another nice woman there who said that yes, they had my referral, and they had received my records from Lovelace. I thought that was odd as I don’t recall telling them I had previously been seen at Lovelace. But maybe I had. Then she said, “Since we have all that, I’ll forward your information to the referral department so they can reach out to you and get you scheduled.”
So…. If I hadn’t called that day, would my referral just have sat there for all eternity? I don’t understand any of this. I didn’t ask that question because certainly pissing off the people responsible for forwarding my info to get an appointment didn’t seem like a wise idea. But what the hell man.
When she mentioned getting my records from Lovelace, she said, “I’m surprised we got them. We have a really hard time getting stuff from them and having them return our phone calls.” “Don’t even get me started,” I told her. “That’s why I need to get away from that clinic.” She also said, “And it’s not just UNM that’s backed up for appointments. All the specialty clinics are.” I said that I was well aware of this, that I was a ‘specialty’ provider, and I’m already booking appointments into 2025. (No exaggeration. It sucks.) She said one woman who called didn’t want to wait the months it was going to take to get an appointment, so instead she called a clinic in Texas and got in within a week.
Hmmm. Another potential avenue. I have ‘federal’ insurance. I’m not bound to care only in New Mexico. Time for a road trip??
A few other things dawned on me… I could check Santa Fe and Rio Rancho, which I don’t think I had done before. And I wondered if I would be able to schedule a telehealth appointment with an out-of-state endocrinologist. I didn’t know how that would work in terms of ordering blood work and tests and such, but I made a mental note to call BCBS and ask that question.
Every other Wednesday when I’m at chemo, they do blood work. On Friday last week, for whatever reason, I decided to look at my results from over the past few months. I used to be very diligent about checking it but then I fell out of the habit because a) either my creatinine was too high, and it was depressing since there’s nothing I can do to reduce my creatinine, or b) it was normal(ish) for me so I didn’t need to check it as religiously. I slacked off.
Holy shit. Over the past several months my blood sugar (part of the comprehensive metabolic panel that also measures creatinine levels) was sky high!! Back in November, it was fine. Since that time, wow. Nothing has changed. I mean I have a terrible diet, but I did in November too. I did change from Trulicity to Ozempic, AND I went without any medication for six weeks while waiting for the endocrinology office to get their thumb out of their ass and help me. But I didn’t change my eating habits in that time.
Obviously, I haven’t been checking my blood sugar at home or I would have realized this. Clearly 100% my fault. And it’s not my oncologist’s job to monitor my diabetes. He’s got enough on his hands with me. And I was having ZERO symptoms. No frequent peeing, no unquenchable thirst, no blurry vision, nothing. Except… I later read that high blood sugar can cause fatigue. Maybe that’s why I’ve been so tired lately? I’m always tired so who knows.
That Friday, I sent a message to my endocrinologist telling her this and saying I need an additional medication since the Ozempic alone isn’t doing the trick. Of course I knew I’d never hear back from her, so I took myself on over to urgent care. I explained the situation to the PA, and she said, “So what medication do you want me to prescribe for you?” Oh. I didn’t know that was how it worked. I thought SHE as the provider would say, “All right, I’m going to prescribe X.” “Ummm, I don’t know, metformin? That’s what I hear everyone takes.” “Okay, I’ll prescribe metformin but get in touch with your nephrologist and make sure it’s okay to take with your kidney disease.” Ah. THAT’S why she earns the big bucks. That didn’t even occur to me.
I messaged my nephrologist that evening and started on the metformin the following day. His office got back to me on Tuesday and said it was fine to take the drug. Just in the one week I’ve been on the metformin, my blood sugar has dropped significantly. It’s not normal but SO much better.
Now I felt it was urgent to find a new endocrinologist. I once again visited BCBS’s website to find providers on my plan. There were 26 providers on the list. Most were at UNM: check, already called. Three were at Lovelace: check, fuck no. Then there were SEVERAL that weren’t listed before. For a moment I got excited. Wow! Did we get a new medical group in or something since the last time I checked this? One was even the initial doc I saw back in the day who diagnosed my thyroid cancer. But my hopes were quickly dashed when I recognized the address: they were all doctors at the VA. Ugh.
Then there were many providers, again including one I’d seen before and very much liked, that had the caveat that “This provider is not in-network for Blue Cross Blue Shield members who reside in Bernalillo, Sandoval, Torrance, or Valencia counties.”
Um, what?? These providers are located IN Albuquerque, at Presbyterian on Central to be exact, but they can’t see patients who live in Albuquerque? Yes, that makes PERFECT sense.
So right off the bat, five providers I can’t see because I live in the same county as their practice, and six are at the VA so I can’t see them. Three were pediatric endocrinology providers, and one was for reproductive endocrinology. My list of 26 options had dwindled significantly.
Adding Rio Rancho didn’t add any more doctors. Adding Santa Fe added four more, two in one practice and two in another. I called the first number but just got their voice mail with only one of the doctor’s names on it so I guess the other has moved on. I didn’t leave a message. I called the second number, which had a Connecticut area code (curious) and got a voice mail that just said, “Hi, this is Dave. Leave a message, and I’ll call you back.” Clearly not the doctors. I googled their names, and both were now in Florida. Big exasperated sigh.
