Kind of concerned

I have a particular health plan that is known for being especially "budget conscious"

Anyway I had my Pacemaker placed in 2006 for Cardioneurogenic Syncope diagnosed on a Tilt table (with Asystole that was reversed.) I have a couple of unrelated chronic health conditions but my heart has no known "intrinsic pathology."

When I joined this Health Plan in 2007 the Cardiologist saw me once that year, and then once in 2008 and in 2009. I have never been seen by a Cardiologist since that time. He said that I did not need to see a Cardiologist anymore! Instead he said that it was sufficient to just have the nurse monitor my rhythm with remote call ins and twice a year office interrogation.

I am now moving (same health plan) and wanted to msg him to ask who should be my "assigned" Cardiologist at the new location. I was frustrated to find that there is not even any doctor in that department who shows up in my online profile of Providers!

I sent the nurse the message. She is fantastic but I am frustrated that there is NO doctor assessment and that they make this unilateral decision.

Are other people having this experience if they have stable checkups and no other pathology involved? I hate to be aggressive with providers and find battling the "system" exhausting.

5 Comments

health plans

by Tracey_E - 2013-07-28 10:07:06

I went for years without seeing the cardiologist, also. I went in every 3-4 months for pm checks. If I had a question I could ask it then and the NP or cardio would call me. Then one day we realized that while my pacer file takes up its own file drawer, my regular file had been sent to storage and they considered me inactive in their computer! We all had a good laugh because his office staff has a very low turnover and I've been a patient for 20+ years now so they all know me. So now I see him once a year. I think it's my dr's policy, not my health plan. I'm otherwise healthy and the pm fixed my heart problems, so as long as nothing is going on and I feel good, he didn't see a reason to have me come in more often.

Does the plan have a contingency for going out of network? I can see anyone I want with my policy, but if I stay in their network it's cheaper.

Any chance of changing plans?

Definitely stay on them and find someone local. You don't want to end up in a situation where you land in the hospital and don't have a cardiologist on record who knows your history. Even if it's not cardiac, whenever I've been in the hospital the cardiologist gets involved.

Thank you

by mchokozi - 2013-07-29 02:07:09

Hi to my Friends in the Club and thanks so much for your replies. :-) It is SO helpful to hear you describe in such detail what your experiences have been. I really appreciate that so much! I am absorbing what you have said and thinking about how it fits for my life.

I also spent a long time browsing through other entries similar to mine. What a wealth of feedback there is! It can be confusing to hear of such diverse approaches to this issue, but in the end it is actually incredibly supportive and informative. Thank so very much!

Quick follow up on this thread

by mchokozi - 2013-07-29 04:07:25

I just received a note from the nurse in the old Cardiology Clinic saying that I will see a Cardiologist when I establish in the new clinic, and then I can see him/her again once every FIVE years. She said that is my right. Really? ;-) (This does not sound like I will be earning any "frequent flyer miles.") ;-)

I am trying to keep a sense of levity with this business, though I do take my health seriously. I will try to find out if this is considered the standard of pacemaker care for "evidence based medicine" in Cardiology. This can be perplexing to say the least. Thanks again.

5 years

by Tracey_E - 2013-07-29 09:07:01

I'm no expert, but it seems to me 5 years would be standard for your average Joe who does not have a heart condition, like physicals are covered every year. When you have a condition that needs monitored, once a year I think is pretty standard.

Thank you again!

by mchokozi - 2013-07-31 04:07:29

Hi Guys,

I just discovered that my "overly" intelligent SPAM filter was routing the comments from you guys to SPAM! Sorry about not responding.

Anyway I just want to say thank you so much for your feedback and nuanced opinions. Also I cannot thank you enough for sharing your humor with me.

To share your experiences with passion and give me ideas is terrific. However when you add in the piece about humor, it is practically like "seeing a doctor" just to read your comments! ;-) What a delight to read your notes!

We are in an HMO so our options are within a narrow range at this point. The HMO is through my husband's job and is the only offered plan. It may be time to look at the Obama options as they are opening up to us. :-)

Take Care to all.

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