So…with the exception of one potential provider in Santa Fe, going out of state, or seeing if I can utilize telehealth for endocrinology, I was back where I started. Ugh. Beyond frustrating.
But… this past Tuesday… a glimmer of hope! A text message from the concierge doc stating they would call me the next day. And guess what, they did! The first opening they offered me wouldn’t work with my schedule as I’d be about three hours away in clinic. The soonest I was able to schedule was for July 30th, the day after my appointment with the Lovelace endocrinologist. I’m going to keep both appointments because what if the new doc cancels, flakes, or otherwise I don’t see her? Or what if I DO see her, and I don’t feel like she is the doctor for me? I need to see someone.
(Did I mention I saw the concierge doc years ago when she was at Lovelace? I think I only saw her once, and the only thing I vaguely remember is that she seemed kind of frazzled. But I suspect that was Lovelace wearing her down more than it was her. One of my coworkers used to see her and really raved about her. She was the only doctor that got to the root of her problem.)
So I currently have two endo appointments back to back. AND…if I get an appointment with UNM, I’ll keep that damn one too! Maybe I’ll need this concierge doc this year but maybe if I get in with UNM, I won’t need to shell out the dough to see her next year. Or maybe I’ll like her enough that I’ll feel it’s worth it to me. But I think it’s a good idea to have a Plan B in my pocket because everyone retires at some point, if they’re lucky.
And one way or another, I HAVE to get out of that Lovelace practice. Any time I think about it, I just get immediately pissed off. They’re not only bad for my physical health but my mental health too.
The way it works with the concierge doc is you have an initial consult with her at a cost of $275.00, then, if you wish to proceed with her services, you have 30 days from the consultation to pay an annual fee of $1500.00. No payment plans, no refunds. Per the website, this includes “unlimited visits and 365/24/7 access to care.” Trust me, I will have LOTS of questions. My main concerns are will SHE communicate with my other providers so I don’t have to act as the go-between like I’m doing now? And of course, can she refer me to the lab I currently use, refer me within network when I need thyroid ultrasounds, etc.?
(On a side note, I saw there are several concierge PCPs in Albuquerque. I was surprised at this due to the cost.)
Speaking of… I am absolutely aware that I’m very fortunate to be able to even consider going to this ‘concierge’ doctor. (It sounds so West Coast, doesn’t it?) I know that’s not an option for many people. And it’s ridiculous that our medical care here in New Mexico is so much in the toilet that one must even consider doing this. I mean I HAVE insurance, good insurance, for which, between my monthly premium and my monthly out-of-pocket cost, I currently pay about $700 a month. So the idea that I now may have to pay nearly two grand to get (hopefully) good care just makes no sense.
I’m well aware that this isn’t just a New Mexico issue, but rural states are hit harder with provider shortages. People don’t want to come to BFE if they can go to Dallas, Chicago, LA, Portland. (And there’s something unique to New Mexico about extremely high malpractice insurance costs? I don’t fully understand it, and it was supposed to have come up before our state legislature, but I don’t know what the outcome was.) BUT… we have weed money!! Why aren’t we using our weed tax to have incentives for providers: student loan repayment, hiring bonuses, retention bonuses, malpractice insurance offsets, private school tuition assistance for those providers with children since the reputation of our school system might otherwise turn good providers away? I have ideas, but no one listens to me. Typical.
I’m off for a couple days this week, and of course they’re full of doctors’ appointments because why not. Tomorrow I was scheduled with the GERD clinic, and I was excited about this because I need some damn relief! I don’t have heartburn every night but at least two nights a week. I used to only have it on the Wednesdays I had chemo, and then not even every Wednesday. But the longer I’ve been on this med, the more frequent the heartburn has become.
But today I had a consult for the colonoscopy that’s scheduled in a few months (wheeee!). The nurse practitioner I saw was really great. Young and full of knowledge. While taking the case history, she asked if I had heartburn. A resounding YES. She said she would order both an endoscopy and a colonoscopy at the same time. I told her about the appointment tomorrow with the GERD clinic. “Well, I’m not telling you not to go, but I can tell you the first thing they are going to recommend is an endoscopy to see if you have a hiatal hernia.” (I don’t even know what this is, although I’ve heard the term a million times. I need to look it up.) “They focus on surgical management, not medical management. You’re not going to walk out of there with a prescription or recommendation for a new medication.” Oh. Well, that was disappointing to hear, but at least I wouldn’t be wasting my time or money on an appointment. I cancelled it.
It’s now been over a week since I messaged my current endocrinologist about my blood sugar and requested additional medication. *Crickets* Nothing. Nada. No surprise, but it’s still discouraging. And as I’ve read more about Ozempic, after four weeks at the lowest dose, in most cases, the doc is supposed to increase the dose. She certainly hasn’t done that. So I’ve been on the lowest dose for three months with no change, and clearly it’s not helping.
For all my bitching and whining about her, she IS a good doctor. She’s just caught in a system that won’t let her BE a good doctor. I’m sure (or at least I hope) it weighs on her that she can’t provide care to her standards, which likely includes getting back to patients when they’ve contacted her. I’d say if she’s smart, she’s looking for another job, but I doubt many other practices are much better.
This whole situation is so sucky. And I don’t mean just for me but for all of us as patients. We deserve so much better.
Low, Low, Low 